Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic patients.
Abstract
OBJECTIVE: To evaluate the effects of varying the glycemic index (GI) of carbohydrate-rich foods on metabolic control in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: In a randomized crossover study, 20 patients, 5 women and 15 men, were given preweighed diets with different GIs during two consecutive 24-day periods. Both diets were composed in accordance with dietary recommendations for people with diabetes. The macronutrient composition and type and amount of dietary fiber were identical. Differences in GI were achieved mainly by altering the structure of the starchy foods. RESULTS: Peripheral insulin sensitivity increased significantly and fasting plasma glucose decreased during both treatment periods. There was a significant difference in the changes of serum fructosamine concentrations between the diets (P < 0.05). The incremental area under the curve for both blood glucose and plasma insulin was approximately 30% lower after the low- than after the high-GI diet. LDL cholesterol was significantly lowered on both diets, with a significantly more pronounced reduction on the low-GI diet. Plasminogen activator inhibitor-1 activity was normalized on the low-GI diet, (-54%, P < 0.001), but remained unchanged on the high-GI diet. CONCLUSIONS: A diet characterized by low-GI starchy foods lowers the glucose and insulin responses throughout the day and improves the lipid profile and capacity for fibrinolysis, suggesting a therapeutic potential in diabetes.
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Because no studies have a time frame shorter than 6 years, it is not possible to determine whether the effect is early or later.
“Because no studies have a time frame shorter than 6 years, it is not possible to determine whether the effect is early, possibly from alterations in clotting factors,60 or later due to reduction in the rate of atheroma formation secondary to oxidative damage.61”
From Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta‐Analysis of Prospective Cohorts (2012) · cites this paper as [60]
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“A controversial issue is whether specific carbohydrate-rich foods should be preferred in the diabetes diet in view of their favorable impact on blood glucose control (3,4).”
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Self-citationPostprandial glucose, insulin, and incretin responses to grain products in healthy subjects
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“Both observational and intervention studies show that a low glycaemic index diet exerts more beneficial effects than a high glycaemic index diet on LDL- and HDL-cholesterol, insulin resistance, and plasminogen activator inhibitor-1 activity (Frost et al. 1999; Jarvi et al. 1999).”
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“Furthermore, Jarvi et al. (1999) showed a net decrease in glucose and insulin responses throughout the day, and an improvement of lipid profile and fibrinolytic capacity, following a strictly controlled low-GI diet when compared to a high-GI diet.”
BackgroundInfluentialSloth, B., Krog-Mikkelsen, I., Flint, A., Tetens, I., Björck, I., Vinoy, S., Elmståhl, H. L., Astrup, A. V., Lang, V., & Raben, A. (2004) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/80.2.337 · Cited by 273 · see citing works
Self-citationInconsistency between glycemic and insulinemic responses to regular and fermented milk products
Östman, E. M., Liljeberg Elmståhl, H. G., & Björck, I. M. (2001) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/74.1.96 · Cited by 270 · see citing works
“Accumulating data now suggest that a diet with a low glycemic index improves blood glucose control, the blood lipid profile, and fibrinolytic activity (2), suggesting a therapeutic role in the treatment of diseases related to insulin resistance.”
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Riccardi, G., Rivellese, A. A., & Giacco, R. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.1.269s · Cited by 264 · see citing works
“The study showed that after 24 d on the low-GI diet, not only was blood glucose control better but insulin sensitivity, LDL cholesterol, and plasminogen activator inhibitor-1 activity were also improved in comparison with a diet of similar composition but with a high GI, thus suggesting a therapeutic potential of this…”
ResultPulse Consumption, Satiety, and Weight Management
McCrory, M. A., Hamaker, B. R., Lovejoy, J. C., & Eichelsdoerfer, P. E. (2010) · Advances in Nutrition · doi:10.3945/an.110.1006 · Cited by 268 · see citing works
Rizkalla, S. W., Taghrid, L., Laromiguiere, M., Huet, D., Boillot, J., Rigoir, A., Elgrably, F., & Slama, G. (2004) · Diabetes Care · doi:10.2337/diacare.27.8.1866 · Cited by 263 · see citing works
“(12) could be because, first, in our study, the GI of the LGI diet was lower (GI 39) than that in the study of Jarvi et al.”
BackgroundResultInfluentialImpact of Diet Composition on Blood Glucose Regulation
Russell, W. R., Baka, A., Björck, I., Delzenne, N., Gao, D., Griffiths, H. R., Hadjilucas, E., Juvonen, K., Lahtinen, S., Lansink, M., et al. (2016) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2013.792772 · Cited by 255 · see citing works
“…carbohydrate foods that promote low but sustained blood glucose levels may be considered advantageous with regard to metabolic control of diabetes (J€arvi et al., 1999), with acute consumption of foods rich in soluble fiber being beneficial for both postprandial glycemic control and the…”
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“High-glycemic-index diets have been related to increased risk of non-insulindependent diabetes mellitus (NIDDM) and coronary heart disease in both men and women (16, 53, 54), while lowglycemic-index diets have been associated with improved lipid profiles and capacity of fibrinolysis in persons with NIDDM (55).”
BackgroundJenkins, D. J., Kendall, C. W., Vuksan, V., Vidgen, E., Parker, T., Faulkner, D., Mehling, C. C., Garsetti, M., Testolin, G., Cunnane, S. C., et al. (2002) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/75.5.834 · Cited by 250 · see citing works
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Low-glycemic index diets as an intervention for diabetes: a systematic review and meta-analysis
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“Diabetics especially, at greater risk from these effects and from the accelerated weight gain that tends to result from these effects, are strongly advised to consume a primarily lowglycemic diet, as such a diet may even have “therapeutic potential in diabetes” (Jarvi, 1999).”
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“[68], the low glycemic index diet resulted in lower serum LDL levels in comparison with the control diet.”
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“Although not extensively studied in epilepsy, low-GI diets are known to lower postprandial plasma glucose and insulin profiles among diabetics and patients with cardiovascular disease (Brand et al., 1991; Fontvieille et al., 1992; Wolever et al., 1992; Jarvi et al., 1999; Rizkalla et al., 2004).”
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“Shortterm dietary intervention studies have suggested that a low-glycemic index diet improves glucose and lipid metabolism (Brand Miller et al, 1994; JaÈrvi et al, 1999; Frost et al, 1996, 1998).”
BackgroundChiavaroli, L., Lee, D., Ahmed, A., Cheung, A., Khan, T. A., Blanco, S., Mejia, Mirrahimi, A., Jenkins, D. J. A., Livesey, G., et al. (2021) · BMJ · doi:10.1136/bmj.n1651 · Cited by 215 · see citing works
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The use of glycaemic index tables to predict glycaemic index of composite breakfast meals
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Natural Products Used for Diabetes
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“Jarvi et al. (1999) and Brand et al. (1991) also found notable decreases in LDL-cholesterol concentrations after periods of 24 d and 12 weeks respectively, and with GI reductions of 19 and 13 units.”
BackgroundResultInfluentialProlongation of Satiety After Low Versus Moderately High Glycemic Index Meals in Obese Adolescents
Ball, S. D., Keller, K. R., Moyer‐Mileur, L. J., Ding, Y.-W., DONALDSON, D. L., & Jackson, W. D. (2003) · PEDIATRICS · doi:10.1542/peds.111.3.488 · Cited by 189 · see citing works
LDL receptor but not apolipoprotein E deficiency increases diet-induced obesity and diabetes in mice
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Should obese patients be counselled to follow a low‐glycaemic index diet? No
Raben, A. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00080.x · Cited by 182 · see citing works
Buyken, A. E., Toeller, M., Heitkamp, G., Karamanos, B. G., Rottiers, R., Muggeo, M., & Fuller, J. (2001) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/73.3.574 · Cited by 178 · see citing works
Maternal carbohydrate intake and pregnancy outcome
Clapp III, J. F. (2002) · Proceedings of the Nutrition Society · doi:10.1079/pns2001129 · Cited by 173 · see citing works
The Pediatric Obesity Epidemic: Causes and Controversies
Slyper, A. H. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031449 · Cited by 174 · see citing works
Sugiyama, M., Tang, A. C., Wakaki, Y., & Koyama, W. (2003) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601606 · Cited by 173 · see citing works
Almonds and postprandial glycemia—a dose-response study
Josse, A. R., Kendall, C. W. C., Augustin, L. S. A., Ellis, P. R., & Jenkins, D. J. A. (2007) · Metabolism · doi:10.1016/j.metabol.2006.10.024 · Cited by 171 · see citing works
β-Cell Adaptation to Insulin Resistance
Liu, Y. Q., Jetton, T. L., & Leahy, J. L. (2002) · Journal of Biological Chemistry · doi:10.1074/jbc.m207157200 · Cited by 166 · see citing works
Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: Assessment of Causal Relations
Livesey, G., Taylor, R., Livesey, H. F., Buyken, A. E., Jenkins, D. J. A., Augustin, L. S. A., Sievenpiper, J. L., Barclay, A. W., Liu, S., Wolever, T. M. S., et al. (2019) · Nutrients · doi:10.3390/nu11061436 · Cited by 163 · see citing works
“processing and reduction in particle size) also led to worsening of markers for glycemic control and lipid profiles [125].”
Self-citationMirrahimi, A., de Souza, R. J., Chiavaroli, L., Sievenpiper, J. L., Beyene, J., Hanley, A. J., Augustin, L. S. A., Kendall, C. W. C., & Jenkins, D. J. A. (2012) · Journal of the American Heart Association · doi:10.1161/jaha.112.000752 · Cited by 161 · see citing works
Dietary hyperglycemia, glycemic index and metabolic retinal diseases
Chiu, C., & Taylor, A. (2010) · Progress in Retinal and Eye Research · doi:10.1016/j.preteyeres.2010.09.001 · Cited by 159 · see citing works
“, 2005) as well as diabetic adults (Järvi et al., 1999; Rizkalla et al., 2004).”
InfluentialOverviews of Pathogen Emergence: Which Pathogens Emerge, When and Why?
Cleaveland, S., Haydon, D. T., & Taylor, L. H. (2007) · Current topics in microbiology and immunology · doi:10.1007/978-3-540-70962-6_5 · Cited by 157 · see citing works
Should obese patients be counselled to follow a low‐glycaemic index diet? Yes
Pawlak, D. B., Ebbeling, C. B., & Ludwig, D. S. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00079.x · Cited by 152 · see citing works
“In addition, the level of PAI-1 (a serum procoagulant) decreased in subjects with type 2 diabetes following a low GI diet compared to controls (85).”
BackgroundCarbohydrate and the Regulation of Blood Glucose and Metabolism
Wolever, T. M. S. (2003) · Nutrition Reviews · doi:10.1301/nr.2003.may.s40-s48 · Cited by 151 · see citing works
Brynes, A., Edwards, C., Ghatei, M., Dornhorst, A., Morgan, L. M., Bloom, S., & Frost, G. (2003) · British Journal of Nutrition · doi:10.1079/bjn2002769 · Cited by 152 · see citing works
“Prospectively, additional short-term benefits of low-gly-caemic diets have included improvements in coagulation (Frost et al. 1994) with reduced concentrations of plasminogen activator inhibitor compound-1 (Jarvi et al. 1999), and fall in blood pressure (Sciarrone et al. 1993).”
BackgroundInteractions between vitamins C and E in human subjects
Hamilton, I. M. J., Gilmore, W., Benzie, I. F. F., Mulholland, C. W., & Strain, J. (2000) · British Journal Of Nutrition · doi:10.1017/s0007114500001537 · Cited by 147 · see citing works
Blood glucose lowering effects of brown rice in normal and diabetic subjects
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“Low blood glucose response to carbohydrate containing foods has been suggested to be beneficial to diabetics and hyperlipidemic individuals (Wolever et al. , 2003; Liu et al ., 2000a; Gilbertson et al ., 2001; Jarvi et al. , 1999; Salmeron et al ., 1997a; 1997b).”
BackgroundAstrup, A. (2001) · International Journal of Obesity · doi:10.1038/sj.ijo.0801698 · Cited by 140 · see citing works
Dumesnil, J. G., Turgeon, J., Tremblay, A., Poirier, P., GILBERT, M. R., Gagnon, L., St-Pierra, S., Garneau, C., Lemieux, I., Pascot, A., et al. (2001) · British Journal Of Nutrition · doi:10.1079/bjn2001427 · Cited by 139 · see citing works
“Results of the present study are consistent with the favourable metabolic effects of a low-glycaemic index diet reported by Jarvi et al. (1999).”
Ells, L. J., Seal, C. J., Kettlitz, B., Bal, W., & Mathers, J. C. (2005) · British Journal Of Nutrition · doi:10.1079/bjn20051554 · Cited by 138 · see citing works
“these contrasting findings is physical activity levels, which are known to correlate inversely with PAI-1 concentrations (Rankinen et al. 1995; Ivey et al. 2003 ).”
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Self-citationThe glycaemic index: importance of dietary fibre and other food properties
Björck, I., & Elmståhl, H. L. (2003) · Proceedings of The Nutrition Society · doi:10.1079/pns2002239 · Cited by 133 · see citing works
Self-citationGlycaemic index and metabolic disease risk
Aston, L. M. (2006) · Proceedings of The Nutrition Society · doi:10.1079/pns2005485 · Cited by 127 · see citing works
“These improvements include decreases in total cholesterol, LDL-cholesterol and triacylglycerol, and increases in HDL-cholesterol with differences in dietary GI of 20–28 over 4–6-week periods (Fontvieille et al. 1992; Wolever et al. 1992; Järvi et al. 1999; Luscombe et al. 1999; Wolever & Mehling, 2002).”
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Wu, T., Giovannucci, E., Pischon, T., Hankinson, S. E., Ma, J., Rifai, N., & Rimm, E. B. (2004) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/80.4.1043 · Cited by 123 · see citing works
“Several studies showed that, when patients with type 2 diabetes are fed isocarbohydrate diets, diets with a low glycemic load (GL) improve glycemic control (17, 18).”
BackgroundHeilbronn, L. K., Noakes, M., & Clifton, P. M. (2002) · Journal of the American College of Nutrition · doi:10.1080/07315724.2002.10719204 · Cited by 124 · see citing works
“[24] found fructosamine and incremental blood glucose levels were lower after the low GI phase, which was achieved by modification of starch.”
Background
- Authors
- Järvi, A. E., Karlström, B. E., Granfeldt, Y. E., Björck, I. E., Asp, N. G., & Vessby, B. O.
- Affiliations
- Uppsala University (SE)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1999-01-01
- Volume
- 22
- Issue
- 1
- Pages
- 10-18
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2142340057
- Cited by
- 484
- References
- 0
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 10 · 2019: 8 · 2018: 5 · 2017: 12 · 2016: 15 · 2015: 10 · 2014: 17 · 2013: 17 · 2012: 14
- FWCI
- 30.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- glycemic index, type 2 diabetes, low glycemic index diet, glycemic control, insulin sensitivity, fructosamine, LDL cholesterol, lipid profile, fibrinolysis, plasminogen activator inhibitor-1, starchy foods, dietary fiber
- MeSH terms
- Aged, Apolipoproteins, Blood Glucose, Body Weight, Cholesterol, Diabetes Mellitus, Type 2, Diet, Diabetic, Dietary Carbohydrates, Female, Glycated Hemoglobin, Humans, Insulin, Lipids, Lipoproteins, Male, Middle Aged, Triglycerides, Cross-Over Studies
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