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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, 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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“Similarly, low-glycemic load-based patterns in women of child-bearing age were associated with improved fibrinolysis (Jarvi et al. 1999).”
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“For example, a randomised, crossover study by Jarvi et al. (1999) demonstrated that a low-GI diet improved glycaemic control as well as decreasing LDL-C and normalising fibrinolytic activity compared to a high-GI diet, identical for macronutrient composition and amount of dietary fibre.”
BackgroundDietary Carbohydrate (Amount and Type) in the Prevention and Management of Diabetes
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“Indeed, there is evidence from the studies of Järvi et al (1995, 1999) that leaving the structure of the plant food intact does confer considerable benefit.”
BackgroundInfluentialHealth potential of polyols as sugar replacers, with emphasis on low glycaemic properties
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“In this trial a decrease in both fasting glucose and insulin levels was achieved in the low GI group ( between - and within - group differences ) , as well as significant reductions in fruc - tosamine levels ( within - group difference ; Jarvi et al , 1999 ) .”
BackgroundInfluentialSutton‐Tyrrell, K., Newman, A. B., Simonsick, E. M., Havlik, R. J., Pahor, M., Lakatta, E. G., Spurgeon, H. A., Vaitkevicius, P. V., & for the Health ABC Investigators (2001) · Hypertension · doi:10.1161/01.hyp.38.3.429 · Cited by 389
Dietary fibre, glycaemic response, and diabetes
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Improving reproductive performance in overweight/obese women with effective weight management
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“Jarvi et al. (1999) documented 27% lower fasting insulin after 24 days following a low GI diet compared to a high GI diet.”
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Jenkins, D. J., Kendall, C. W., Augustin, L. S., Franceschi, S., Hamidi, M., Marchie, A., Jenkins, A. L., & Axelsen, M. (2002) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/76/1.266s · Cited by 379
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BackgroundSlowly Digestible Starch—A Review
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Self-citationPostprandial glucose, insulin, and incretin responses to grain products in healthy subjects
Juntunen, K. S., NISKANEN, L. K., Liukkonen, K. H., Poutanen, K. S., Holst, J. J., & Mykkänen, H. M. (2002) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/75.2.254 · Cited by 301
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“001) as well as lowering of both blood glucose and plasma insulin concentrations by 30 percent, and a 29 percent decrease in LDL-C [253].”
InfluentialAstrup, A. V., Ryan, L., Grunwald, G. K., Storgaard, M., Saris, W. H. M., Melanson, E., & Hill, J. O. (2000) · British Journal Of Nutrition · doi:10.1017/s0007114500000921 · Cited by 294
“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).”
BackgroundBouché, C., Rizkalla, S. W., Luo, J., Vidal, H., Véronèse, A., Pacher, N., Fouquet, C., Lang, V., & Slama, G. (2002) · Diabetes Care · doi:10.2337/diacare.25.5.822 · Cited by 287
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“More recently, a study showed that consumption of low-GI foods by people with type 2 diabetes not only improved peripheral insulin sensitivity but also lowered plasma plasminogen activator inhibitor-1 (PAI-1), thereby improving the capacity for fibrinolysis (40).”
BackgroundRizkalla, S., Bellisle, F., & Slama, G. (2002) · British Journal of Nutrition · doi:10.1079/bjn2002715 · Cited by 277
“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
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
“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.”
BackgroundSelf-citationRole of glycemic index and glycemic load in the healthy state, in prediabetes, and in diabetes
Riccardi, G., Rivellese, A. A., & Giacco, R. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.1.269s · Cited by 264
“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 282
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
“(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
“…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…”
BackgroundMethodSelf-citationWirfält, E., Hedblad, B., Gullberg, B., Mattisson, I., Andren, C., Rosander, U., Janzon, L., & Berglund, G. (2001) · American Journal of Epidemiology · doi:10.1093/aje/154.12.1150 · Cited by 251
“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
Carbohydrate Digestibility and Metabolic Effects
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Glycemic Load and Chronic Disease
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Low-glycemic index diets as an intervention for diabetes: a systematic review and meta-analysis
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In poor health: Supermarket redlining and urban nutrition
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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).”
BackgroundMarsh, K. A., Steinbeck, K. S., Atkinson, F. S., Petocz, P., & Brand-Miller, J. C. (2010) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2010.29261 · Cited by 228
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“[68], the low glycemic index diet resulted in lower serum LDL levels in comparison with the control diet.”
BackgroundEfficacy, safety, and tolerability of the low glycemic index treatment in pediatric epilepsy
Muzykewicz, D. A., Lyczkowski, D. A., Memon, N., Conant, K. D., Pfeifer, H. H., & Thiele, E. A. (2009) · Epilepsia · doi:10.1111/j.1528-1167.2008.01959.x · Cited by 218
“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).”
BackgroundDietary fibre, lente carbohydrates and the insulin-resistant diseases
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Adipose tissue and the insulin resistance syndrome
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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
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The use of glycaemic index tables to predict glycaemic index of composite breakfast meals
Flint, A., Møller, B. K., Raben, A., Pedersen, D., Tetens, I., Holst, J. J., & Astrup, A. (2004) · British Journal of Nutrition · doi:10.1079/bjn20041124 · Cited by 202
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Natural Products Used for Diabetes
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Gumbs, A. A., Modlin, I. M., & Ballantyne, G. H. (2005) · Obesity Surgery · doi:10.1381/0960892053723367 · Cited by 188
Meta-analysis of the health effects of using the glycaemic index in meal-planning
Opperman, A. M., Venter, C. S., Oosthuizen, W., Thompson, R. L., & Vorster, H. H. (2004) · British Journal of Nutrition · doi:10.1079/bjn20041203 · Cited by 192
“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
LDL receptor but not apolipoprotein E deficiency increases diet-induced obesity and diabetes in mice
Schreyer, S. A., Vick, C. M., Lystig, T., Mystkowski, P., & LeBoeuf, R. C. (2002) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.2002.282.1.e207 · Cited by 182
Should obese patients be counselled to follow a low‐glycaemic index diet? No
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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
Maternal carbohydrate intake and pregnancy outcome
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The Pediatric Obesity Epidemic: Causes and Controversies
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Sugiyama, M., Tang, A. C., Wakaki, Y., & Koyama, W. (2003) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601606 · Cited by 173
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
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 173
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
“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
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 166
“, 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 161
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
“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
Brynes, A. E., Edwards, C. M. B., Ghatei, M. A., Dornhorst, A., Morgan, L., Bloom, S. R., & Frost, G. S. (2003) · British Journal Of Nutrition · doi:10.1079/bjn2002769 · Cited by 145
“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
Blood glucose lowering effects of brown rice in normal and diabetic subjects
Panlasigui, L. N., & Thompson, L. U. (2006) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637480500410879 · Cited by 143
“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
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 140
“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 140
“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 ).”
BackgroundNilsson, A. C., Östman, E. M., Knudsen, K. E. B., Holst, J. J., & Björck, I. (2010) · Journal of Nutrition · doi:10.3945/jn.110.123604 · Cited by 133
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 135
Self-citationGlycaemic index and metabolic disease risk
Aston, L. M. (2006) · Proceedings of The Nutrition Society · doi:10.1079/pns2005485 · Cited by 129
“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).”
BackgroundJeong, S., & Yoon, M. (2009) · Experimental & Molecular Medicine · doi:10.3858/emm.2009.41.6.045 · Cited by 125
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
“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
“[24] found fructosamine and incremental blood glucose levels were lower after the low GI phase, which was achieved by modification of starch.”
Background
Metadata
- 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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