Low-glycemic index diets in the management of diabetes
Low-glycemic index diets in the management of diabetes
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DOI：
10.2337/diacare.26.8.2261
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发表时间：
2003-08-01
期刊：
影响因子：
16.2
通讯作者：
Colagiuri, S
中科院分区：
文献类型：
--
作者：
Brand-Miller, J;Hayne, S;Colagiuri, S
目的：在糖尿病的管理中使用低血糖指数（GI）的饮食是有争议的，世界各地的建议相反。我们进行了一项荟萃分析的随机对照试验，以确定是否低GI饮食，与传统或高GI饮食相比，改善糖尿病患者的总体血糖控制，通过降低HbA（1c）或果糖胺水平进行评估。研究设计和方法-文献检索确定了14项研究，包括356名受试者，符合严格的纳入标准。采用随机、交叉或平行试验设计，试验时间为12天~ 12个月（平均10周），每日至少两餐。只有10项研究记录了两种类型的dietes.Results -低GI饮食降低HbA（1c）的0.43个百分点（CI 0.72-0.13）以上，高GI饮食产生的餐后糖化血红蛋白的差异。将HbA（1c）和果糖胺数据结合在一起并调整基线差异，低GI饮食比高GI饮食的糖化蛋白质减少7.4%（8.8-6.0）。如果数据未针对基线水平进行调整或排除短期研究，则该结果稳定且变化不大。从荟萃分析中系统地取出每项研究并没有改变CIs.CONCLUSIONS -选择低GI食物代替常规或高GI食物对糖尿病患者的中期血糖控制有一个小的，但临床上有用的影响。增量获益类似于也针对餐后高血糖的药物。
OBJECTIVE - The use of diets with low glycemic index (GI) in the management of diabetes is controversial, with contrasting recommendations around the world. We performed a meta-analysis of randomized controlled trials to determine whether low-GI diets, compared with conventional or high-GI diets, improved overall glycemic control in individuals with diabetes, as assessed by reduced HbA(1c) or fructosamine levels.RESEARCH DESIGN AND METHODS - Literature searches identified 14 Studies, comprising 356 subjects, that met strict inclusion criteria. All were randomized crossover or parallel experimental design of 12 days' to 12 months' duration (mean 10 weeks) with modification of at least two meals per day. Only 10 studies documented differences in postprandial glycemia on the two types of diet.RESULTS - Low-GI diets reduced HbA(1c) by 0.43% points (Cl 0.72-0.13) over and above that produced by high-GI diets. Taking both HbA(1c) and fructosamine data together and adjusting for baseline differences, glycated proteins were reduced 7.4% (8.8-6.0) more on the low-GI diet than on the high-GI diet. This result was stable and changed little if the data were unadjusted for baseline levels or excluded studies of short duration. Systematically taking out each study from the meta-analysis did not change the CIs.CONCLUSIONS - Choosing low-GI foods in place of conventional or high-GI foods has a small but clinically useful effect on medium-term glycemic control in patients With diabetes. The incremental benefit is similar to that offered by pharmacological agents that also target postprandial hyperglycemia.