The SA Journal Diabetes & Vascular Disease Vol 8 No 2 (June 2011) - page 38

DIETICIAN REVIEW SA JOURNAL OF DIABETES & VASCULAR DISEASE
84 VOLUME 8 NUMBER 2 • JUNE 2011
to be considered together with the GI of the food.2
The temperature of the food when eaten as well as the
preparation and cooking methods affect the GI of the food. It is also
affected by gastric emptying and the rate of intestinal digestion,
including amylase, fibre and moisture content. A further reason
cited for the decreased effectiveness of the GI is that it measures
individual foods and not the total meal.2
Individual blood glucose levels can vary from individual to
individual. The GI is also not necessarily the best indicator of
healthy food choices. Cooldrinks, sweets and high-fat foods such
as ice cream can have a low GI, but are not healthy.11
A meta-analysis conducted by Franz in 2003 reported that low-GI
compared to high-GI diets decreased HbA1c levels by approximately
0.4% (a 7% decrease) from baseline.5 Heilbronn et al. completed
a randomised, controlled trial involving 45 diabetics to determine
the effect of a low-GI versus high-GI diet on blood glucose levels.
All subjects followed the normal Australian diet for four weeks.
Thereafter they were randomly assigned to a high-GI or low-GI
group for a further eight weeks. A dietician counselled the patients
every two weeks. The results revealed that mean HbA1c levels were
significantly reduced in both groups. There was no statistically
significant difference between the groups.5
Patient satisfaction with the low-GI diet
Several studies have measured patient satisfaction with the
low-GI diet. Many patients reported that they would continue
to incorporate the concept as part of their lifestyle change post
completion of the study. These studies demonstrate that the
low-GI concept is not too complicated for diabetics to apply. When
diabetic patients were provided with the appropriate education,
they reported enjoying the low-GI diet.
The type of patient who would benefit the most from a
low-GI diet is one who has a good knowledge base on his/her
disease condition and is already practising the basic nutrition
recommendations and is motivated to achieve better glycaemic
control.1
Conclusions
Clinicians need to educate themselves on the concept of the low-GI
diet as well as its importance in glycaemic control. They should
encourage patients to see a dietician to help the patient set targets
for dietary change that are manageable and achievable. Follow-up
consultations with the dietician are needed to ensure continued
compliance with the low-GI diet.
References
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