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Decrease in Glycemic Index Associated with Improved Glycemic Control among Latinos with Type 2 Diabetes

Published:December 26, 2014DOI:https://doi.org/10.1016/j.jand.2014.10.012

      Abstract

      Background

      Glycemic index and glycemic load are used to facilitate glucose control among adults with type 2 diabetes, with a low glycemic index diet associated with improved glycemic control.

      Objective

      To examine long-term longitudinal associations between changes in glycemic index and glycemic load with glycemic and metabolic control among Latino adults with diabetes.

      Design

      Secondary data from intervention and comparison participants in the Latinos en Control trial (2006 to 2008) were analyzed.

      Participants/setting

      Data on dietary intake and metabolic characteristics were from low-income, Latino adults (N=238; 87.7% Puerto Rican) with type 2 diabetes.

      Intervention

      The Latinos en Control trial was a randomized clinical trial targeting diabetes self-management among Latinos with type 2 diabetes. Participants were randomized to a group-based behavioral intervention or usual care and followed through 12 months.

      Main outcome measures

      Outcomes included hemoglobin A1c (HbA1c) levels, fasting blood glucose, lipid profiles, anthropometrics, and blood pressure.

      Statistical analysis

      Glycemic index and load were analyzed using data from three 24-hour dietary recalls conducted at baseline, 4 months, and 12 months. Repeated measures regression models were used to examine change in glycemic index and load associated with metabolic characteristics at 12 months. Covariates included sex, age, body mass index, blood pressure, total energy intake, medication use and intensity, physical activity, intervention status (intervention vs usual care), and time.

      Results

      Increases in glycemic index from baseline to 12 months were associated with increased logarithm of HbA1c levels (β=0.003; P=0.034) and waist circumference (β=0.12; P=0.026) over time, but not with fasting glucose, blood lipids, or body mass index. There was modest evidence to support small, positive associations between glycemic load and HbA1c levels and waist circumference.

      Conclusions

      Lowering glycemic index is associated with improvements in certain metabolic risk factors among Latinos with diabetes. Targeting glycemic index may be an important component of dietary strategies for diabetes self-management.

      Keywords

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      Biography

      M. L. Wang is an assistant professor, Department of Community Health Sciences, Boston University School of Public Health and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA.

      Biography

      L. Gellar is an associate professor, Department of Nursing and Health Professions, University of South Carolina Beaufort; at the time of the study, she was an assistant professor of public health nutrition, Department of Nutrition, University of Tennessee, Knoxville.

      Biography

      B. H. Nathanson is chief executive officer, OptiStatim, LLC, Longmeadow, MA.

      Biography

      L. Pbert is a professor of medicine, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.

      Biography

      I. Ockene is a professor of medicine, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.

      Biography

      M. C. Rosal is a professor of medicine, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.

      Biography

      Y. Ma is an associate professor of medicine, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.