Intensive low-glycaemic-load dietary intervention for the management of glycaemia and serum lipids among women with gestational diabetes: a randomized control trial. 
The effect of consumption of low-glycemic-index and low-glycemic-load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus The Effect of High- and Low-Glycemic Index Energy Restricted Diets on Plasma Lipid and Glucose Profiles in Type 2 Diabetic Subjects with Varying Glycemic Control Lifestyle intervention in people with insulin-dependent diabetes mellitus (IDDM) Effects of lifestyle intervention and meal replacement on glycaemic and body-weight control in Chinese subjects with impaired glucose regulation: a 1-year randomised controlled trial. Efficacy of dietary instructions in newly diagnosed non-insulin-dependent diabetic patients. Comparison of two different patient education regimens. Continuous glucose monitoring to assess the ecologic validity of dietary glycemic index and glycemic load. Baseline characteristics of the Indian cohort from the IMPROVE™ study: a multinational, observational study of biphasic insulin aspart 30 treatment for type 2 diabetes One-year follow-up of untreated obese white children and adolescents with impaired glucose tolerance: high conversion rate to normal glucose tolerance. Evaluation of a Pharmaceutical Care Model on Diabetes Management Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Preliminary report: the effect of a 6-month dietary glycemic index manipulation in addition to healthy eating advice and weight loss on arterial compliance and 24-hour ambulatory blood pressure in men: a pilot study. High-carbohydrate-low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance. Glycemic index and glycemic load are associated with some cardiovascular risk factors among the PREMIER study participants [Evaluation of a programme to monitor drug therapy in type-2 diabetics]. Relationship of insulin secretion and glycemic response to dietary intervention in non-insulin-dependent diabetes.
OBJECTIVE The present study aim ed to compare the effects of a general dietary intervention and an intervention with low glycaemic load ( GL ) on glycaemic control , blood lipid metabolism and pregnancy outcomes in women with gestational diabetes mellitus . DESIGN Participants were r and omly assigned to two groups , receiving either an individualized general dietary intervention ( Control group ) or an intensive low-GL intervention ( Low-GL group ) every two weeks , from 24 - 26 weeks of gestation to delivery . SETTING The Center of Maternal Primary Care in Guangdong General Hospital , China . SUBJECTS Ninety-five women with gestational diabetes mellitus were enrolled from June 2008 to July 2009 . RESULTS After the intervention , both groups significantly decreased their dietary intakes of energy , fat and carbohydrate . The Low-GL group had significantly lower values for GL ( 122 v. 136 ) and glycaemic index ( 50 v. 54 ) but greater dietary fibre intake ( 33 v. 29 g/d ) than did the Control group ( all P<0·01 ) . Significantly greater decreases in fasting plasma glucose ( -0·33 v. -0·02 mmol/l , P<0·01 ) and 2 h postpr and ial glucose ( -2·98 v. -2·51 mmol/l , P<0·01 ) , significantly lower increases in total cholesterol ( 0·12 v. 0·23 mmol/l ) and TAG ( 0·41 v. 0·56 mmol/l ) and a significantly lower decrease in HDL cholesterol ( -0·01 v. -0·11 mmol/l ) were also observed in the Low-GL group compared with the Control group ( all P<0·05 ) . There were no significant differences in body weight gain , birth weight or other maternal-fetal perinatal outcomes between the two groups . CONCLUSIONS The low-GL targeted dietary intervention outperformed the general dietary intervention in glycaemic control and the improvement of blood lipid levels in women with gestational diabetes mellitus Abstract Purpose The aim of the present study was to examine the effects of consumption of desserts with low glycemic index ( GI ) and low glycemic load ( GL ) , as part of a balanced hypo-caloric diet , on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus ( T2DM ) . Methods A total of 61 subjects with T2DM were r and omly assigned to the intervention ( n = 30 ) or to the control group ( n = 31 ) . Both groups followed the same hypo-caloric ( −500 kcal ) diet for 12 weeks . Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group . Results Thirty subjects in the control and 28 subjects in the intervention group completed the trial . Body weight , body mass index , and waist circumference were reduced significantly in both groups . Arterial blood pressure , fasting blood glucose , glycosylated hemoglobin , insulin , and γ-GT were reduced significantly only in the intervention group ; however , there were no significant differences between the two groups at endpoint . C-reactive protein was reduced in the intervention , and HDL cholesterol was also reduced in the control group ; the reductions were significantly different at the end of the trial . No significant changes were observed in the other plasma lipids , uric acid , leptin , adiponectin , and interleukin-6 in either study group . Conclusions Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM Objective : To determine whether glycemic index ( GI ) differentially affects improved glucose and lipid profiles observed during weight loss in overweight subjects previously diagnosed with type 2 diabetes with variable glucose tolerance . Methods : Twenty-three female and twenty-two male overweight subjects participated in 12 weeks of energy restriction ( average BMI 33.2 kg/m2 , age 56.7 years , glycated hemoglobin ( GHb ) 6.7 % ) . After a four-week run-in on a high saturated fat ( SFA ) diet ( 1540 kcal/day , 17 % SFA ) , the free-living subjects were r and omly assigned to either a high- ( 75 GI units ) or low- ( 43 GI units ) GI diet ( 1440 kcal/day , 60 % carbohydrate , 5 % SFA ) for eight weeks . Weight , serum lipids , plasma glucose and glycated hemoglobin were measured every four weeks . An oral glucose tolerance test ( OGTT ) was also performed at baseline , weeks 4 and 12 . From the baseline OGTT results subjects were divided into three groups of low , median and high glucose tolerance . Results : At baseline , BMI , age and glycated hemoglobin concentrations were not different between subjects allocated to the high- or low-GI diets . After four weeks , weight loss was 3.6 ± 0.3 kg . Fasting glucose ( −5.6 % ) , glycated hemoglobin ( −2.8 % ) , area under the glucose curve ( −13.0 % ) and triglyceride ( −13.8 % ) concentrations were reduced ( p < 0.02 ) . Between weeks 4 and 12 reductions were observed in weight ( −4.9 % ) , fasting glucose ( −4.6 % ) , area under glucose curve ( −10.1 % ) , glycated hemoglobin ( −7.2 % ) , triglyceride ( −7.5 % ) and LDL-C ( −13.2 % ) concentrations . Weight loss was not different between low and high-GI diets . However , glycated hemoglobin was reduced twofold more in subjects consuming a low-GI diet as compared to subjects consuming a high-GI diet , but this was not statistically significant . LDL concentrations were also reduced more in subjects with low glucose tolerance on the low-GI diet ( p = 0.02 ) . Conclusion : Weight loss produces substantial improvements in glycemic control and lipoprotein metabolism . Lowering the glycemic index of high carbohydrate , low fat diets increases the fall in LDL cholesterol in subjects with type 2 diabetes with low glucose tolerance , but has little effect on glycemic control Objective : To investigate the impact of intensive lifestyle education on dietary practice s , exercise and metabolic measurements in people with insulin-dependent diabetes mellitus ( IDDM ) . Design : Sixty-one volunteer subjects with IDDM were r and omised to intensive ( Group 1 ) or st and ard ( Group 2 ) education programmes for six months . During a second six month period of observation Group 1 subjects received routine surveillance for their condition and those in Group 2 were given intensive advice ( phase 2 ) . Current insulin regimens were modified to optimise glycaemic control before the start of the intervention phase . Nutrient intakes , weight , blood pressure , glycated haemoglobin ( HbA ) , plasma lipids , lipoproteins and maximal oxygen consumption ( VO max ) were measured at the time of recruitment and at three monthly intervals during the trial and phase 2 . Setting : Department of Human Nutrition at the University of Otago . Results : Glycated haemoglobin decreased significantly in both groups between recruitment and r and omisation , the improvement being sustained during the six months of the r and omised trial and for group 1 during the six months of post trial observation . A further decrease was seen in Group 2 during the second six month period when they were given intensive advice . Comparable changes were seen with total and low density lipoprotein ( LDL ) cholesterol in Group 1 during the trial , but significant decreases were only seen in Group 2 in association with intensive intervention ( phase 2 ) . These changes occurred in parallel with increases in intakes of carbohydrate and monounsaturated fatty acids , a reduction in intakes of total and saturated fat , and an improvement in maximum oxygen consumption . Conclusions : A lifestyle programme for people with IDDM results in modest changes in diet and exercise habits sufficient to improve measures of glycaemic control and lipoprotein mediated risk of coronary heart disease independent of changes in insulin regime . More innovative approaches to achieve lifestyle changes are required to meet current recommendations which in turn are likely to produce even greater beneficial changes than those observed here . Sponsorship : This study was supported by the Eli Lilly Research Grant ( Eli Lilly and Company ( New Zeal and ) Ltd ) , The Deans Research Grant ( Otago Medical School , New Zeal and ) and The New Zeal and Dietetic Association ( Abbott Award ) The purpose of the present study was to evaluate the impact of a lifestyle intervention programme , combined with a daily low-glycaemic index meal replacement , on body-weight and glycaemic control in subjects with impaired glucose regulation ( IGR ) . Subjects with IGR were r and omly assigned to an intervention group ( n 46 ) and a control group ( n 42 ) . Both groups received health counselling at baseline . The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 months of the study , and follow-up visits performed monthly until the end of the 1-year study . Outcome measurements included changes in plasma glucose , glycated Hb ( HbA1c ) , plasma lipids , body weight , blood pressure and body composition ( such as body fat mass and visceral fat area ) . The results showed that body-weight loss after 1 year was significant in the intervention group compared with the control group ( -1·8 ( SEM 0·35 ) v. -0·6 ( SEM 0·40 ) 2·5 kg , P<0·05 ) . The 2 h plasma glucose concentration decreased 1·24 mmol/l in the intervention group and increased 0·85 mmol/l in the control group ( P<0·05 ) compared with their baseline , respectively . A 5 kg body-weight loss at 1 year was associated with a decrease of 1·49 mmol/l in 2 h plasma glucose ( P<0·01 ) . The incidence of normal glucose regulation ( NGR ) in the two groups was significantly different ( P=0·001 ) . In conclusion , the combination of regular contact , lifestyle advice and meal replacement is beneficial in promoting IGR to NGR Eighty consecutive newly diagnosed non-insulin-dependent diabetic patients were r and omly allocated into two groups to compare two different patient education regimens . One group received individual dietary instructions by a nurse and the other a short , written leaflet given by a doctor . The principal aim of the dietary instructions was weight reduction . A significant weight loss and improvement in the control of diabetes occurred in both groups , and these changes were similar in the two groups . At the end of one year 's follow-up , however , only 25 % of the patients were satisfactorily controlled ( fasting blood glucose less than or equal to 6.0 mmol/l ) . The degree of weight loss correlated only weakly with the improvement in the metabolic control . The degree of obesity and insulin secretion capacity as measured at the beginning of the study did not predict the improvement of glycaemic control during the study . At the end of the study a significant improvement was observed in serum lipids of patients with good control ( fasting blood glucose less than or equal to 6.0 mmol/l ) or weight loss ( greater than 5 kg ) . In conclusion , both brief , written and individual dietary instructions induced a significant weight loss as well as improved glucose and lipid metabolism in newly diagnosed non-insulin-dependent diabetic patients , but satisfactory metabolic control was achieved only in a minority of the patients BACKGROUND The circumstances under which the glycemic index ( GI ) and glycemic load ( GL ) are derived do not reflect real-world eating behavior . Thus , the ecologic validity of these constructs is incompletely known . OBJECTIVE This study examined the relation of  dietary intake to glycemic response when foods are consumed under free-living conditions . DESIGN Participants were 26 overweight or obese adults with type 2 diabetes who participated in a r and omized trial of lifestyle modification . The current study includes baseline data , before initiation of the intervention . Participants wore a continuous glucose monitor and simultaneously kept a food diary for 3 d. The dietary  variables  included  GI , GL , and intakes of energy , fat , protein , carbohydrate , sugars , and fiber .  The glycemic response variables included AUC , mean and SD of continuous glucose monitoring ( CGM ) values , percentage of CGM values in euglycemic and hyperglycemic ranges , and mean amplitude of glycemic excursions . Relations between daily dietary intake and glycemic outcomes were examined . RESULTS Data were available from 41 d of monitoring . Partial correlations , controlled for energy intake , indicated that GI or GL was significantly associated with each glycemic response outcome . In multivariate analyses , dietary GI accounted for 10 % to 18 % of the variance in each glycemic variable , independent of energy and carbohydrate intakes ( P < 0.01 ) . CONCLUSIONS The data support the ecologic validity of the GI and GL constructs in free-living obese adults with type 2 diabetes . GI was the strongest and most consistent independent predictor of glycemic stability and variability Introduction The IMPROVE ™ study is an openlabel , nonr and omized , observational study aim ed at determining the safety and efficacy of biphasic insulin aspart 30 ( BIAsp 30 ) treatment in subjects with type 2 diabetes from 11 countries . Here , we report the baseline data of the Indian cohort . Methods All subjects with type 2 diabetes requiring insulin and considered suitable for BIAsp 30 therapy based on their physician ’s clinical judgment were eligible to enter the study . The data recorded at baseline included demographic characteristics , detailed medical histories , physician-cited reasons for starting BIAsp 30 treatment , and the chosen dosage regimens . Results The Indian cohort included 17,995 subjects with diabetes . Poor glycemic control ( glycated hemoglobin [ HbA1c ] , 8.7%–9.6 % ) was observed at baseline in all four geographical zones ( North , South , East , and West ) and pre study treatment groups ( no therapy , only oral antidiabetic drug [ OAD ] , OAD ± insulin , and OAD ± insulin ± BIAsp 30 )  . Prevalence of both micro- and macrovascular complications was high , also reflecting poor glycemic control . Improving HbA1c and fasting and postpr and ial blood glucose levels were the most common reasons for starting BIAsp 30 therapy . The subjects were prescribed a mean BIAsp 30 dose of approximately 24 IU , and a twice-daily regimen was employed in almost 80 % of subjects . Conclusion The baseline results of the IMPROVE study Indian cohort confirm the poor glycemic control and the delayed initiation and /or inadequacy of treatment in subjects with type 2 diabetes . These results also highlight the need for timely and appropriately intensive insulin-based therapy AIMS Impaired glucose tolerance ( IGT ) is regarded at risk factor for later diabetes . The aim of this study was to identify predictive factors for outcome of IGT in obese children and adolescents . METHODS We prospect ively examined 79 obese white children and adolescents ( mean age 13.1 + /- 2.1 years , 51 % female , 76 % pubertal ) with IGT .  Anthropometrics , 2-h glucose in oral glucose tolerance test ( OGTT ) , fasting glucose , insulin , insulin resistance index homeostasis model assessment ( HOMA ) , glycated haemoglobin ( HbA(1c ) ) , lipids , blood pressure , waist circumference and pubertal stage were determined at baseline and 1 year later . RESULTS At follow-up , 32 % of the children continued to have IGT , 66 % converted to normal glucose metabolism , one child had impaired fasting glucose and one child developed Type 2 diabetes mellitus ( T2DM ) . Children with improvement of IGT had significantly lower weight , waist circumference , triglycerides , 2-h glucose during OGTT and HbA(1c ) at baseline compared with children who continued to have IGT . In the children whose glucose tolerance became normal , weight fell , and serum insulin concentrations , HOMA , lipids and blood pressure improved . They were also more likely to enter the late or post-pubertal stage than children who continued to have IGT . CONCLUSIONS Predictive factors for the frequent normalization of IGT in obese children and adolescents were lower weight , HbA(1c ) and 2-h glucose levels in OGTT at baseline , as well as a reduction of weight and entering late puberty stages during follow-up . Cardiovascular risk factors and HOMA improved along with the improvement of IGT , supporting an association between IGT , insulin resistance and features of the metabolic syndrome OBJECTIVE : To assess the effectiveness of a pharmaceutical care model on the management of non-insulin-dependent diabetes mellitus ( NIDDM ) in urban African-American patients . DESIGN : Eligible patients were r and omized to either a pharmacist intervention or control group and followed over a 4-month period . Patients in the intervention group received diabetes education , medication counseling , instructions on dietary regulation , exercise , and home blood glucose monitoring , and evaluation and adjustment of their hypoglycemic regimen . Patients in the control group continued to receive st and ard medical care provided by their physicians . SETTING : A university-affiliated internal medicine outpatient clinic . PARTICIPANTS : The study population consisted of urban African-American patients with NIDDM currently attending the clinic . MAIN OUTCOME MEASURES : Primary outcome measures included fasting plasma glucose and glycated hemoglobin concentrations . Secondary outcome endpoints included blood pressure , serum creatinine , creatinine clearance , microalbumin to creatinine ratio , total cholesterol , triglycerides , high-density lipoprotein , and low-density lipoprotein concentrations . Quality -of-life assessment s were performed in both groups at baseline and at the end of the study . RESULTS : Thirty-nine patients ( 17 intervention , 22 control ) completed the study . The intervention group consisted of 12 women and 5 men with a mean ± SD age of 59 ± 12 years , total body weight ( TBW ) of 93 ± 22 kg , body mass index ( BMI ) of 34 ± 7 kg/m2 , and duration of NIDDM 6.8 ± 6.5 years . The control group consisted of 15 women and 7 men with a mean age of 65 ± 12 years , TBW of 88 ± 19 kg , BMI of 33 ± 7 kg/m2 , and a duration of NIDDM of 6.2 ± 4.8 y. Significant improvement in glycated hemoglobin ( p = 0.003 ) and fasting plasma glucose ( p = 0.015 ) was achieved in the intervention group . No change in glycemia was observed in the control subjects . Statistically significant differences in the final glycated hemoglobin ( p = 0.003 ) and fasting plasma glucose ( p = 0.022 ) concentrations were noted between groups . No significant changes in blood pressure control , lipid profile , renal function parameters , weight , or quality -of-life measures were noted within or between groups . CONCLUSIONS : Our data demonstrate the effectiveness of pharmaceutical care in the reduction of hyperglycemia associated with NIDDM in a group of urban African-American patients CONTEXT The results of clinical trials involving diet in the treatment of obesity have been inconsistent , possibly due to inherent physiological differences among study participants . OBJECTIVE To determine whether insulin secretion affects weight loss with 2 popular diets . DESIGN , SETTING , AND PARTICIPANTS R and omized trial of obese young adults ( aged 18 - 35 years ; n = 73 ) conducted from September 2004 to December 2006 in Boston , Mass , and consisting of a 6-month intensive intervention period and a 12-month follow-up period . Serum insulin concentration at 30 minutes after a 75-g dose of oral glucose was determined at baseline as a measure of insulin secretion . Outcomes were assessed at 6 , 12 , and 18 months . Missing data were imputed conservatively . INTERVENTIONS A low-glycemic load ( 40 % carbohydrate and 35 % fat ) vs low-fat ( 55 % carbohydrate and 20 % fat ) diet . MAIN OUTCOME MEASURES Body weight , body fat percentage determined by dual-energy x-ray absorptiometry , and cardiovascular disease risk factors . RESULTS Change in body weight and body fat percentage did not differ between the diet groups overall . However , insulin concentration at 30 minutes after a dose of oral glucose was an effect modifier ( group x time x insulin concentration at 30 minutes : P = .02 for body weight and P = .01 for body fat percentage ) . For those with insulin concentration at 30 minutes above the median ( 57.5 microIU/mL ; n = 28 ) , the low-glycemic load diet produced a greater decrease in weight ( -5.8 vs -1.2 kg ; P = .004 ) and body fat percentage ( -2.6 % vs -0.9 % ; P = .03 ) than the low-fat diet at 18 months . There were no significant differences in these end points between diet groups for those with insulin concentration at 30 minutes below the median level ( n = 28 ) . Insulin concentration at 30 minutes after a dose of oral glucose was not a significant effect modifier for cardiovascular disease risk factors . In the full cohort , plasma high-density lipoprotein cholesterol and triglyceride concentrations improved more on the low-glycemic load diet , whereas low-density lipoprotein cholesterol concentration improved more on the low-fat diet . CONCLUSIONS Variability in dietary weight loss trials may be partially attributable to differences in hormonal response . Reducing glycemic load may be especially important to achieve weight loss among individuals with high insulin secretion . Regardless of insulin secretion , a low-glycemic load diet has beneficial effects on high-density lipoprotein cholesterol and triglyceride concentrations but not on low-density lipoprotein cholesterol concentration . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00130299 OBJECTIVE To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes . RESEARCH DESIGN AND METHODS Children with type 1 diabetes ( n = 104 ) were recruited to a prospect i ve , stratified , r and omized , parallel study to examine the effects of a measured carbohydrate exchange ( CHOx ) diet versus a more flexible low-glycemic index ( GI ) dietary regimen on HbA(1c ) levels , incidence of hypo- and hyperglycemia , insulin dose , dietary intake , and measures of quality of life over 12 months . RESULTS At 12 months , children in the low-GI group had significantly better HbA(1c ) levels than those in the CHOx group ( 8.05 + /- 0.95 vs. 8.61 + /- 1.37 % , P = 0.05 ) . Rates of excessive hyperglycemia ( > 15 episodes per month ) were significantly lower in the low-GI group ( 35 vs. 66 % , P = 0.006 ) . There were no differences in insulin dose , hypoglycemic episodes , or dietary composition . The low-GI dietary regimen was associated with better quality of life for both children and parents . CONCLUSIONS Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA(1c ) levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes We aim ed to determine whether altering dietary glycemic index ( GI ) in addition to healthy eating and weight loss advice affects arterial compliance and 24-hour blood pressure ( BP ) , both coronary heart disease ( CHD ) risk factors . Middle-aged men with at least 1 CHD risk were r and omized to a  6-month low-GI ( LGI ) or high-GI ( HGI ) diet . All were advised on healthy eating and weight loss . They were seen monthly to assess dietary compliance and anthropometrics . Carotid-femoral pulse wave velocity ( PWV ) , fasting blood lipid profile , and glucose and insulin concentrations were measured at baseline and at months 3 and 6 . Six-hour postpr and ial glucose and insulin responses and 24-hour ambulatory BP were also assessed at baseline and month 6 . Thirty-eight subjects ( HGI group , n = 16 ; LGI group , n = 22 ) completed the study . At month 6 , groups differed in dietary GI , glycemic load , and carbohydrate intake ( P < .001 ) . Fasting insulin concentration and insulin resistance ( calculated by homeostatic model assessment ) were lower in the LGI than the HGI group ( P < .01 ) . The reduction in total cholesterol and 24-hour BP was bigger in the LGI than the HGI group ( P < .05 ) ; and only the LGI group had significant reductions ( P < .05 ) in PWV , low-density lipoprotein cholesterol , and triacylglycerol concentration . There were no differences in postpr and ial glucose or insulin responses between the groups . The results suggest that an LGI diet may be more beneficial in reducing CHD risk , including PWV and 24-hour BP , even in the setting of healthy eating and weight loss ; and thus , further study is warranted Controversy exists about the optimal amount and source of dietary carbohydrate for managing insulin resistance . Therefore , we compared the effects on insulin sensitivity ( SI ) , pancreatic responsivity ( AIRglu ) and glucose disposition index of dietary advice aim ed at reducing the amount or altering the source of dietary carbohydrate in subjects with impaired glucose tolerance ( IGT ) . Subjects were r and omized to high-carbohydrate-high-glycaemic index ( GI ) ( high-GI , n 11 ) , high-carbohydrate-low-GI ( low-GI , n 13 ) , or low-carbohydrate-high-monounsaturated fat ( MUFA , n 11 ) dietary advice , with SI , AIRglu and DI measured using a frequently sample d , intravenous glucose tolerance test before and after 4 months treatment . Carbohydrate and fat intakes and diet GI , respectively , were : high-GI , 53 % , 28 % , 83 ; low-GI , 55 % , 25 % , 76 ; MUFA , 47 % , 35 % , 82 . Weight changes on each diet differed significantly from each other : high-GI , -0.49 ( sem 0.29 ) kg ; low-GI , -0.19 ( sem 0.40 ) kg ; MUFA + 0.27 ( sem 0.45 ) kg . Blood lipids did not change , but glycated haemoglobin increased significantly on MUFA , 0.02 ( sem 0.11 ) % , relative to low-GI , -0.19 ( sem 0.08 ) % , and high-GI , -0.13 ( sem 0.14 ) % . Diastolic blood pressure fell by 8 mmHg on low-GI relative to MUFA ( P=0.038 ) . Although SI and AIRglu did not change significantly , DI , a measure of the ability of beta-cells to overcome insulin resistance by increasing insulin secretion , increased on low-GI by > 50 % ( P=0.02 ) . After adjusting for baseline values , the increase in DI on low-GI , 0.17 ( sem 0.07 ) , was significantly greater than those on MUFA , -0.09 ( sem 0.08 ) and high-GI , -0.03 ( sem 0.02 ) ( P=0.019 ) . Thus , the long-term effects of altering the source of dietary carbohydrate differ from those of altering the amount . High-carbohydrate-low-GI dietary advice improved beta-cell function in subjects with IGT , and may , therefore , be useful in the management of IGT Background The clinical significance of glycemic index ( GI ) and glycemic load ( GL ) is inconclusive . Objective This study was conducted to examine the association of GI and GL with clinical cardiovascular disease ( CVD ) risk factors including body weight , blood pressure ( BP ) , serum lipids , fasting glucose , insulin and homocysteine over time among the PREMIER participants . Design PREMIER was an 18-month r and omized lifestyle intervention trial , conducted from 2000 to 2002 , design ed to help participants reduce BP by following the Dietary Approaches to Stop Hypertension ( DASH ) dietary pattern , losing weight , reducing sodium and increasing physical activity . GI and GL were estimated from 24 h diet recall data at baseline , 6 and 18 months after intervention . PROC MIXED model was used to examine the association of changes in GI or GL with changes in CVD risk factors . Results A total of 756 r and omized participants , 62 % females and 34 % African Americans and who averaged 50.0±0.3 years old and 95.3±0.7 kg , were included in this report . Neither GI nor GL changes was associated with changes in any risk factors at 6 months . At 18 months , however , the GI change was significantly and positively associated with total cholesterol ( TC ) change only ( p<0.05 , β=23.80±12.11 mg/dL or 0.62±0.31 mmol/L ) with a significant age interaction . The GL change was significantly associated with TC ( p=0.02 , β=0.28±0.15 mg/dL or 0.01±0.00 mmol/L ) positively and with low density lipoprotein cholesterol ( LDL-C ) changes negatively ( p=0.03 , β=−0.01±0.00 mg/dL or −0.00±0.00 mmol/L ) , and significant age interactions were observed for both . Conclusions GI and GL was associated with TC and LDL-C after controlling for energy , fat and fiber intake and other potential confounders and the associations were modified by age . Further investigation into this relationship is important because of its potential clinical impact OBJECTIVES To evaluate the results of pharmaceutical intervention in a programme to monitor the drug therapy of type-2 diabetics ; and to assess the improvement of the indicators , glycosylated haemoglobin , basal glycaemia , lipid profile , albumin/creatinine , blood pressure , BMI , medication-related problems and adherence . DESIGN R and omised clinical trial . SETTING 14 local pharmacies in the province of Pontevedra ( Galicia ) , Spain . SUBJECTS 126 type-2 diabetics , over 18 years old and who joined voluntarily a monitoring programme , distributed 50 - 50 into intervention and control groups . VARIABLES The main variable was HbA1c . Other variables were : clinical indicators of metabolic control ( mean basal glycaemia , lipid profile ) , blood pressure , BMI , medication-related problems , underst and ing of the illness and its complications , adherence to medical treatment and to changes in life-style , and incidence of complications . METHODS Introduction and r and omisation of patients . Recording of the initial status of the research variables , study and assessment stage , pharmaceutical interventions to detect and resolve any passing medication-related  problems and educational activities . Referral to family doctor if his/her intervention required . Follow-up lasted 12 months with monthly scheduled visits and on-dem and visits , after which the variables were assessed once more . The stages of study , evaluation , intervention and education did not occur in the control group . DISCUSSION The study will enable the role of the chemist in achieving the objectives of controlling type-2 diabetes patients to be achieved through educational intervention and assistance in drug therapy monitoring Forty-two obese subjects with non-insulin-dependent diabetes mellitus had their plasma insulin , C peptide , and glucose levels measured after an overnight fast and in response to a 75-g oral glucose loading . Subjects were then prospect ively followed up with dietary treatment , and the same measurements were repeated at 1 year . Although insulin values tended to be lower with greater fasting hyperglycemia at baseline , no correlation was observed among three parameters . However , near-normalization of glycemia ( measured as the level of hemoglobin A1 ) was associated with significantly higher fasting and stimulated plasma insulin concentrations .  Sixteen subjects were matched to each other for equivalent baseline hyperglycemia ( by glycosylated hemoglobin ) and divided into group 1 ( normalization of the hemoglobin A1 value to 7.0 % + /- 0.3 % [ mean + /- SE ] ) and group 2 ( persistent hyperglycemia ) ( hemoglobin A1 value , 10.7 % + /- 0.7 % [ mean + /- SE ] ) . Before dietary therapy , the plasma insulin concentrations were twofold to threefold higher in group 1 , and despite similar degrees of weight loss , group 2 failed to demonstrate improved glycemia . We concluded that the outcome of diet therapy for non-insulin-dependent diabetes mellitus is dependent on the duration of diabetes and endogenous insulin secretory reserve . There is a subgroup of patients with non-insulin-dependent diabetes mellitus in whom delayed dietary intervention may have a beneficial effect
Other parameters under investigation were not affected by either low or high glycaemic indices .
The present systematic review and meta- analysis provides evidence of a beneficial effect of a low glycaemic index/load diet in children and adolescents being either overweight or obese .
The objective of the present systematic review and meta- analysis was to synthesize the available literature data investigating the effects of low glycaemic index/low glycamic load dietary regimens on anthropometric parameters , blood lipid profiles , and indicators of glucose metabolism in children and adolescents .