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Evidence Builds for Use of Glycemic Index to Control Diabetes


WebMD Health News
Reviewed by Gary D. Vogin, MD

July 19, 2001 -- Children with Type 1 diabetes must pay careful attention to the foods they eat to maintain good control of their blood sugar levels. For many, this can be the most trying part of the disease.

Editor's Note: Food Pyramid Replaced

In June 2011, the USDA replaced the food pyramid with a new plate icon.

Most of the time, it's done by counting carbohydrates. There is a certain amount of carbohydrates that require a certain amount of insulin to regulate blood sugar levels so if you count carbs, you learn how much insulin is needed to prevent under- and overtreatment. But Australian researchers suggest that not all carbs are created equal and that some affect blood sugar levels faster than others.

That's why they favor flexible diet advice based on the food pyramid and what's called the glycemic index (GI). The glycemic index of foods indicates how quickly specific foods affect blood sugar based on a scale of one to 100.

For example, if your blood sugar is dropping during exercise, you would prefer to eat carbohydrates with a high GI because they raise your blood sugar quickly, but if you want to keep your blood sugar from dropping during a few hours of mild activity, you might eat extra carbohydrates with a lower glycemic index and longer action time.

In the July issue of Diabetes Care, twice as many children who chose foods based on the GI index had good control of blood sugar levels after one year, compared with those on the carbohydrate counting group. In addition, children in the low GI group had fewer episodes of high blood sugar levels than those who engaged in carbohydrate counting.

The American Diabetes Association (ADA) doesn't feel the GI research warrants changes to their current nutrition recommendations which state it is the total carbohydrates you eat, not the type, that most influences your blood sugar.

But "an overwhelming majority of children and parents who had been exposed to the two types of diet both stated that the low GI diet was easier to follow," study author Heather R. Gilbertson, a dietitian at the Royal Children's Hospital Campus in Parkville VIC, Australia, tells WebMD.

Why?

"It ... is readily learned as it's simply based on the concept of the healthy diet pyramid. Meals and snacks need to be regular and based on carbohydrate foods," she says. "[Children] found it easier to select their own meals, found that family activities were not limited, found it less of a hindrance to usual family routine and reported less conflict and tension within the family unit."

John Buse, MD, the director of the Diabetes Care Center at the University of North Carolina at Chapel Hill, says that "this is an important study conceptually and might be a reasonable thing to try in people who are failing at carbohydrate counting."

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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