Benefits may be greater than what can be achieved solely through the use of drugs or insulin.
A new study, published in the BMJ, showed improvements in blood sugar levels, cholesterol, weight and other risk factors.
The findings revealed that adhering to a low glycaemic diet leads to small but significant improvements in blood sugar levels, cholesterol, weight, and other risk factors in people with diabetes.
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According to the researchers, these improvements were seen in addition to existing drug or insulin therapy, implying that a low glycemic diet could be especially useful as an add-on treatment to help people with diabetes better achieve their goals.
The glycaemic index (GI) measures how quickly different foods affect blood sugar levels, and research has shown that low-GI foods, such as vegetables, most fruits, pulses, and wholegrains, can help people with diabetes maintain stable blood sugar levels and reduce their risk of heart disease.
Clinical guidelines all over the world recommend a low GI or GL (glycaemic load) diet for people with diabetes. However, the most recent guidelines from the European Association for the Study of Diabetes (EASD) were published over 15 years ago, and several trials have been published since then.
To help inform the update of the EASD nutrition treatment guidelines, researchers set out to summarize the effect of low GI/GL dietary patterns on blood sugar control and other known risk factors in diabetes.
Their findings are based on 27 randomized controlled trials published up until May 2021 that looked at the effect of low-GI/GL diets on diabetes for three weeks or more.
A total of 1,617 people with type 1 or type 2 diabetes took part in the trials, the majority of whom were middle aged, overweight or obese, and had moderately controlled type 2 diabetes treated with drugs or insulin.
The trials were of varying quality, but the researchers were able to use the GRADE system to assess the certainty of the evidence.
When compared to higher-GI/GL control diets, low-GI/GL dietary patterns were associated with small but clinically meaningful reductions in blood sugar levels (HbA1c).
Other risk factors, such as fasting glucose (blood sugar levels after a fast), LDL cholesterol, body weight, and C-reactive protein (a chemical associated with inflammation), were also reduced, but not blood insulin levels, HDL cholesterol, waist circumference, or blood pressure.
The certainty of the evidence was high for blood sugar reduction and moderate for the majority of other outcomes, indicating that the available evidence is a good indicator of the likely benefit in this population.
The researchers acknowledge several limitations that may have influenced their findings, including the imprecision of the evidence for the effect of low GI/GL dietary patterns on LDL cholesterol and waist circumference, and the scarcity of available trials comparing blood pressure and inflammatory markers.
However, they say their findings show that low GI/GL dietary patterns “are considered an acceptable and safe dietary strategy that can produce small meaningful reductions in the primary target for glycaemic control in diabetes, HbA1c, fasting glucose, and other established cardiometabolic risk factors.”
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“Our synthesis supports existing recommendations for the use of low GI/GL dietary patterns in the management of diabetes,” they conclude.
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