The argument against glycemic index: what are the other options?

Abstract

There is debate among professionals regarding the use of the glycemic index (GI) for meal planning. In type-1 diabetes, there are 4 studies (average duration approximately 4 weeks) comparing high versus low GI diets; none reported improvements in HbA1c, and although 2 reported improvements in fructosamine, 2 reported no differences. In type-2 diabetes, there are 12 studies (average duration approximately 5 weeks); 3 reported improvements in HbA1c and fructosamine, 5 reported no differences in HBA1c, and 3 reported no differences in fructosamine. In adults, there is limited evidence that a low GI diet is beneficial for weight loss or satiety. Three epidemiologic studies reported that a low GI/glycemic load (GL) is associated with a reduced risk of developing diabetes or prevalence of insulin resistance; however, 5 studies report no association between GI/GL and the risk of developing diabetes, fasting insulin or insulin resistance, or adiposity. In general, the total amount of carbohydrate in a meal is the primary meal-planning strategy for people with diabetes. The GI can be used as an adjunct for the fine tuning of postprandial blood glucose responses. Other food/meal-planning interventions have been shown to be more effective than the use of the GI.