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How do you effectively manage diabetes through diet?

Posted on September 12, 2014 by Ruth Buttigieg | 0 comments

Diabetes is a condition associated with the body’s inability to maintain stable blood glucose levels for a variety of different reasons. As blood sugar is directly affected by the composition of the food eaten, irrespective of the underlying physiological issue causing diabetes, then logic would dictate that a change in dietary habits is required so as to help manage the condition as much as possible.

 

Glycaemic Load, Glycaemic Index, low-carb and low carb ketogenic diets are popular approaches designed to help manage blood sugar levels. The similarities and differences at times seem to be subtle at best, so how do you get equipped with all the knowledge you need to make an informed choice?

 

The difference between GI, GL, Low Carb & Ketogenic diets and their impact on blood sugar management



Approach

Terminology

In Practice

Low carb Ketogenic

Carbohydrate intake is restricted (less than 60g a day). What this restriction does is encourage the body to use up its fat stores as fuel. This happens because the low presence of simple and starchy carbohydrates in the meals does not give rise to a blood sugar spikes.

A well formulated ketogenic meal plan, one can notice that it is balanced, natural and low in sugar. It also provides omega 3 and 6 fatty acids as well as essential amino acids. It is full of food containing antioxidants, vitamins, minerals, and most importantly dietary fibre to ensure minimal blood sugar spikes in the progress.


The body will be fuelling itself from stored body fat as well as from the dietary fat consumed. Due to this, blood sugar levels remain stable and in turn reduces the need for high insulin levels.

Low Carb

Not as strict a restriction as ketogenic diets. Daily total carbohydrate intake between 130-150g.

More similar to Paleo and other grain-free protocol diets as items such as sweet potatoes and other fruit are allowed.

A well formulated low carb lifestyle will have positive benefits on diabetes, however, due to the higher carbohydrate intake, may not bring about stable blood sugars as quickly as a ketogenic diet.

Glycaemic Index (GI)

Used to identify food items that can be quickly broken down into their respective simple sugars. Scale runs from high GI (100 rating eg: white bread) to low GI (0 rating eg: eggs)

Can be a simple approach, however some ingredients can still be had even though they are sugars. The reason being that these items bypass the usual metabolic pathways and hence are not picked up in the lab methods used to determine the GI number of a food item.

Glycaemic Load (GL)

A number that takes into account the GI of the food item and also the available carbohydrate in it:


( GI x amount of carbohydrate in food item ) / 100

            

Can be a simple approach, however recipes containing multiple ingredients can make it a bit of a mathematical mess.

 

So what’s the final verdict?

 

Minimising sugars in the diet is always a positive and your body will thank you for it. However, starchy carbohydrates will still have a negative impact on blood sugar levels as starches are linked sugar molecules. Hence, once digested, starch will have the same impact as granulated sugar does on blood sugar levels.


However, the science and personal testimonies, all show that specifically following a low carbohydrate diet which actively minimises sugars and starches will deliver better results and help to successfully manage diabetes through diet.

 

References:

 

Brand-Miller, J., Hayne, S., Petocz, P. and Colagiuri, S. (2003). Low--Glycemic Index Diets in the Management of Diabetes A meta-analysis of randomized controlled trials. Diabetes care, 26(8), pp.2261--2267.

Dashti, H., Mathew, T., Khadada, M., Al-Mousawi, M., Talib, H., Asfar, S., Behbahani, A. and Al-Zaid, N. (2007). Beneficial effects of ketogenic diet in obese diabetic subjects. Molecular and cellular biochemistry, 302(1-2), pp.249--256.

Evert, A., Boucher, J., Cypress, M., Dunbar, S., Franz, M., Mayer-Davis, E., Neumiller, J., Nwankwo, R., Verdi, C., Urbanski, P. and others, (2013). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care, 36(11), pp.3821--3842.

Feinman, R., Pogozelski, W., Astrup, A., Bernstein, R., Fine, E., Westman, E., Accurso, A., Frasetto, L., McFarlane, S., Nielsen, J. and others, (2014). Dietary Carbohydrate restriction as the first approach in diabetes management. Critical review and evidence base. Nutrition.

Goff, L., Cowland, D., Hooper, L. and Frost, G. (2013). Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutrition, Metabolism and Cardiovascular Diseases, 23(1), pp.1--10.

Guldbrand, H., Dizdar, B., Bunjaku, B., Lindstr\"om, T., Bachrach-Lindstr\"om, M., Fredrikson, M., \"Ostgren, C. and Nystrom, F. (2012). In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Diabetologia, 55(8), pp.2118--2127.

Jonasson, L., Guldbrand, H., Lundberg, A. and Nystrom, F. (2014). Advice to follow a low-carbohydrate diet has a favourable impact on low-grade inflammation in type 2 diabetes compared with advice to follow a low-fat diet. Annals of medicine, (0), pp.1--6.

Murakami, K., McCaffrey, T. and Livingstone, M. (2013). Associations of dietary glycaemic index and glycaemic load with food and nutrient intake and general and central obesity in British adults.British Journal of Nutrition, 110(11), pp.2047--2057.

Saslow, L., Kim, S., Daubenmier, J., Moskowitz, J., Phinney, S., Goldman, V., Murphy, E., Cox, R., Moran, P. and Hecht, F. (2014). A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes. PloS one, 9(4), p.91027.

Sign.ac.uk, (2014). Guideline 116: Management of diabetes. [online] Available at: http://www.sign.ac.uk/guidelines/fulltext/116/index.html [Accessed 12 Sep. 2014].

Sleeth, M., Psichas, A. and Frost, G. (2013). Weight gain and insulin sensitivity: a role for the glycaemic index and dietary fibre?. British Journal of Nutrition, 109(09), pp.1539--1541.

Tappy, L., L\^e, K., Tran, C. and Paquot, N. (2010). Fructose and metabolic diseases: new findings, new questions. Nutrition, 26(11), pp.1044--1049.

Thomas, D., Elliott, E., Baur, L. and others, (2007). Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev, 3(3).

Unwin, D. and Unwin, J. (2014). Low carbohydrate diet to achieve weight loss and improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general practice. Practical Diabetes, 31(2), pp.76--79.

von Bibra, H., Wulf, G., St John Sutton, M., Pf\"utzner, A., Schuster, T. and Heilmeyer, P. (2014). Low-carbohydrate/high-protein diet improves diastolic cardiac function and the metabolic syndrome in overweight-obese patients with type 2 diabetes. IJC Metabolic \& Endocrine, 2, pp.11--18.

Yancy Jr, W., Foy, M., Chalecki, A., Vernon, M., Westman, E. and others, (2005). A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr Metab (Lond), 2, p.34.

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