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Carbohydrate counting and glycaemic index

May 20, 2015

Nutritional advice for people with diabetes has changed over the last decades, from ‘avoid carbohydrates’ to ‘calculate the precise intake’ and ‘follow personal nutrition plan’.

For people with type 1 diabetes, carbohydrate counting education is seen as the first objective. Many studies have shown that intensive insulin therapy (which includes injections of rapid-acting insulin before each meal in an amount proportional to the carbohydrates) improves glycaemic control.

For people with type 2 diabetes, studies associate glycaemic index of carbohydrates with an improved glycaemic control, improved lipid serum concentrations and feelings of satiety, supporting weight loss in people with type 2 diabetes. However, recent studies have shown that the amount of carbohydrate in a food is a stronger predictor of glucose response than glycaemic index.

In addition, the objectives of a nutrition plans should take into account personal preferences in order to improve glycaemic control and lifestyle of the person with diabetes.

We would like to know about your experiences and daily practices. Do you think that carbohydrate counting and the glycaemic index are of interest to both people with type 1 or type 2 diabetes? Do you use specific techniques to develop nutrition plans for specific populations, like children or pregnant women?

How do you educate people with type 1 and type 2 diabetes about the effect of carbohydrates on their glycaemic control?

Information about the discussion leader

The discussion will be moderated by María Inés Landó, Lic., RD, CDE (Lecturer at University of Buenos Aires, University of Salvador and School of Certified Diabetes Educators of the Argentine Society of Diabetes)

References

  1. American Diabetes Association. Standard of Medical Care in Diabetes. Diabetes Care 2015;38(Suppl. 1)
  2. Evert AB, Boucher JL, Cypress M, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 2014;37(Suppl. 1):S120–S143.
  3. Laurenzi A, Bolla AM, Panigoni G, Doria V, Uccellatore A, Peretti E, et al. Effects of carbohydrate counting on glucose control and quality of life over 24 weeks in adult patients with type 1 diabetes on continuous subcutaneous insulin infusion: a randomized, prospective clinical trial (GIOCAR). Diabetes Care. 2011 Apr;34(4):823–7.
  4. Brand-Miller J, Hayne S, Petocz P, Colagiuri S. Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care. 2003 Aug;26(8):2261–7.
  5. DAFNE Study Group. Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: Dose Adjustment For Normal Eating (DAFNE) randomised controlled trial. BMJ 2002;325:746