Type 1 Diabetes and the GI Diet

Among my friends growing up was a girl with Type I diabetes.  She stood out because even the most miniscule amount of sugar wasn’t allowed anywhere near her mouth . . . not cake at birthday parties . . . not a small candy bar after a softball game . . . and certainly not a drop of soda at anytime.  While such strictness undoubtedly helped control her condition, I have to wonder how the rigidity played on her quality of life.

All people with diabetes should “eat healthy,”  yet those with Type 1 diabetes also must measure the quantity, type and timing of their food choices – simply ensuring they eat their daily quota of fruits and vegetables won’t cut it.  Focus on blood glucose and insulin levels is key.

You see, most foods are broken down into glucose by digestive enzymes. The glucose is then absorbed from the intestine into the bloodstream. The hormone, insulin, then takes the glucose from the bloodstream to either use or store for later.  People who do not have diabetes will produce just the right amount of insulin to cope with the rise in blood glucose that occurs after a meal.

People with Type 1 diabetes, however, are unable to produce insulin; instead they must inject it into their bodies.  To keep their blood glucose level close to normal after eating, they must inject just the right amount of insulin to deal with the food they’ve eaten. The injection should be timed right, so that the insulin arrives in the bloodstream at the same time that the glucose is absorbed into their blood-streams.

Too little insulin (for the amount of glucose coming from the digested food) results in very high blood glucose levels or hyperglycemia. Too much insulin (or not enough glucose coming from the digested food) spurs low blood glucose levels or hypoglycemia.  Every food morsel must be balanced, weighed and measured.

Since my grade school days, there have been many advances in blood sugar monitoring and insulin delivery. Knowledge of proper diets have, unfortunately, lagged behind.

Most doctors and dietitians agree that careful monitoring of glucose levels is key to minimizing complications from the disease. The standard diet given to both children and adults is based on a diabetic carbohydrate exchange list which has been shown to be ineffective as many children and their parents struggle to understand or follow the guidelines.

The Glycemic Index diet has proven to be far more effective.  Simply, the Glycemic Index (GI) is a ranking of foods on a scale from 0 to 100 based on the extent to which they raise blood sugar levels after eating.

The group of foods primarily responsible for the rise and fall in blood glucose levels after a meal are carbohydrates. The Glycemic Index provides a ranking of how quickly carbohydrates in food are digested by the body, compared to pure glucose which has a ranking of 100 percent. When carbohydrates are quickly broken down, high levels of glucose are released into the bloodstream very soon after a meal. Some examples of these foods (which have rankings of 70 percent or more) are white breads, potatoes, cornflakes and white rice.

Conversely, foods that contain carbohydrates that break down slowly, and release glucose gradually into the bloodstream, have a low GI (a ranking of 55 percent or less). Examples of low GI foods are most fruits, rolled oats, whole-wheat pastas, basmati rice and legumes. Medium GI foods have a ranking of between 56 and 69 percent.

Studies have shown that the GI diet is an effective user-friendly way of controlling diabetes.   For example, a study published in the American Journal of Clinical Nutrition found that children who followed the low GI diet enjoyed more stable blood sugar levels, fewer episodes of hyperglycemia and generally better quality of life than their counterparts following the CHOx diet.

In addition, a small study published in the issue of Diabetes Care shows that a low Glycemic diet leads to better blood glucose control in children and adolescents with Type 1 diabetes.  Researchers found that the youngsters’ blood glucose levels were in their target range 66% of the time when they were eating low-GI meals but only 47% of the time when eating high-GI meals—a notable difference. The children also required less insulin.

Moreover, a new study has found that eating a high glycemic index (GI) diet may cause faster progression to type 1 diabetes in those people with a genetic predisposition.

Researchers at the Barbara Davis Center for Childhood Diabetes in Colorado studied whether dietary glycemic index are associated with the progression of islet autoimmunity to type 1 diabetes. Islet autoimmunity occurs when the body develops antibodies to the insulin-producing cells in the pancreas — it is just one step away from Type 1 diabetes.

Investigators studied eating habits of 89 children seen as genetically predisposed to diabetes.  The results published online in the Journal of Endocrinology and Metabolism, found that 89 children developed islet autoimmunity and 17 subsequently developed type 1 diabetes.

While GI levels were not related the development of islet cell autoimmunity, eating a high GI diet did result in a faster progression to type 1 diabetes in children who already had islet autoimmunity.

For these reasons, the GI diet can help prevent the onset of type I diabetes, and definitely make afflicted children healthier with excellent quality of lives so they can even enjoy some occasional birthday cake.  For more information, consult glycemic index chart to better understand food interactions and hidden glucose values.

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