Sunday, December 03, 2006

Glycemic Index

I'm currently working on writing a paper on the glycemic index and the control of blood glucose. Why? Because my Physiology lab won't let me do the endocrinology lab. Why? Because eating food is BAD for diabetics. Grrrr. ANYWAY. I've never really gotten into the glycemic index. The research I've been finding is very conflicting. The Glycemic index is either a great thing or an evil thing, depending on who writes the article. I'm looking at reputable sites, like the American Diabetes Association and the American Dietetic Association. My question is: What does the OC, as a group of people who need to control their blood glucose think of the glycemic index? Has anyone seen any good studies on it? Have you tried it? What did you think?


Scott K. Johnson said...

I feel very uneducated on it, but feel it would be very beneficial to my control.

That being said, I've not taken the next step to educate myself about it and apply it to my daily living.

I do believe that David Mendosa has a lot of information about it, and that might be a place to start. Google his name along with glycemic index, and I'm sure you'll find some useful stuff.

Worth a shot anyway!

karondaray said...

I am with Scott on this one .. i don't know a thing about it. I really think that its something that could be useful.

In the "real" world does it really help? thats my question. If i am home and I cook pasta, if its al dente it has a diffrent GI than if its well done. Or what about the stuff you put on it after. Is it butter and garlic or is suace.

Diabetes makes me feel like a failure at math. I can't imagine trying to add up carbs and THEN try to figure the GI into that.

Is GI for every one? Don't we already know that pizza can be a killer on the bloods suagrs if its Saturday and the planets have aligned in a straight line. But next tuesday the planets have shifted and the pizza is fine.

Too much for me.

MileMasterSarah said...

I think that the glycemic index is important for helping to choose which types of food to eat, and when. I have never researched it much, but I do know that I feel generally better when I am eating lower glycemic foods.

MileMasterSarah said...

I think that the glycemic index is important for helping to choose which types of food to eat, and when. I have never researched it much, but I do know that I feel generally better when I am eating lower glycemic foods.

Felix Kasza said...

I do a low-GL diet, with a BG average and standard deviation of 73 mg/dL and ~22 mg/dL. Works for me.

Um, could you point me to an article painting low-GL stuff as evil? I think it is pretty much universally accepted that BG spikes are bad; see Byetta and Symlin studies. Anyway, I would like to know who thinks that flattening pp spikes is a bad idea.


Jen said...

I guess evil is too strong a word. There are many site I originally looked at that say it is not the best method for diet control with diabetics. Most agree it can have a place, but that is has its faults.
Some of the articles I'm looking at are:
I'm getting frusrated finding articles that expand on the relationship between glycemic index and blood glucose. Most say low GI= low rise, high GI=high rise and that's it. Now I can make up a lot of fluff to fill in papers, but I can't make three pages out of that!
Off to do more research!

Anonymous said...

Just stop talking. We don't care.

Jen said...

I'm sorry if you don't care. I am not forcing you or anyone else to read my blog. I don't know what your issue is with me. If you would like to email privately at, you may do so. If you continue to leave comments like this on my blog, I will have to disable anonymous comments.

Hannah said...

Number one: Boooo to jerky anonymous commenters. Keep your jerky remarks to yourself. Maybe you don't have diabetes...therefore, this blog probably isn't your cup of tea anyway. Go read your friends' MySpace pages.

Number two: If you come up with anything interesting on the Glycemic Index, let me know. I'm totally clueless about it.

Chrissie in Belgium said...

Jen, Why do people have to make comments if they are not interested - just FO! Mendosa has mountains on this. It is all about balancing sugar absorption with insulin absorption. Since diabetics who take insulin have to balance food, sugar absorption with the timeing of their insulin, it is important to know when the bg will go up after eating defferent foods. Low glycemic index foods work better for me. This is b/c humalog just does not work as fast as your bg will rise if you eat food that very quickly raises your blood sugar.

Felix Kasza said...

Hi Jen,

and thanks for the links!

I am aware (like everybody, I think) of the limitations of the GI as a tool -- beginning with the distinction between GI and GL (GI is for a portion containing a set amount of carbs, independent of what one would actually eat; glycaemic load scales this by actual portion size).

There are even more factors affecting GI/GL. For instance, it is possible to stuff oneself with pastries to the point where they cause an extended BG spike, simple because the digestive system cannot keep up with the sheer quantity of food.

But what the articles seem to point out is that GI/GL is inadequate as a tool for "controlling" diabetes or causing weight loss -- I am not arguing with that, but I do say that the articles knock down a straw man.

First, regarding weight loss: There is a current theory that a BG spike (in non-D or type 2 folks) causes a sharp insulin response, with insulin remaining in the bloodstream even after the glucose is gone, causing more carb cravings and ultimately a positive-feedback loop.

Studies have so far not found concrete evidence for this claim (in the form of lingering increased insulin levels, for instance). And what with the half-life of insulin being around five seconds, any such excess would have to have been produced _after_ the initial BG spike was countered; that would be a clear case of malregulation, known as hyperinsulinaemia.

For "controlling" diabetes, the usefulness of GI/GL depends on one's goals, I would say. If "control" is meant to achieve what diet and exercise can do for a lucky type 2, then no, GI/GL are not good enough. But if "control" is taken to mean "fine-tuning" or "improved results", then GI/GL is very much the thing. It may have limitations, but the glycaemic index today is the only measure that we have for guessing at a food's BG impact beyond carb count (pure or TAG).

I say this is way better than nothing. The only way I can maintain a fasting target of 60 mg/dl and a postprandial target of below 120 mg/dl without running low all the time is bu judiciously selecting what and how much I eat -- and if I do eat outside my usual habits, at least I know what I am doing.


P.S.: Nice thing about Christmas? I get to eat pound cake: One pount of chocolate cake, filled with one pound of extra-dark molten chocolate, surrounded by one pound of ice cream, and topped with one pound of sugared whipped heavy cream. I am already drooling!

Jen said...

Thanks for the addition information Felix. Just for my own curiousity, what do you use to manage your diabetes? You seem to have excellent control.

karondaray said..., that explained a whole lot more and better than what i tryed to find on-line. Way to go Felix .

Felix Kasza said...

Hi Jen,

to manage my D, my first and most important tool is the massive amount of anal-retentiveness that my parents gave me. :-)

Jokes aside: MM 722, now with a CGMS sensor (yay! only 4+ instead of 15+ fingersticks a day!); Bayer Ascensia Contour -- accuracy and precision are lab-quality on all three of them, and no coding; Humalog.

But the real tools are those I can only influence a little or not at all, and these make clear that my HbA1c results are none of my merit at all. For one, I have an excellent glucagon response; unless I exercise like a maniac, it is _really_ hard for me to go low to the point that I am unable to self-treat. Two, I trained myself to be fully capable down to 50+ mg/dl. Limited capabilities (as in, noticing and treating a low) down to 20 or 25 mg/dl.

Without these two safety nets, I freely admit that I would never let myself risk things like a 60 mg/dl fasting target; I may be anal, but I try not to be reckless. (And when I exercise, I try to start at 90 mg/dl with a temp basal of .25u/h and keep a _very_ close eye on my BG.)

The only thing that I can add to what nature gave me is the willingness to spend an extraordinary amount of time on managing my diabetes. I am lucky in that I am a LADA, diagnosed in 1994; I didn't have to go through puberty with the D, and by the time it hit, I had already learned to reject instant gratification for later and greater results.

The motivation is in large part provided by fear. After years of not caring -- we are all immortal, right? -- I had non-healing ulcers, beginnings of retinopathy, microalbuminuria, neuropathy, and so forth. The retinopathy brought me to my senses, and I started clamping down brutally; within six months my HbA1c went from 13+ to under 7 (that was on MDI), and with the pump now, I have yet to have result of 5% or more.

As I said, sheer fright is driving me to extremes, and for sure it is paying off big time -- a few numb spots on the soles of my feet remain, my wound healing will never be great, but all the rest of the eginning complications are gone. And knowing that I essentially used up all my safety buffer, I plan on remaining anal. Even if food was one of my great pleasures in life.

Hey, for those who do not have to watch their waistlines: I am a fairly good cook (meats and sauces, and Hungarian/Bohemian desserts). The meats and sauces are generally not very carby, or they are so loaded with heavy cream that the carbs qualify as low-GL. I'd be happy to share!


Tiffany said...

The Glycemic Index is an incredibly helpful tool for Diabetics.

I don't stick to an eating regime based on the GI, but the Index does help me to predict the effects of the foods I eat on my BG levels, and use the dual/square wave bolus on my pump to its best effect. The Glycemic Index is a listing of foods that have a numeric value. This number correlates to the metabolic properties of that food (KISS version)in relation to digestion.

IMO, the GI isn't necessarily the miracle diet - though it works wonders for many - but it is a real feather in the cap of Diabetic control. It's a tool that helps us to predict the effects of foods on our BG levels, thus aiding with stabilization of blood glucose. Since starting the Paradigm RT with the continuous glucometer, I have been working on my own GI index for the foods I eat.

I could go into more depth here, Jen, but I'll spare everyone lol. If you'd like more info you are welcome to email me and I'll gladly pull together some info for you.

PS -- Anonymous: Seriously, buddy, just stop talking. We really don't care. Get a life while you're at it.