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Factors associated with dietary glycemic index and glycemic load in pregnant women and risk for gestational diabetes mellitus

Hasbullah FY, Mohd Yusof BN, Shariff ZM, Rejali Z, Yong HY, Mitri J

Int J Food Sci Nutr, 2020 Jun;71(4):516-524.
PMID: 31686557 DOI: 10.1080/09637486.2019.1686752

The risk of gestational diabetes mellitus (GDM) increases during the second trimester of pregnancy. However, the role of dietary glycemic index (GI) and glycemic load (GL) on GDM risk is controversial. We aimed to determine the association of established risk factors of GDM with GI and GL among healthy pregnant women, and whether GI and GL were subsequently related to GDM risk. Dietary GI and GL were assessed in healthy pregnant women from the Seremban Cohort Study using a food frequency questionnaire. After adjusting for energy intake, high GI was significantly associated with lower household income, shorter stature, higher proportion of carbohydrate intake, lower sugar proportion and lower fibre intake. High GL was significantly associated with younger maternal age, higher carbohydrate proportion and lower fibre intake. GI and GL intakes were not significantly associated with GDM risk. However, they were associated with a few established risk factors of GDM.

Matched MeSH terms: Glycemic Index*
Fulltext Effect of quantity and quality of pre-exercise carbohydrate meals on central fatigue

Khong TK, Selvanayagam VS, Hamzah SH, Yusof A

J Appl Physiol (1985), 2018 10 01;125(4):1021-1029.
PMID: 29975601 DOI: 10.1152/japplphysiol.00221.2018

Both the quantity and quality of pre-exercise carbohydrate (CHO) meals have been shown to improve endurance performance. However, their role in attenuating central fatigue (CF) is inconclusive. The use of neurophysiological techniques, such as voluntary activation (VA) and the central activation ratio (CAR), alongside maximum voluntary contraction (MVC) and sustained MVC (sMVC) can provide information on CF. Hence, the objective of this study was to investigate the effects of isocaloric pre-exercise meals: 1) a high versus low quantity of CHO and 2) a high quantity of CHO with a high versus low glycemic index (GI) on MVC, VA, and CAR following a 90-min run. The high and low quantity of CHO was 1.5 and 0.8 g/kg body wt, respectively, and high and low GI was ~75 and ~40, respectively. Blood insulin, serotonin, tryptophan, and gaseous exchange were also measured. High CHO preserved sMVC, VA, CAR, and serotonin postrunning with greater CHO oxidation and insulin response, whereas in low CHO, greater reductions in sMVC, VA, and CAR were accompanied by higher serotonin and fat oxidation with lower insulin response. These observations indicate central involvements. Meanwhile, high GI CHO better preserved force (sMVC), CAR, and tryptophan with greater CHO oxidation and insulin response compared with low GI. The findings of this study suggest that pre-exercise meals with varying quantity and quality of CHO can have an effect on CF, where greater CHO oxidation and insulin response found in both high CHO and high GI lead to attenuation of CF. NEW & NOTEWORTHY This paper examined the effects of carbohydrate interventions (high and low: quantity and quality wise) on central activity during prolonged exercise using mainly neurophysiological techniques along with gaseous exchange and blood insulin, serotonin, and tryptophan data.

Matched MeSH terms: Glycemic Index*
Glycaemic responses to liquid food supplements among three Asian ethnic groups

Tey SL, Van Helvoort A, Henry CJ

Eur J Nutr, 2016 Dec;55(8):2493-2498.
PMID: 26467048

PURPOSE: A limited number of studies have compared the glycaemic index (GI) and glycaemic responses (GR) to solid foods between Caucasians and Asians. These studies have demonstrated that Asians have greater GI and GR values for solid foods than Caucasians. However, no study has compared the GI and GR to liquids among various Asian ethnic groups.
METHODS: A total of forty-eight males and females (16 Chinese, 16 Indians, and 16 Malay) took part in this randomised, crossover study. Glycaemic response to the reference food (glucose beverage) was measured on three occasions, and GR to three liquids were measured on one occasion each. Liquids with different macronutrient ratio's and carbohydrate types were chosen to be able to evaluate the response to products with different GIs. Blood glucose concentrations were measured in duplicate at baseline (-5 and 0 min) and once at 15, 30, 45, 60, 90, and 120 min after the commencement of beverage consumption.
RESULTS: There were statistically significant differences in GI and GR between the three liquids (P

Matched MeSH terms: Glycemic Index*
Fulltext Plasma adiponectin concentrations are associated with dietary glycemic index in Malaysian patients with type 2 diabetes

Loh BI, Sathyasuryan DR, Mohamed HJ

Asia Pac J Clin Nutr, 2013;22(2):241-8.
PMID: 23635368 DOI: 10.6133/apjcn.2013.22.2.04

Adiponectin, an adipocyte-derived hormone has been implicated in the control of blood glucose and chronic inflammation in type 2 diabetes. However, limited studies have evaluated dietary factors on plasma adiponectin levels, especially among type 2 diabetic patients in Malaysia. The aim of this study was to investigate the influence of dietary glycemic index on plasma adiponectin concentrations in patients with type 2 diabetes. A cross-sectional study was conducted in 305 type 2 diabetic patients aged 19-75 years from the Penang General Hospital, Malaysia. Socio-demographic information was collected using a standard questionnaire while dietary details were determined by using a pre-validated semi-quantitative food frequency questionnaire. Anthropometry measurement included weight, height, BMI and waist circumference. Plasma adiponectin concentrations were measured using a commercial ELISA kit. Data were analyzed using multiple linear regression. After multivariate adjustment, dietary glycemic index was inversely associated with plasma adiponectin concentrations (β =-0.272, 95% CI -0.262, - 0.094; p<0.001). It was found that in individuals who consumed 1 unit of foods containing high dietary glycemic index that plasma adiponectin level reduced by 0.3 μg/mL. Thirty two percent (31.9%) of the variation in adiponectin concentrations was explained by age, sex, race, smoking status, BMI, waist circumference, HDL-C, triglycerides, magnesium, fiber and dietary glycemic index according to the multiple linear regression model (R2=0.319). These results support the hypothesis that dietary glycemic index influences plasma adiponectin concentrations in patients with type 2 diabetes. Controlled clinical trials are required to confirm our findings and to elucidate the underlying mechanism.

Matched MeSH terms: Glycemic Index*
A transgressive brown rice mediates favourable glycaemic and insulin responses

Karupaiah T, Aik CK, Heen TC, Subramaniam S, Bhuiyan AR, Fasahat P, et al.

J Sci Food Agric, 2011 Aug 30;91(11):1951-6.
PMID: 21480266 DOI: 10.1002/jsfa.4395

BACKGROUND: We evaluated glycaemic response of a brown rice variant (BR) developed by cross-breeding. Subjects (n = 9) consumed 50 g carbohydrate equivalents of BR, white rice (WR) and the polished brown rice (PR) in comparison to 50 g glucose reference (GLU) in a cross-over design. Plasma glucose and insulin at 0, 15, 45, 60, 90, 120 and 180 min were measured and incremental area under the curve (IAUC) and indices for glucose (GI) and insulin (II) calculated.
RESULTS: BR compared to PR or WR produced the lowest postprandial glycaemia (GI: 51 vs 79 vs 86) and insulinaemia (II: 39 vs 63 vs 68) irrespective of amylose content (19 vs 23 vs 26.5%). Only BR was significantly different from GLU for both plasma glucose (P = 0.012) and insulin (P = 0.013) as well as IAUC(glu) (P = 0.045) and IAUC(ins) (P = 0.031). Glycaemic and insulinaemic responses correlated positively (r = 0.550, P < 0.001). Linear trends for IAUC(glu) and IAUC(ins) indicated a greater secretion of insulin tied in with a greater glycaemic response for WR (r(2) = 0.848), moderate for PR (r(2) = 0.302) and weakest for BR (r(2) = 0.122).
CONCLUSION: The brown rice variant had the lowest GI and II values but these advantages were lost with polishing.

Matched MeSH terms: Glycemic Index*
Improvement of dietary quality with the aid of a low glycemic index diet in Asian patients with type 2 diabetes mellitus

Barakatun Nisak MY, Ruzita AT, Norimah AK, Gilbertson H, Nor Azmi K

J Am Coll Nutr, 2010 Jun;29(3):161-70.
PMID: 20833988 DOI: 10.1080/07315724.2010.10719830

OBJECTIVES: This randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM).

METHODS: Asian patients with T2DM (N = 104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietary intake and food choices were assessed with the use of a 3-day food record.

RESULTS: At week 12, both groups achieved the recommendations for carbohydrate (52 ± 4% and 54 ± 4% of energy) and fat (30 ± 4% and 28 ± 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A(1c) level at week 12 for patients in the lowest GI/GL quartile (Δ = -0.7 ± 0.1%) compared with those in the highest GI/GL quartile (Δ = -0.1 ± 0.2%).

CONCLUSIONS: These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM.

Matched MeSH terms: Glycemic Index*
A low-GI diet is associated with a short-term improvement of glycaemic control in Asian patients with type 2 diabetes

Yusof BN, Talib RA, Kamaruddin NA, Karim NA, Chinna K, Gilbertson H

Diabetes Obes Metab, 2009 Apr;11(4):387-96.
PMID: 19175374 DOI: 10.1111/j.1463-1326.2008.00984.x

AIMS: The aim of this study is to compare the efficacy of low glycaemic index (GI) vs. conventional carbohydrate exchange (CCE) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes.
METHODS: A total of 104 patients with type 2 diabetes were randomly assigned to either a low GI (GI) or CCE dietary advice over a 12-week period. The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c (HbA1c), fructosamine level and plasma glucose. The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure, lipid profile and insulin levels. The oral antidiabetic medications remained unchanged throughout the duration of the study.
RESULTS: A low-GI diet was associated with significant changes in the fructosamine level (DeltaGI = -0.20 +/- 0.03; DeltaCCE = -0.08 +/- 0.03 mmol/l, p < 0.01) and waist circumference (DeltaGI group = -1.88 +/- 0.30 cm; DeltaCCE group: -0.36 +/- 0.4 cm, p < 0.05) at week 4. At week 12, the changes in fasting glucose (DeltaGI = -0.03 +/- 0.3; DeltaCCE = 0.7 +/- 0.3 mmol/l; p < 0.05) and waist circumference (DeltaGI = -2.35 +/- 0.47 cm; DeltaCCE group = -0.66 +/- 0.46 cm; p < 0.05) in the GI group was significantly lower than the CCE group. With the low-GI diet, the changes in postprandial glycaemia at time 0, 60, 150 and 180 min after consuming the standard test meal was lower than with the CCE diet (p < 0.05). No significant differences were found between the groups for the remaining parameters that were measured.
CONCLUSIONS: Use of a low-GI diet resulted in significant changes of serum fructosamine level, plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet. The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit.

Matched MeSH terms: Glycemic Index*
Fulltext Evaluating Crossbred Red Rice Variants for Postprandial Glucometabolic Responses: A Comparison with Commercial Varieties

Se CH, Chuah KA, Mishra A, Wickneswari R, Karupaiah T

Nutrients, 2016 May 20;8(5).
PMID: 27213446 DOI: 10.3390/nu8050308

Consumption of white rice predisposes some Asian populations to increased risk of type 2 diabetes. We compared the postprandial glucometabolic responses to three newly-developed crossbred red rice variants (UKMRC9, UKMRC10, UKMRC11) against three selected commercial rice types (Thai red, Basmati white, Jasmine white) using 50-g carbohydrate equivalents provided to 12 normoglycaemic adults in a crossover design. Venous blood was drawn fasted and postprandially for three hours. Glycaemic (GI) and insulin (II) indices, incremental areas-under-the-curves for glucose and insulin (IAUCins), indices of insulin sensitivity and secretion, lactate and peptide hormones (motilin, neuropeptide-Y, orexin-A) were analyzed. The lowest to highest trends for GI and II were similar i.e., UKMRC9 < Basmati < Thai red < UKMRC10 < UKMRC11 < Jasmine. Postprandial insulinaemia and IAUCins of only UKMRC9 were significantly the lowest compared to Jasmine. Crude protein and fiber content correlated negatively with the GI values of the test rice. Although peptide hormones were not associated with GI and II characteristics of test rice, early and late phases of prandial neuropeptide-Y changes were negatively correlated with postprandial insulinaemia. This study indicated that only UKMRC9 among the new rice crossbreeds could serve as an alternative cereal option to improve diet quality of Asians with its lowest glycaemic and insulinaemic burden.

Matched MeSH terms: Glycemic Index*
Socioeconomic Status and Glycemic Index Among Punjabis in Kuala Lumpur, Malaysia: Possible Association with Metabolic Syndrome

Kaur S, Yim HS, Abdul Jalil R, Mohd-Yusof BN, Jan Mohamed HJ

J Immigr Minor Health, 2018 Dec;20(6):1380-1386.
PMID: 29603090 DOI: 10.1007/s10903-018-0731-8

There are only limited reports on Punjabi's health status in Malaysia. This cross-sectional study assessed the prevalence of metabolic syndrome (Mets) and its risk factors among 277 subjects recruited from the Malaysian Punjabi community. Overall prevalence of Mets was 43%, but 61% among females. Subjects classified with Mets had significantly (p index, visceral fat and percentage of body fat. Daily carbohydrate and glycemic index (GI) were also higher among Mets subjects (p

Matched MeSH terms: Glycemic Index/physiology*
Fulltext Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus

Sangeetha-Shyam, Fatimah A, Rohana AG, Norasyikin AW, Karuthan C, Nik SS, et al.

Malays J Nutr, 2013 Apr;19(1):9-23.
PMID: 24800381 MyJurnal

Introduction: Gestational diabetes mellitus (GDM) increases risks for type 2
diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve
cardio-metabolic outcomes in insulin-resistant individuals. We examined the
feasibility of lowering GI through GI-based-education among Asian post-GDM
women. Methods: A 3-month investigation was carried out on 60 Malaysian
women with a mean age of 31.0±4.5 years and a history of GDM. Subjects were
randomised into two groups: LGIE and CHDR. The CHDR group received
conventional healthy dietary recommendations only. The LGIE group received
GI based-education in addition to conventional healthy dietary recommendations.
At baseline and after 3-months, dietary intake of energy and macronutrient
intakes including GI diet and glycaemic load was assessed using 3-day food
records. Diabetes-Diet and GI-concept scores and physical activity levels were
assessed using a questionnaire. Adherence to dietary instructions was measured
at the end of 3 months. Results: At the end of 3 months, the LGIE group had
significant reductions in energy intake (241.7±522.4Kcal, P=0.037, ES=0.463), total
carbohydrate (48.7±83.5g, P=0.010, ES=0.583), GI (3.9±7.1, P=0.017, ES=0.549) and
GL (39.0±55.3, P=0.003, ES=0.705) and significant increases in protein (3.7±5.4g,
0.003, ES=0.685) and diet fibre (4.6±7.3g, P=0.06). The CHDR group had a significant
reduction in fat only (5.7±9.4g, P=0.006, ES=0.606). There was a 30% increase in
GI-concept scores in the LGIE group (p< 0.001). Changes in GI-concept scores
correlated significantly to the reduction in dietary GI (r = -0.642, P=0.045). Dietary
adherence was comparable in both groups. Conclusion: GI-education improves
GI-concept knowledge and helps lower dietary glycaemic index among women
with a history of GDM.
Keywords: Diet, gestational diabetes mellitus, glycaemic index, glycaemic load,
prevention, type 2 diabetes

Matched MeSH terms: Glycemic Index/physiology*
Fulltext Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomized trial

Shyam S, Arshad F, Abdul Ghani R, Wahab NA, Safii NS, Nisak MY, et al.

Nutr J, 2013 May 24;12:68.
PMID: 23705645 DOI: 10.1186/1475-2891-12-68

BACKGROUND: Gestational Diabetes Mellitus (GDM) increases risks for type 2 diabetes and weight management is recommended to reduce the risk. Conventional dietary recommendations (energy-restricted, low fat) have limited success in women with previous GDM. The effect of lowering Glycaemic Index (GI) in managing glycaemic variables and body weight in women post-GDM is unknown.
OBJECTIVE: To evaluate the effects of conventional dietary recommendations administered with and without additional low-GI education, in the management of glucose tolerance and body weight in Asian women with previous GDM.
METHOD: Seventy seven Asian, non-diabetic women with previous GDM, between 20- 40y were randomised into Conventional healthy dietary recommendation (CHDR) and low GI (LGI) groups. CHDR received conventional dietary recommendations only (energy restricted, low in fat and refined sugars, high-fibre). LGI group received advice on lowering GI in addition. Fasting and 2-h post-load blood glucose after 75 g oral glucose tolerance test (2HPP) were measured at baseline and 6 months after intervention. Anthropometry and dietary intake were assessed at baseline, three and six months after intervention. The study is registered at the Malaysian National Medical Research Register (NMRR) with Research ID: 5183.
RESULTS: After 6 months, significant reductions in body weight, BMI and waist-to-hip ratio were observed only in LGI group (P<0.05). Mean BMI changes were significantly different between groups (LGI vs. CHDR: -0.6 vs. 0 kg/m2, P= 0.03). More subjects achieved weight loss ≥5% in LGI compared to CHDR group (33% vs. 8%, P=0.01). Changes in 2HPP were significantly different between groups (LGI vs. CHDR: median (IQR): -0.2(2.8) vs. +0.8 (2.0) mmol/L, P=0.025). Subjects with baseline fasting insulin≥2 μIU/ml had greater 2HPP reductions in LGI group compared to those in the CHDR group (-1.9±0.42 vs. +1.31±1.4 mmol/L, P<0.001). After 6 months, LGI group diets showed significantly lower GI (57±5 vs. 64±6, P<0.001), GL (122±33 vs. 142±35, P=0.04) and higher fibre content (17±4 vs.13±4 g, P<0.001). Caloric intakes were comparable between groups.
CONCLUSION: In women post-GDM, lowering GI of healthy diets resulted in significant improvements in glucose tolerance and body weight reduction as compared to conventional low-fat diets with similar energy prescription.

Matched MeSH terms: Glycemic Index*
Fulltext Effects of brown rice and white rice on expression of xenobiotic metabolism genes in type 2 diabetic rats

Imam MU, Ismail M

Int J Mol Sci, 2012;13(7):8597-608.
PMID: 22942722 DOI: 10.3390/ijms13078597

Xenobiotics constantly influence biological systems through several means of interaction. These interactions are disturbed in type 2 diabetes, with implications for disease outcome. We aimed to study the implications of such disturbances on type 2 diabetes and rice consumption, the results of which could affect management of the disease in developing countries. In a type 2 diabetic rat model induced through a combination of high fat diet and low dose streptozotocin injection, up-regulation of xenobiotic metabolism genes in the diabetic untreated group was observed. Xenobiotic metabolism genes were upregulated more in the white rice (WR) group than the diabetic untreated group while the brown rice (BR) group showed significantly lower expression values, though not as effective as metformin, which gave values closer to the normal non-diabetic group. The fold changes in expression in the WR group compared to the BR group for Cyp2D4, Cyp3A1, Cyp4A1, Cyp2B1, Cyp2E1, Cyp2C11, UGT2B1, ALDH1A1 and Cyp2C6 were 2.6, 2, 1.5, 4, 2.8, 1.5, 1.8, 3 and 5, respectively. Our results suggest that WR may upregulate these genes in type 2 diabetes more than BR, potentially causing faster drug metabolism, less drug efficacy and more toxicity. These results may have profound implications for rice eating populations, constituting half the world's population.

Matched MeSH terms: Glycemic Index
Fulltext The effect of dietary glycemic index and glycemic load on overweight individuals and type 2 diabetes patients: an overview of the literature

Chekima, K., Wong, B. T. Z., Ooi, Y. B. H., Ismail M. N., Tan, C. H.

Malaysian Journal of Medicine and Health Sciences, 2019;15(102):45-45.
MyJurnal

Introduction: Type 2 diabetes is increasing at an alarming rate worldwide. One of the leading factors to this condition is obesity. Low glycemic index (GI) and glycemic load (GL) diets have been proposed as lifestyle changes to address obesity, however, there is a lack of consensus on the optimal approach for weight loss, glycemic control and improving insulin sensitivity. In addition, the outcome of these diets are equivocal, with some studies suggesting beneficial outcomes and others suggesting otherwise. Furthermore, discrepant study designs have led to divergent conclusions. In order to provide a comprehensive overview of the low GI and low GL diets, a systematic review of literature on relevant observational studies and randomised control trials was performed on these databases:- The Cochrane Library, Medline, PubMed, Embase, Cinahl and Web of Science. Methods: The review was conducted based on the methodological standards for the conduct and reporting of Cochrane intervention reviews, Version 1.07, November 2018. Population, Intervention, Comparison and Outcomes (PICO) tool was used as the organising framework to define key elements of the review question. Results: Pertinent outcome variables include body weight, insulin resistance, HbA1c, fasting serum glucose, BMI, waist-to-hip ratio, triglyceride, HDL and LDL cholesterol. Our current understanding of these diets has been complicated by the reports that were based on different study designs and study populations. This review defines the issues, gaps in the research, study design, and evidence that is needed to inform practice, policy making and future research. There is also a dearth of information on the effect of low GI and GL diets on the Asian populations, specifically on improving insulin resistance. High carbohydrate diets are a mainstay of Asian societies. Conclusion: As cases of obesity and type 2 diabetes surge, there is an urgent need for research on low GI and GL dietary modifications among the Asian populations.

Matched MeSH terms: Glycemic Index
Fulltext Levels of knowledge about the glycemic index concept among women with gestational diabetes mellitus

Norfarhana Mohd Anuar, Barakatun Nisak Mohd Yusof, Farah Yasmin Hasbullah, Siti Nur’Asyura Adznam, Zuriati Ibrahim, Nor Fadhlina Zakaria, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):185-191.
MyJurnal

Introduction: Low glycemic index (GI) diet is recommended as part of medical nutrition therapy for the management of gestational diabetes mellitus (GDM). While the clinical benefits are evident, data assessing knowledge of the GI concept among women with GDM are scarce. This was a needs assessment study to determine the level of knowl- edge about the GI concept among women with GDM. Methods: Using a cross-sectional design, we included 85 women with GDM (mean age: 30.6 ± 4.0, pre-pregnancy BMI: 24.8 ± 4.1 kg/m2, gestational age: 34.0 ± 4.0 weeks) from Hospital Serdang, Malaysia. Knowledge about the GI concept was assessed using a developed questionnaire. Additional questions on GDM were assessed using Gestational Diabetes Mellitus Knowledge Questionnaire (GDM- KQ). Subjects with less than 50%, 51-74%, and more than 75% total score were categorized as having poor, fair, and good knowledge levels, respectively. Results: The mean knowledge score obtained by the subjects was 12.8 ± 3.5. More subjects scored correctly for GDM-related knowledge (68.2%). More than half (58.8%) had heard about the GI concept previously and 55.3% understood the definition of GI. The average knowledge score about the GI con- cept was 55.6%; subjects scored highest on the influence of different carbohydrates (teh tarik versus milk) on blood glucose level (87.1%). However, the majority of the subjects had fair knowledge level (62.4%). Conclusion: Women with GDM had moderate knowledge about the GI concept. Results of the needs assessment served as preliminary data for the development of a GI-based nutrition education program in Malaysia.

Matched MeSH terms: Glycemic Index
Fulltext The effect of low glycemic index bread eaten with different fillings on blood glucose response in healthy individuals

Barakatun Nisak Mohd Yusof, Ruzita Abd. Talib, Norimah A. Karim, Nor Azmi Kamarudin, Fatimah Arshad

Jurnal Sains Kesihatan Malaysia, 2008;6(1):1-10.
MyJurnal

White and whole meal breads have been classified as high glycemic index (GI) foods which in turn produce the greatest rise in blood glucose. One of the commercial bread products in Malaysia known as Brown breads (BB) has been recently marketed as a healthy choice for diabetics due to its low GI value. This study was conducted to examine the effect of BB when eaten with different fillings on blood glucose response among healthy individuals and to describe the influences of these fillings in reducing blood glucose response. Five test meals using BB (BB eaten with baked beans, BB eaten with vegetable, BB eaten with apple, BB eaten with roast chicken and BB eaten with seaweeds) had been prepared for this study. Postprandial blood glucose response was determined for each test meal and reference food (glucose) that contained 50 g carbohydrate respectively. A total of 21 healthy subjects were recruited by advertisement to participate. Only 20 subjects (15 males, 5 females, Mean + SD Age : 24.4 + 3.7 years; BMI 23.4 + 3.0 kgm-2) completed this study. After an overnight fast, subjects consumed BB eaten with fillings according to the assigned group given and three repeated tests of reference food (glucose). Fasting capillary blood glucose samples were taken at time 0 and at 15, 30, 45, 60, 90 and 120 min respectively after the meal began. The blood glucose response was obtained by calculating the incremental area under the curve (AUC). Blood glucose response after consuming reference food (251.8 + 12.1 mmol.min/L) was significantly higher than all the test meals (p < 0.05). Among the test meals, BB eaten with baked beans produced the highest rise in blood glucose (97.0 + 16.9 mmol.min/L) whereas BB eaten with seaweeds demonstrated the lowest response in blood glucose (33.3 + 6.5 mmol.min/L) and the difference was statistically significant (p < 0.05). The postprandial blood glucose response after ingestion of BB when eaten with vegetable was 73.3 + 19.1 mmol.min/L followed by BB eaten with apple (58.9 + 12.2 mmol.min/L) and BB eaten with roast chicken (56.5 + 10.1 mmol.min/L). Generally, BB when eaten with fillings produced a slow rise in blood glucose response than the reference food. Combining this BB with fillings had the effect of reducing the postprandial blood glucose further.

Matched MeSH terms: Glycemic Index
Fulltext Low-glycaemic index diet to improve dietary intake among women with gestational diabetes mellitus

Nor Azlin, M.I., Zalilah, M.S., Farhanah, A.S., Barakatun Nisak, M.Y.

Pertanika Journal of Science & Technology, 2017;25(107):31-42.
MyJurnal

This study examines the effect of a low glycaemic index (LGI) intervention to improve dietary intake among women with Gestational Diabetes Mellitus (GDM). Women with GDM were randomised to receive either a low GI intervention (LGI; n = 20) or standard nutrition therapy (SNT; n = 20) for a 4-week period. Food Frequency Questionnaire (FFQ) and Three-Day Diet Record assessed the dietary intake and food choices. Dietary intake and food choices of the participants were comparable at baseline. At the end of the study, energy, protein, fat and carbohydrate were reduced in both groups (p < 0.05). In the LGI group, fibre and calcium intake was higher compared with SNT group. More participants in
the LGI group consumed rice from the low GI varieties, the whole grain breads and the low GI biscuits (p<0.05) compared with participants in the SNT group. The diet GI reduced significantly in the LGI group (50 ± 9 units) compared with the SNT group (57 ± 6) (p < 0.05). Findings showed low GI dietary intervention improved the dietary intake of women with GDM.
Keywords: Carbohydrate, dietary intake, Gestational Diabetes Mellitus, low glycaemic index
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Glycemic Index
Fulltext Relationship between dyslipidaemia and glycaemic status in patients with Type 2 diabetes mellitus

Thambiah SC, Samsudin IN, George E, Zahari Sham SY, Lee HM, Muhamad MA, et al.

Malays J Pathol, 2016 Aug;38(2):123-30.
PMID: 27568669 MyJurnal

The risk of coronary heart disease (CHD) is dramatically increased in diabetic patients due to their atherogenic lipid profile. The severity of CHD in diabetic patients has been found to be directly associated with glycated haemoglobin (HbA1c). According to the Malaysian Clinical Practice Guidelines on diabetes mellitus (DM), HbA1c level less than 6.5% reduces the risk of microvascular and macrovascular complications. Hence, this study aimed to determine the relationship between dyslipidaemia and glycaemic status in patients with type 2 DM (T2DM) patients in Hospital Putrajaya, a tertiary endocrine centre in Malaysia. This was a cross sectional, retrospective study of 214 T2DM patients with dyslipidaemia who had visited the endocrine clinic between January 2009 and December 2012. Significant correlations were found between fasting blood glucose (FBG) and HbA1c with total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL), non-high density lipoprotein cholesterol (non-HDL), LDL/HDL ratio and TC/HDL ratio; greater correlation being with HbA1c than FBG. In patients with HbA1c ≥ 6.5%, TC, TG, non-HDL and TC/HDL ratio were significantly higher than in patients with HbA1c < 6.5%. Non-HDL, LDL/HDL ratio, TC/HDL ratio and HbA1c were significantly lower in patients on statin treatment than nontreated patients (p<0.05). This significant association between glycaemic status and dyslipidaemia emphasises the additional possible use of HbA1c as a biomarker for dyslipidaemia as well as a potential indirect predictor of cardiovascular disease (CVD) risk in T2DM patients.

Matched MeSH terms: Glycemic Index
Role of Composite Glycemic Indices: A Comparison of the Comprehensive Glucose Pentagon Across Diabetes Types and HbA1c Levels

Rama Chandran S, A Vigersky R, Thomas A, Lim LL, Ratnasingam J, Tan A, et al.

Diabetes Technol Ther, 2020 02;22(2):103-111.
PMID: 31502876 DOI: 10.1089/dia.2019.0277

Background:
Complex changes of glycemia that occur in diabetes are not fully captured by any single measure. The Comprehensive Glucose Pentagon (CGP) measures multiple aspects of glycemia to generate the prognostic glycemic risk (PGR), which constitutes the relative risk of hypoglycemia combined with long-term complications. We compare the components of CGP and PGR across type 1 and type 2 diabetes.
Methods:
Participants: n = 60 type 1 and n = 100 type 2 who underwent continuous glucose monitoring (CGM). Mean glucose, coefficient of variation (%CV), intensity of hypoglycemia (INThypo), intensity of hyperglycemia (INThyper), time out-of-range (TOR <3.9 and >10 mmol/L), and PGR were calculated. PGR (median, interquartile ranges [IQR]) for diabetes types, and HbA1c classes were compared.
Results:
While HbA1c was lower in type 1 (type 1 vs. type 2: 8.0 ± 1.6 vs. 8.6 ± 1.7, P = 0.02), CGM-derived mean glucoses were similar across both groups (P > 0.05). TOR, %CV, INThypo, and INThyper were all higher in type 1 [type 1 vs. type 2: 665 (500, 863) vs. 535 (284, 823) min/day; 39% (33, 46) vs. 29% (24, 34); 905 (205, 2951) vs. 18 (0, 349) mg/dL × min2; 42,906 (23,482, 82,120) vs. 30,166 (10,276, 57,183) mg/dL × min2, respectively, all P

Matched MeSH terms: Glycemic Index*
The role of digestive factors in determining glycemic response in a multiethnic Asian population

Tan VM, Ooi DS, Kapur J, Wu T, Chan YH, Henry CJ, et al.

Eur J Nutr, 2016 Jun;55(4):1573-81.
PMID: 26160548 DOI: 10.1007/s00394-015-0976-0

PURPOSE: There are wide inter-individual differences in glycemic response (GR). We aimed to examine key digestive parameters that influence inter-individual and ethnic differences in GR in healthy Asian individuals.
METHODS: Seventy-five healthy male subjects (25 Chinese, 25 Malays, and 25 Asian-Indians) were served equivalent available carbohydrate amounts (50 g) of jasmine rice (JR) and basmati rice (BR) on separate occasions. Postprandial blood glucose concentrations were measured at fasting (-5 and 0 min) and at 15- to 30-min interval over 180 min. Mastication parameters (number of chews per mouth and chewing time per mouthful), saliva α-amylase activity, AMY1 gene copy numbers and gastric emptying rate were measured to investigate their relationships with GR.
RESULTS: The GR for jasmine rice was significantly higher than for basmati rice (P 0.05).
CONCLUSION: Mastication parameters contribute significantly to GR. Eating slowly and having larger food boluses before swallowing (less chewing), both potentially modifiable, may be beneficial in glycemic control.

Matched MeSH terms: Glycemic Index*
Fulltext Nutritional Strategies in Prediabetes: A Scoping Review of Recent Evidence

Yau JW, Thor SM, Ramadas A

Nutrients, 2020 Sep 29;12(10).
PMID: 33003593 DOI: 10.3390/nu12102990

Nutritional therapy has been conventionally recommended for people with prediabetes as a method to delay or halt progression to type 2 diabetes. However, recommended nutritional strategies evolve over time. Hence, we performed a scoping review on recently reported nutritional interventions for individuals with prediabetes. Ovid MEDLINE, PubMed, Embase, Scopus, CINAHL and PsycINFO databases were searched to identify relevant research articles published within the past 10 years. Ninety-five articles involving a total of 11,211 participants were included in this review. Nutritional strategies were broadly classified into four groups: low calorie diet, low glycemic index diet, specific foods, and a combination of diet and exercise. The most frequently assessed outcomes were plasma glucose, serum insulin, serum lipid profile, body mass index and body weight. More than 50% of reported interventions resulted in significant improvements in these parameters. Nutritional interventions have demonstrated feasibility and practicality as an effective option for prediabetes management. However, the intervention variability demonstrates the challenges of a 'one-size-fits-all' approach. Investigations in genetically diverse populations and objective assessment of progression rate to diabetes are necessary to better comprehend the impact of these nutritional strategies in prediabetes.

Matched MeSH terms: Glycemic Index

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