Glycemic index in diabetes mellitus pathogenesis and treatment

Abstract

The incidence of type 2 diabetes mellitus is thought to be mediated by the increase of insulin resistance or by pancreatic exhaustion as a result of the increased demand for insulin. Carbohydrates intake may be involved in this process. Many metabolic studies have shown that food sources of carbohydrate vary greatly in their rate of absorption and effects on blood glucose and insulin concentrations. One way of quantifying this variation in response to dietary carbohydrate is the glycemic index. In this review, we examine evidence relating dietary glycemic index to type 2 diabetes incidence and the role of glycemic index of diet in the management of diabetes. Both metabolic and epidemiologic evidence suggests that replacing high-glycemic- index forms of carbohydrate with low-glycemicindex carbohydrates will reduce the risk of type 2 diabetes. Reducing glycemic index is also a good way to obtain good clinical results in the form of lowering the level of glycated hemoglobin, decreased incidence of hypoglycemia episodes and improving lipid profile. It is expected, that the results of the studies published in the next few years will help to precise the role of glycemic index in the pathogenesis of type 2 diabetes and the usefulness of glycemic index in nutritional treatment of diabetic patients.