Diet and Glycemic Index in Children with Type 1 Diabetes

Abstract

In children with type 1 diabetes, a healthy lifestyle is important to control postprandial glycemia and to avoid hyperglycemic peaks that worsen the inflammatory state of vessels and tissues. Glycemic index and glycemic load are two important indexes which assess the quality and quantity of foods consumed during meals. The main macronutrients of the diet have a different effect on postprandial blood glucose levels, so it is important that diabetic children consume foods which determine a slower and steadier glycemic peak. In this review, we present the results of the most recent studies carried out in the pediatric population with T1D, whose aim was to analyze the effects of low-glycemic-index foods on glycemic control. The results are promising and demonstrate that diets promoting low-glycemic-index foods guarantee a greater glycemic stability with a reduction in postprandial hyperglycemic peaks. However, one of the main limitations is represented by the poor adherence of children to a healthy diet. In order to obtain satisfactory results, a possibility might be to ensure a balanced intake of low-, moderate- and high-glycemic-index foods, preferring those with a low glycemic index and limiting the consumption of the high- and moderate-glycemic-index types.

Super Bolus—A Remedy for a High Glycemic Index Meal in Children with Type 1 Diabetes on Insulin Pump Therapy?—A Randomized, Double-Blind, Controlled Trial

“…Postprandial hyperglycemia (PPH) is highly prevalent among people with type 1 diabetes (T1D). High glycemic index (h-GI) meals are mainly responsible for PPH; thus, many clinical practice guidelines recommend a low glycemic index (l-GI) diet for people with T1D [ 1 , 2 , 3 ]. L-GI patterns are associated with improved glycemic control as well as reduced cardiometabolic risk [ 4 ].…”

“…A poor adherence to a healthy diet is an everyday struggle and a difficult part of diabetes management among children [ 3 ]. Low-carbohydrate or ketogenic diets have recently become very popular because they ease the glycemic spikes, and provide greater glycemic stability and lower HbA1c values [ 3 ].…”

“…A poor adherence to a healthy diet is an everyday struggle and a difficult part of diabetes management among children [ 3 ]. Low-carbohydrate or ketogenic diets have recently become very popular because they ease the glycemic spikes, and provide greater glycemic stability and lower HbA1c values [ 3 ]. Despite the positive effects, the International Society for Pediatric and Adolescent Diabetes (ISPAD) do not recommend these types of diets for children because they are potentially inadequately nourished and may lead to growth and pubertal problems [ 1 , 3 ].…”

“…Low-carbohydrate or ketogenic diets have recently become very popular because they ease the glycemic spikes, and provide greater glycemic stability and lower HbA1c values [ 3 ]. Despite the positive effects, the International Society for Pediatric and Adolescent Diabetes (ISPAD) do not recommend these types of diets for children because they are potentially inadequately nourished and may lead to growth and pubertal problems [ 1 , 3 ]. The possible strategy in this group is not to exclude the h-GI carbohydrates from the diet but to properly balance the consumption of h-GI and l-GI meals [ 3 ].…”

Effects of Dietary Carbohydrate Concentration and Glycemic Index on Blood Glucose Variability and Free Fatty Acids in Individuals with Type 1 Diabetes

“…In adults with T1DM, low-CHO diets reduced postprandial hyperglycemia, improved glycated hemoglobin (HbA1c), increased the time in interval, and reduced the risk of hypoglycemia due to reduced insulin requirements [4]. Studies wherein meal skipping was avoided and a balanced macronutrient intake was realized reported that better metabolic control was achieved and glycemic control was improved [5,6]; therefore, individuals with diabetes should consume foods that set a slower and more stable glycemic peak [7]. Moreover, the recommendation for individuals using continuous glucose monitoring is to spend >70% of the time with sensor glucose values in the range (TIR) (3.9-10.0 mmol/L), <25% of the time above the range (TAR) (>10.0 mmol/L), and <4% of the time below the range (TBR) (<3.9 mmol/L) [8].…”