Glycaemic and Insulin Response to Equi-Quantity of Selected Common Indian Staples in Individuals with Type 2 Diabetes Mellitus

Abstract

INTRODUCTIONCarbohydrate (CHO) is the most important energy producing nutrient in the daily diet, but its digestion, absorption and metabolism in the body depends on its source, types of carbohydrate, co-nutrient present in the food and processing technique.For long, selection of CHO rich food was done based on its Glycaemic Index (GI) value [1]. GI compares foods on equi-carbohydrate basis. It compares the postprandial glycaemic impact of equiquantity of carbohydrate from different test foods and standard food. Because the quantity of carbohydrate is different in different food, the total amount of food consumed to get equal quantity of CHO varies a lot. Therefore, comparison of two foods becomes difficult.Typical Indian meal is rich in CHO where staple cereals contribute almost 60% of our daily energy. But the CHO metabolism is com pletely deranged in patients with diabetes mellitus. Dietary management in diabetic patients focuses to maintain blood sugar levels close to normal. This is achieved by mainly controlling the amount and type of CHO intake.Therefore, it is important to classify food as a whole to understand their postprandial glycaemic impact. Glycaemic Index food (GI food ) , [2] is a newer concept in this regard and compares postprandial impact of whole foods, including the CHO content, with the standard food on equi-quantity basis. GI compares the quality of CHO present in the selected food, whereas GI Food compares the impact of whole food, not only the CHO content of the food. This enables to determine the suitability of whole food with lower postprandial impact. GI food values of common Indian starchy food have been analysed extensively in our laboratory and published in several peer reviewed journals [3][4][5].IAUC in response to 50 g available CHO from test food GI = × 100 IAUC in response to 50 g available CHO from standard food IAUC in response to relevant portion from test food GI FOOD = × Amount of food (50/100 g) IAUC in response to equal weight of standard food Based on GI value, the most common staple of India, rice, associated with a high GI value, is generally seen to be restricted for people with diabetes and other metabolic disorders. On the other hand, Indian flat bread i.e., chapatti, made from flour of other important staple cereal, whole wheat, is favorably consumed for its low GI value.However, several aspects of food such as the food structure, nutrient content, type of starch, type of cooking method, processing of food etc., also exert an impact over the glycaemic response of a food product and has not been accounted for, while determining the GI [3][4][5][6][7], as we do not consume CHO in isolation. Gl based on equal quantity of single nutrient as carbohydrate, may not suitable for comparing two products.Recently, number of starchy foods have been assessed for their postprandial glycaemic impact and their demand of insulin to digest the same. The present report is comparing two common staple as to which cereal has lower postprandial glycaemic impact for subjects with com...

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