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Are the glycemic and insulinemic index values of carbohydrate foods similar in healthy control, hyperinsulinemic and type 2 diabetic patients?

European Journal of Clinical Nutrition volume 65, pages 727–734 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

a criticism of glycemic index (GI) is that it does not indicate the insulin response of foods (insulinemic index, II). However, it is unknown if the GI and II values of foods are equivalent in all subjects, a necessary criterion for clinical utility. We compared GI and II values in non-diabetic subjects with fasting-serum-insulin (FSI) <40 pmol/l (healthy control) or with FSI ⩾40 pmol/l (hyper[I]) and subjects with type 2 diabetes (T2DM), and to see whether GI and II were related to the serum-glucose concentrations, insulin sensitivity, β-cell function and hepatic insulin extraction (HIE) of the subjects.

Subjects/Methods:

Serum-glucose, -insulin and -C-peptide responses after 50 g available-carbohydrate portions of glucose (tested three times by each subject), sucrose, instant mashed-potato, white-bread, polished-rice and pearled-barley were measured in healthy control (n=9), hyper[I] (n=12) and T2DM (n=10) subjects.

Results:

Food GI values did not differ significantly among the three subject groups, whereas II values were higher in T2DM (100±7) than healthy controls (78±5) and hyper[I] subjects (70±5) (mean±s.e.m., P=0.05). II was inversely associated with insulin sensitivity (r=−0.66, P<0.0001) and positively related to fasting- and postprandial-glucose (both r=0.68, P<0.0001) and HIE (r=0.62, P=0.0002). In contrast, GI was not related to any of the biomarkers (P>0.05).

Conclusion:

The GI is a valid property of foods because its value is similar in healthy control, hyper [I] and T2DM subjects, and is independent of subjects’ metabolic status. However, II may depend upon the glycaemic control, insulin sensitivity and HIE of the subjects.

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Acknowledgements

XLP designed and ran the study, collected and analyzed data, and wrote the manuscript. TMSW designed and secured funding for the study and wrote the manuscript. XLP was supported by St Michael's Hospital-Li Ka Shing Knowledge Institute Scholarship and Ontario Graduate Scholarship (OGS). The study was supported by Canadian Institute of Health Research (CIHR) operating grant MOP-79382. We thank Melissa Kwong for GLP-1 measurements and Cindy Huang, Michelle Liu for assistance with the running of the study and data entry. The study was presented in poster form at the 28th International Symposium on Diabetes and Nutrition of the Diabetes and Nutrition Study Group (DNSG) of the EASD, 1–4 July, 2010, Oslo, Norway.

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Authors and Affiliations

  1. Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Cannada

    X Lan-Pidhainy & T M S Wolever

  2. Keenan Research Center of Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Cannada

    T M S Wolever

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  1. X Lan-Pidhainy
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Correspondence to T M S Wolever.

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XLP declares no conflict of interest. TMSW is the president and part owner of Glycemic Index Laboratories Inc. and Glycemic Index Testing Inc.

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Lan-Pidhainy, X., Wolever, T. Are the glycemic and insulinemic index values of carbohydrate foods similar in healthy control, hyperinsulinemic and type 2 diabetic patients?. Eur J Clin Nutr 65, 727–734 (2011). https://doi.org/10.1038/ejcn.2011.28

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