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    The Effect of Glycemic Index and Glycemic Load on Glucose Control, Lipid Profiles and Anthropometrics Among Low-Income Latinos With Type 2 Diabetes: A Dissertation

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    Authors
    Gellar, Lauren A.
    Faculty Advisor
    Dr. Lori Pbert
    Academic Program
    Clinical and Population Health Research
    UMass Chan Affiliations
    Quantitative Health Sciences
    Document Type
    Doctoral Dissertation
    Publication Date
    2011-03-30
    Keywords
    Diabetes Mellitus
    Type 2
    Hispanic Americans
    Glycemic Index
    Blood Glucose
    Lipoproteins
    Anthropometry
    Amino Acids, Peptides, and Proteins
    Carbohydrates
    Community Health and Preventive Medicine
    Diagnosis
    Endocrine System Diseases
    Endocrinology, Diabetes, and Metabolism
    Environmental Public Health
    Epidemiology
    Health Services Research
    Investigative Techniques
    Lipids
    Nutritional and Metabolic Diseases
    Race and Ethnicity
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    Abstract
    Background The incidence of type 2 diabetes has increased dramatically, particularly among Latinos. While several studies suggest the beneficial effect of lowering glycemic index and glycemic load in patients with type 2 diabetes, no data exists regarding this issue in the Latino population. The purpose of this study was to determine the effect of lowering glycemic index and glycemic load on diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes. Methods Subjects participated in a 12 month randomized clinical trial. The intervention targeted diabetes knowledge, attitudes and behavioral capabilities related to diabetes self management with content including nutrition and physical activity. The nutrition protocol emphasized reduction in glycemic index, fat, salt and portion size and increase in fiber. The control group was given usual care. Measurements included Hba1c, fasting glucose, total cholesterol (TC), low density lipoproteins (LDL) and high density lipoproteins (HDL), HDL:LDL ratio, TC:HDL ratio, waist circumference and BMI and were collected at baseline, 4 and 12-months. Results Two hundred fifty two Latino adults with type 2 diabetes participated in the study. Baseline mean HbA1C was 8.98% (SD=1.87), BMI was 34.76 kg/cm (SD=6.94), age was 56 (SD=11.18) years and 76% were female. Reduction in glycemic index was positively associated with a reduction in logHbA1c (p=0.006), HDL:LDL ratio (p=0.037) and waist circumference (p=0.003) overtime, but not with fasting glucose, TC, LDL and HDL, TC:HDL ratio, body weight or BMI. No significant associations were found between glycemic load and any measures. Conclusion Results suggest that lowering glycemic index may have a positive effect on some markers of diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes, but not others. While statistically significant reductions in GI and GL were noted, the actual reduction was small. Thus, greater reduction in GI and GL may be needed for clinical significance and greater effect on metabolic outcomes. Future research should target populations with higher baseline GI and GL.
    DOI
    10.13028/zytb-hn96
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/31860
    Rights
    Copyright is held by the author, with all rights reserved.
    ae974a485f413a2113503eed53cd6c53
    10.13028/zytb-hn96
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