The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein.

@article{citeulike:2349240, abstract = {BACKGROUND: The optimal source and amount of dietary carbohydrate for managing type 2 diabetes (T2DM) are unknown. OBJECTIVE: We aimed to compare the effects of altering the glycemic index or the amount of carbohydrate on glycated hemoglobin (HbA(1c)), plasma glucose, lipids, and C-reactive protein (CRP) in T2DM patients. DESIGN: Subjects with T2DM managed by diet alone (n = 162) were randomly assigned to receive high-carbohydrate, high-glycemic-index (high-GI), high-carbohydrate, low-glycemic-index (low-GI), or low-carbohydrate, high-monounsaturated-fat (low-CHO) diets for 1 y. RESULTS: The high-GI, low-GI, and low-CHO diets contained, respectively, 47\%, 52\%, and 39\% of energy as carbohydrate and 31\%, 27\%, and 40\% of energy as fat; they had GIs of 63, 55, and 59, respectively. Body weight and HbA(1c) did not differ significantly between diets. Fasting glucose was higher (P = 0.041), but 2-h postload glucose was lower (P = 0.010) after 12 mo of the low-GI diet. With the low-GI diet, overall mean triacylglycerol was 12\% higher and HDL cholesterol 4\% lower than with the low-CHO diet (P < 0.05), but the difference in the ratio of total to HDL cholesterol disappeared by 6 mo (time x diet interaction, P = 0.044). Overall mean CRP with the low-GI diet, 1.95 mg/L, was 30\% less than that with the high-GI diet, 2.75 mg/L (P = 0.0078); the concentration with the low-CHO diet, 2.35 mg/L, was intermediate. CONCLUSIONS: In subjects with T2DM managed by diet alone with optimal glycemic control, long-term HbA(1c) was not affected by altering the GI or the amount of dietary carbohydrate. Differences in total:HDL cholesterol among diets had disappeared by 6 mo. However, because of sustained reductions in postprandial glucose and CRP, a low-GI diet may be preferred for the dietary management of T2DM.}, address = {Departments of Nutritional Sciences and Statistics, University of Toronto, Toronto, Canada.}, author = {Wolever, T. M. and Gibbs, A. L. and Mehling, C. and Chiasson, J. L. and Connelly, P. W. and Josse, R. G. and Leiter, L. A. and Maheux, P. and Rabasa-Lhoret, R. and Rodger, N. W. and Ryan, E. A. }, citeulike-article-id = {2349240}, issn = {0002-9165}, journal = {Am J Clin Nutr}, keywords = {crp, diabetes, diet, glycemiapp}, month = {January}, number = {1}, pages = {114--125}, posted-at = {2008-02-07 14:25:11}, priority = {2}, title = {The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein.}, url = {http://www.ajcn.org/cgi/content/abstract/87/1/114}, volume = {87}, year = {2008} }

TY - JOUR ID - citeulike:2349240 L3 - citeulike-article-id:2349240 TI - The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. JF - Am J Clin Nutr VL - 87 IS - 1 SP - 114 EP - 125 AD - Departments of Nutritional Sciences and Statistics, University of Toronto, Toronto, Canada. SN - 0002-9165 N2 - BACKGROUND: The optimal source and amount of dietary carbohydrate for managing type 2 diabetes (T2DM) are unknown. OBJECTIVE: We aimed to compare the effects of altering the glycemic index or the amount of carbohydrate on glycated hemoglobin (HbA(1c)), plasma glucose, lipids, and C-reactive protein (CRP) in T2DM patients. DESIGN: Subjects with T2DM managed by diet alone (n = 162) were randomly assigned to receive high-carbohydrate, high-glycemic-index (high-GI), high-carbohydrate, low-glycemic-index (low-GI), or low-carbohydrate, high-monounsaturated-fat (low-CHO) diets for 1 y. RESULTS: The high-GI, low-GI, and low-CHO diets contained, respectively, 47%, 52%, and 39% of energy as carbohydrate and 31%, 27%, and 40% of energy as fat; they had GIs of 63, 55, and 59, respectively. Body weight and HbA(1c) did not differ significantly between diets. Fasting glucose was higher (P = 0.041), but 2-h postload glucose was lower (P = 0.010) after 12 mo of the low-GI diet. With the low-GI diet, overall mean triacylglycerol was 12% higher and HDL cholesterol 4% lower than with the low-CHO diet (P < 0.05), but the difference in the ratio of total to HDL cholesterol disappeared by 6 mo (time x diet interaction, P = 0.044). Overall mean CRP with the low-GI diet, 1.95 mg/L, was 30% less than that with the high-GI diet, 2.75 mg/L (P = 0.0078); the concentration with the low-CHO diet, 2.35 mg/L, was intermediate. CONCLUSIONS: In subjects with T2DM managed by diet alone with optimal glycemic control, long-term HbA(1c) was not affected by altering the GI or the amount of dietary carbohydrate. Differences in total:HDL cholesterol among diets had disappeared by 6 mo. However, because of sustained reductions in postprandial glucose and CRP, a low-GI diet may be preferred for the dietary management of T2DM. KW - crp KW - diabetes KW - diet KW - glycemiapp AU - Wolever, TM AU - Gibbs, AL AU - Mehling, C AU - Chiasson, JL AU - Connelly, PW AU - Josse, RG AU - Leiter, LA AU - Maheux, P AU - Rabasa-Lhoret, R AU - Rodger, NW AU - Ryan, EA PY - 2008/01// UR - http://www.ajcn.org/cgi/content/abstract/87/1/114 ER -