Effect of Quality Carbohydrates on the Prevention and Therapy of Noncommunicable Diseases: Obesity and Type 2 Diabetes

Abstract

Glycemic index (GI) is defined as "how certain meals raise blood glucose after eating, expressed as a percentage of the area under the glucose response curve when the same amount of carbohydrate was consumed as glucose or bread." Glycemic load (GL) corrects GI according to the quantity of carbohydrates ingested. Both have been related to a higher risk of developing obesity and type 2 diabetes (DM2). High GI meals have been altered to create structurally similar meals with low GI levels. Observational studies and clinical trials have been developed using subjects with DM2 and subjects with obesity undergoing bariatric surgery. It was possible to lower the GI of meals, keeping the sensory properties of the original high GI preparation. Observational studies conducted on DM2 under treatment with metformin have shown associations between GI, GL and glycated hemoglobin. However, the same has not been proven with DM2 individuals under basal insulin therapy. Another observational study in subjects with obesity undergoing bariatric surgery showed that GI affects weight loss after surgery. Regarding experimental studies, a better glucose response has been seen following low GI breakfast intake in DM2 subjects undergoing intensive insulin therapy (IIT).