Effects of Varying Carbohydrate Content of Diet in Patients With Non—Insulin-Dependent Diabetes Mellitus

Garg, Abhimanyu; Bantle, John P.; Henry, Robert R.; Coulston, Ann M.; Griver, Kay; Raatz, Susan K.; Brinkley, Linda; Chen, Y-D. Ida; Grundy, Scott M.; Huet, B.; Reaven, Gerald M.

doi:10.1001/jama.1994.03510420053034

Cited by 298 publications

(46 citation statements)

References 49 publications

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“…The postprandial insulin area was greater following the addition of a saturated fat (butter) to a meal relative to the addition of a MUFA (olive oil) in adults with type 2 diabetes [29]. Similarly, postprandial glucose and insulin levels were reduced in type 2 diabetic patients fed a high-MUFA diet relative to a highcarbohydrate diet [30]. However, in subjects with impaired glucose tolerance, a high-MUFA diet fed for 8 weeks did not improve insulin sensitivity [31].…”

Section: Fatty Acid Saturation and Insulin Resistancementioning

confidence: 99%

The influence of dietary fat on insulin resistance

Lovejoy

2002

Curr Diab Rep

126

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Dietary fat has been implicated in the development of insulin resistance in both animals and humans. Most, although not all, studies suggest that higher levels of total fat in the diet result in greater whole-body insulin resistance. Although, in practice, obesity may complicate the relationship between fat intake and insulin resistance, clinical trials demonstrate that high levels of dietary fat can impair insulin sensitivity independent of body weight changes. In addition, it appears that different types of fat have different effects on insulin action. Saturated and certain monounsaturated fats have been implicated in causing insulin resistance, whereas polyunsaturated and omega-3 fatty acids largely do not appear to have adverse effects on insulin action. Given the importance of insulin resistance in the development of diabetes and heart disease, establishing appropriate levels of fat in the diet is an important clinical goal.

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Section: Fatty Acid Saturation and Insulin Resistancementioning

confidence: 99%

The influence of dietary fat on insulin resistance

Lovejoy

2002

Curr Diab Rep

126

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“…In 2002, the ADA also recommended modest carbohydrate restriction (35% to 40% of kilocalories [kcal]) for GDM [4•]. This recommendation was based on limited observational evidence that high carbohydrate levels (55% compared to 40% of total energy) may be associated with deterioration in glycemic control, and accentuation of hyperinsulinemia among persons with type 2 diabetes [28] as well as pregnant women with GDM [29,30]. (7) BMI-body mass index.…”

Section: Energy and Carbohydrate Levelsmentioning

confidence: 99%

Gestational diabetes and nutritional recommendations

Gunderson

2004

Curr Diab Rep

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The goals of medical nutrition therapy for gestational diabetes mellitus (GDM) are to meet the maternal and fetal nutritional needs, as well as to achieve and maintain optimal glycemic control. Nutrition requirements during pregnancy are similar for women with and without GDM. The American Diabetes Association and the American College of Obstetrics and Gynecology recommend nutrition therapy for GDM that emphasizes food choices to promote appropriate weight gain and normoglycemia without ketonuria, and moderate energy restriction for obese women. Current controversies in GDM nutrition therapy involve manipulation of dietary composition (amounts and types of carbohydrates and fats), gestational weight gain, and energy and carbohydrate restriction. Randomized controlled trials are needed to determine which dietary compositions and patterns promote normoglycemia as well as optimal maternal and infant outcomes. Until better evidence is available, nutrition therapy will remain a cornerstone of GDM management with potential benefits that cannot be fully realized in clinical practice.

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“…Substitution of energy from saturated fat with that from carbohydrate or cis monounsaturated fat will result in similar reductions in serum LDL cholesterol [7]. However, the cis monounsaturated fat diet may be more advantageous for patients with diabetes mellitus [8]. A recent meta-analysis from our center evaluated randomized, crossover trials comparing high cis monounsaturated fat and high-carbohydrate diets [9].…”

Section: Reduction In Saturated Fat and Trans Monounsaturated Fat Intakementioning

confidence: 99%