JAMA: 2008-12-17, Vol. 300, No. 23, Author in the Room™ Audio Interview

Interview with David J.A. Jenkins, MD, PhD, author of Effect of a Low Glycemic Index or a High Cereal Fiber Diet on Type 2 Diabetes: A Randomized Trial. Summary Points: 1. Drugs such as the a–glucosidase inhibitor acarbose, which reduces the rate of digestion and absorption of carbohydrate and so flattens the post prandial glycemic response, have been shown to improve diabetes control, reduce the risk of developing hypertension, and lower the risk for cardiovascular disease. 2. Can a selection of more slowly digested carbohydrate foods achieve qualitatively similar benefits to drugs? Current data suggest that selection of diets containing low–glycemic intake foods have modest benefits in reducing glycated hemoglobin A1c even in patients with type 2 diabetes treated with 1 to 3 antihyperglycemic medications. 3. Foods with a low glycemic index include many traditional study foods such as dried peas, beans, lentils, intact-grain breads, pasta, oats, barley, parboiled rice, and temperate-climate fruits and berries. Low–glycemic index starchy foods are digested less readily in vitro. 4. Other effects include a tendency for higher high-density lipoprotein cholesterol levels, lower C-reactive protein values, and greater weight loss in the per-protocol completers, ie, those who completed the study with no change in medications.