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. 1982 Mar;57(3):187–194. doi: 10.1136/adc.57.3.187

Whole foods and increased dietary fibre improve blood glucose control in diabetic children.

A L Kinmonth, R M Angus, P A Jenkins, M A Smith, J D Baum
PMCID: PMC1627610  PMID: 6280621

Abstract

In prescribing a diabetic diet more attention has traditionally been paid to the amount of dietary carbohydrate than to its type or structure. We have compared the effect on blood glucose of substituting unrefined, whole foods for refined, processed foods in liberal carbohydrate diets (50-55% of dietary energy) eaten by 10 diabetic children in a randomised crossover study. All measurements were made at home. The unrefined diet used whole foods (including) dried beans) supplying 60 g/day of dietary fibre. The refined diet used processed foods supplying 20 g/day of dietary fibre. Diets were isocaloric for carbohydrate, fat, and protein. Glycaemic control was assessed by daily urine analysis for glucose, home blood glucose measurements, glycosylated haemoglobin, and by a 24-hour profile of blood and urinary glucose carried out at home after 6 weeks on each diet. Glycaemic control was significantly better on the unrefined diet. On profile days mean blood glucose levels on the unrefined and refined diets respectively were: preprandial: 5.5 and 8.4 mmol/l; postprandial 8.5 and 12.2 mmol/l. The mean 24-hour urinary glucose excretion on the unrefined diet was 9.3 g and on the refined diet was 38.0 g. Six months after the study the children were eating appreciably more dietary fibre than before (mean increase 13.6 g/day). Attention to food type and structure can improve blood glucose control in diabetic children and should provide an acceptable and more rational basis for dietary prescription than one based on carbohydrate quantity alone.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albano J. D., Ekins R. P., Maritz G., Turner R. C. A sensitive, precise radioimmunoassay of serum insulin relying on charcoal separation of bound and free hormone moieties. Acta Endocrinol (Copenh) 1972 Jul;70(3):487–509. doi: 10.1530/acta.0.0700487. [DOI] [PubMed] [Google Scholar]
  2. Bingham S., Cummings J. H., McNeil N. I. Intakes and sources of dietary fiber in the British population. Am J Clin Nutr. 1979 Jun;32(6):1313–1319. doi: 10.1093/ajcn/32.6.1313. [DOI] [PubMed] [Google Scholar]
  3. Coulston A., Greenfield M., Kraemer F., Tobey T., Reaven G. Effect of source of dietary carbohydrate on plasma glucose and insulin responses to test meals in normal subjects. Am J Clin Nutr. 1980 Jun;33(6):1279–1282. doi: 10.1093/ajcn/33.6.1279. [DOI] [PubMed] [Google Scholar]
  4. Deckert T., Poulsen J. E., Larsen M. Prognosis of diabetics with diabetes onset before the age of thirty-one. I. Survival, causes of death, and complications. Diabetologia. 1978 Jun;14(6):363–370. doi: 10.1007/BF01228130. [DOI] [PubMed] [Google Scholar]
  5. Goulder T. J., Alberti K. G. Dietary fibre and diabetes. Diabetologia. 1978 Oct;15(4):285–287. doi: 10.1007/BF02573820. [DOI] [PubMed] [Google Scholar]
  6. Haber G. B., Heaton K. W., Murphy D., Burroughs L. F. Depletion and disruption of dietary fibre. Effects on satiety, plasma-glucose, and serum-insulin. Lancet. 1977 Oct 1;2(8040):679–682. doi: 10.1016/s0140-6736(77)90494-9. [DOI] [PubMed] [Google Scholar]
  7. Jenkins D. J., Wolever T. M., Leeds A. R., Gassull M. A., Haisman P., Dilawari J., Goff D. V., Metz G. L., Alberti K. G. Dietary fibres, fibre analogues, and glucose tolerance: importance of viscosity. Br Med J. 1978 May 27;1(6124):1392–1394. doi: 10.1136/bmj.1.6124.1392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Jenkins D. J., Wolever T. M., Taylor R. H., Barker H. M., Fielden H. Exceptionally low blood glucose response to dried beans: comparison with other carbohydrate foods. Br Med J. 1980 Aug 30;281(6240):578–580. doi: 10.1136/bmj.281.6240.578. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kiehm T. G., Anderson J. W., Ward K. Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men. Am J Clin Nutr. 1976 Aug;29(8):895–899. doi: 10.1093/ajcn/29.8.895. [DOI] [PubMed] [Google Scholar]
  10. Kinmonth A. L., Baum J. D. Timing of pre-breakfast insulin injection and postprandial metabolic control in diabetic children. Br Med J. 1980 Mar 1;280(6214):604–606. doi: 10.1136/bmj.280.6214.604. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kuzuya H., Blix P. M., Horwitz D. L., Steiner D. F., Rubenstein A. H. Determination of free and total insulin and C-peptide in insulin-treated diabetics. Diabetes. 1977 Jan;26(1):22–29. doi: 10.2337/diab.26.1.22. [DOI] [PubMed] [Google Scholar]
  12. Miranda P. M., Horwitz D. L. High-fiber diets in the treatment of diabetes mellitus. Ann Intern Med. 1978 Apr;88(4):482–486. doi: 10.7326/0003-4819-88-4-482. [DOI] [PubMed] [Google Scholar]
  13. Rivellese A., Riccardi G., Giacco A., Pacioni D., Genovese S., Mattioli P. L., Mancini M. Effect of dietary fibre on glucose control and serum lipoproteins in diabetic patients. Lancet. 1980 Aug 30;2(8192):447–450. doi: 10.1016/s0140-6736(80)91886-3. [DOI] [PubMed] [Google Scholar]
  14. SCHLICHTKRULL J., MUNCK O., JERSILD M. THE M-VALVE, AN INDEX OF BLOOD-SUGAR CONTROL IN DIABETICS. Acta Med Scand. 1965 Jan;177:95–102. doi: 10.1111/j.0954-6820.1965.tb01810.x. [DOI] [PubMed] [Google Scholar]
  15. Simpson H. C., Simpson R. W., Lousley S., Carter R. D., Geekie M., Hockaday T. D., Mann J. I. A high carbohydrate leguminous fibre diet improves all aspects of diabetic control. Lancet. 1981 Jan 3;1(8210):1–5. doi: 10.1016/s0140-6736(81)90112-4. [DOI] [PubMed] [Google Scholar]
  16. Welch S. G., Boucher B. J. A rapid micro-scale method for the measurement of Haemoglobin A1(a+b+c). Diabetologia. 1978 Mar;14(3):209–211. doi: 10.1007/BF00429782. [DOI] [PubMed] [Google Scholar]

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