Glycemic index in the diet of European outpatients with type 1 diabetes: relations to glycated hemoglobin and serum lipids

Background: Little is known about the Variation of the glycemic index (GI) in the diet of European outpatients with type 1 diabetes and how the GI of a commonly consumed diet is associated with metabolic control. Objective: The present study examined the calculated dietary GI of European outpatients with type 1 diabetes for possible relations to glycated hemogl obin (Hb A(1c)) and serum lipid concentrations. Design: The relation of the GI (calculated from a 3-d dietary record) to Hb A(1c), serum cholesterol (total, LDL, and HDL), and fasting triacylglycero l was analyzed in 2810 people with type I diabetes from the EURODIAB Compli cations Study. Results: The GT was independently related to Hb A(1c) (P = 0.0001). Compare d with the highest GI quartile (median GI: 89), adjusted Hb A(1c) in the lo west GI quartile (median GI: 75) was 11% lower in patients from southern Eu ropean centers and 6% lower in patients from northern, western, and eastern European centers. Of the serum lipids, only the HDL cholesterol in patient s from these European centers was independently related to the GI (P = 0.00 2). In southern European centers, the consumption of pasta, temperate-clima te fruit, white bread, and potatoes largely determined the patients' dietar y GI, whereas in the northern, western, and eastern European centers, consu mption of bread, potatoes, and temperate-climate fruit was most relevant. Conclusions: This study in European patients with type 1 diabetes showed th ar a lower dietary GI is related to lower Hb A(1c) concentrations, independ ently of fiber intake. The consumption of bread and pasta had the biggest e ffect on the overall dietary GI of European outpatients.