(1) There is a large bulk of evidence that using low GI foods has a greatly significant impact on the amelioration of the metabolic disturbances observed in diabetic and/or hyperlipidemic patients and in subjects affected by the metabolic syndrome. Studies showing convincing evidence against this concept are very rare if any.
(2) Improvement is observed not only of postprandial blood glucose and insulin variations but also of circulating plasma lipid levels and of the morphology and function of adipocytes.
(3) Using the concept of low GI foods in the diet counseling of diabetic patients does not exclude other measures to improve postprandial and overall blood glucose control. On the contrary, the use of low GI foods should be considered as one among other means and tools available to improve diabetes control (such as other dietary modifications, and use of specific and nonspecific drug therapies altering postprandial blood glucose). Among these therapies, the most promising ones are a-glucosidase inhibitors, glinides, rapid insulin analogues and in the near future GLP-1 analogues. Again, all these classes of drugs could be associated with one another in order to obtain a postprandial delta excursion target not below 20 and not above 40-50 mg/dl blood glucose.
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