The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes

Diabetes Care. 2001 Jul;24(7):1137-43. doi: 10.2337/diacare.24.7.1137.


Objective: To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes.

Research design and methods: Children with type 1 diabetes (n = 104) were recruited to a prospective, stratified, randomized, parallel study to examine the effects of a measured carbohydrate exchange (CHOx) diet versus a more flexible low-glycemic index (GI) dietary regimen on HbA(1c) levels, incidence of hypo- and hyperglycemia, insulin dose, dietary intake, and measures of quality of life over 12 months.

Results: At 12 months, children in the low-GI group had significantly better HbA(1c) levels than those in the CHOx group (8.05 +/- 0.95 vs. 8.61 +/- 1.37%, P = 0.05). Rates of excessive hyperglycemia (>15 episodes per month) were significantly lower in the low-GI group (35 vs. 66%, P = 0.006). There were no differences in insulin dose, hypoglycemic episodes, or dietary composition. The low-GI dietary regimen was associated with better quality of life for both children and parents.

Conclusions: Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA(1c) levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Blood Glucose / metabolism*
  • Child
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / diet therapy*
  • Diabetes Mellitus, Type 1 / rehabilitation
  • Diet, Diabetic*
  • Dietary Carbohydrates / classification*
  • Energy Intake
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Humans
  • Hyperglycemia / epidemiology
  • Hypoglycemia / epidemiology
  • Incidence
  • Male
  • Occupations
  • Parents / education
  • Patient Education as Topic*
  • Prospective Studies
  • Quality of Life*
  • Research Design
  • Socioeconomic Factors
  • Time Factors


  • Blood Glucose
  • Dietary Carbohydrates
  • Glycated Hemoglobin A