Hermansen Marie-Louise F, Eriksen Nina M B, Mortensen Lene S, Holm Lotte, Hermansen Kjeld
Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus Sygehus THG, Tage-Hansens Gade 2, DK-8000 Aarhus C, Denmark.
Rev Diabet Stud. 2006 Summer;3(2):61-71. doi: 10.1900/RDS.2006.3.61. Epub 2006 Aug 10.
The large increase in type 2 diabetes (T2DM), the considerable lifetime risk of diabetes and the loss of lifetime call for concerted action to prevent T2DM and its complications. Since diabetes is characterized by abnormal glucose metabolism, the question arises of whether a high intake of carbohydrates that are rapidly absorbed as glucose may increase the risk and worsen the course of T2DM. To quantify the impact of carbohydrates on blood glucose the glycemic index (GI) and the glycemic load (GL) have been applied. The GI of a food is a method of ranking carbohydrate rich foods according to their glycemic responses. GI is defined as the incremental area under the blood glucose curve of 50g carbohydrate of a test food expressed as a percentage of the area of the response to an equivalent amount of a reference food (glucose or white bread). In relation to GI/GL and prevention of T2DM there is insufficient information from observational studies to determine whether a positive association exists or not. Only randomized controlled clinical intervention studies will be able to provide the final answer. From meta-analyses of randomised controlled clinical trials comparing low and high GI diets in the treatment of diabetes it has been found that low GI diets improve the glycemic control. Labeling of foods with GI would be helpful for persons with diabetes, but the usefulness for healthy subjects remains to be clarified. At present it seems premature to introduce GI labeling for the entire population.
2型糖尿病（T2DM）的大幅增加、糖尿病相当高的终生患病风险以及寿命的缩短，都需要采取一致行动来预防T2DM及其并发症。由于糖尿病的特征是葡萄糖代谢异常，因此就出现了一个问题，即大量摄入能迅速被吸收为葡萄糖的碳水化合物是否会增加T2DM的风险并使病情恶化。为了量化碳水化合物对血糖的影响，人们采用了血糖生成指数（GI）和血糖负荷（GL）。食物的GI是根据富含碳水化合物食物的血糖反应对其进行排名的一种方法。GI的定义是，测试食物中50克碳水化合物的血糖曲线下增量面积，以等量参考食物（葡萄糖或白面包）反应面积的百分比表示。关于GI/GL与预防T2DM，观察性研究提供的信息不足，无法确定是否存在正相关关系。只有随机对照临床干预研究才能给出最终答案。从比较低GI饮食和高GI饮食治疗糖尿病的随机对照临床试验的荟萃分析中发现，低GI饮食可改善血糖控制。用GI对食物进行标注对糖尿病患者会有帮助，但对健康受试者的有用性仍有待阐明。目前，对全体人群采用GI标注似乎为时过早。
