Vetter D, Brogard J M, Blicklé J F, Paris-Bockel D, Dorner M
Rev Med Interne. 1986 Nov;7(5):529-35. doi: 10.1016/s0248-8663(86)80050-9.
The last decade has witnessed drastic changes in our views on diet for diabetics, whether insulin-dependent or not. To bring blood glucose levels down to normal values, thereby preventing diabetic microangiopathy or alleviating its course, remains the compelling purpose of treatment, but the modalities and constraints of the dietetic measures which contribute to this result have been radically revised. Leaving aside fashions and controversies, three tendencies have emerged: the low carbohydrate diet does not improve the glycaemic balance but implies an excessive fat intake which may aggravate the microangiopathy. Of course, an hypocaloric diet remains fundamental in the management of obese non-insulin dependent diabetics; the effects on glycaemia of the carbohydrate ration constituents must be reconsidered. The classical distinction between "fast" and "slow" sugars seems to be excessive and insufficient, if not erroneous. Food replacements must take into account the glycaemic index; a minimal dietary fibre intake has a favourable effect on post-prandial glycaemia and lipid metabolism and is to be recommended, notably to diabetics.
在过去十年里，我们对糖尿病患者饮食的看法发生了巨大变化，无论患者是否依赖胰岛素。将血糖水平降至正常范围，从而预防糖尿病微血管病变或缓解其病程，仍然是治疗的迫切目标，但有助于实现这一目标的饮食措施的方式和限制已被彻底修订。撇开时尚潮流和争议不谈，出现了三种趋势：低碳水化合物饮食并不能改善血糖平衡，但意味着脂肪摄入过多，这可能会加重微血管病变。当然，低热量饮食在肥胖的非胰岛素依赖型糖尿病患者的管理中仍然至关重要；必须重新考虑碳水化合物定量成分对血糖的影响。“快速”糖和“慢速”糖之间的经典区分似乎过于绝对且并不充分，甚至可能是错误的。食物替代必须考虑血糖生成指数；最低限度的膳食纤维摄入量对餐后血糖和脂质代谢有有利影响，值得推荐，尤其是对糖尿病患者。
