Blood-Glucose Control Of Diabetic Children Eating Un-Refined (U) Or Refined (R), High-Carbohydrate Diets

Increasing the proportion of carbohydrate in diabetic diets may improve diabetic control in adults, but it is unclear whether this is due to the amount or type of carbohydrate eaten. A randomised crossover outpatient study was performed on 6 diabetic children to compare the effect of eating unrefined or refined high carbohydrate diets (50-55%C) from acceptable food sources, on blood glucose control. The unrefined diet used wholefoods such as beans and wholemeal bread (mean fibre:energy ratio 3:100), and the refined diet used processed foods such as white bread (mean fibre:energy ratio 1:100). The diets were individualised and were isocaloric for carbohydrate, lat, and protein. Diabetic control was assessed by daily urinalysis for glucose, home blood glucose monitoring (Ames;Eyetone) and fortnightly estimations of glycosylated haemoglobin. After 6 weeks on each diet, morning metabolic profiles, and 24-hour capillary blood and urinary glucose measurements were taken at home. The levels of blood glucose and b-hydroxybutyrate from the morning profiles, and the capillary blood and urinary glucose measurements from the 24-hour profiles were all lower on the unrefined diet. Mean blood glucose levels (mmo1/L±SEM) were; fasting 6.5±1.3 (U), 8.5±2.3 (R), peak (post breakfast) 13±2.6 (U), 17.3±1.6 (R), midday 6.2±0.7 (U),12.14 ± 1.2* (R). Mean 24-hour urinary glucose was; 14.4±5 gm (U) 53.8±21.7 gm (R)*. The use of whole foods high in dietary fibre can improve glycaemic control of diabetic children on liberal carbohydrate diets.