Original Research

It is the glycaemic response to, not the carbohydrate content of food that matters in diabetes and obesity: The glycaemic index revisited

David Unwin, David Haslam, Geoffrey Livesey
Journal of Metabolic Health | Journal of Insulin Resistance: Vol 1, No 1, | a8 | DOI: https://doi.org/10.4102/jir.v1i1.8 | © 2016 David Unwin, David Haslam, Geoffrey Livesey | This work is licensed under CC Attribution 4.0
Submitted: 18 April 2016 | Published: 19 August 2016

About the author(s)

David Unwin, General Practice, Norwood Surgery, United Kingdom
David Haslam, Chair National Obesity Forum, Luton University Hospital, United Kingdom
Geoffrey Livesey, Royal Society of Medicine, United Kingdom


Background: The low-carbohydrate diet for diabetes and obesity is over 200 years old. A new lease of life comes with evidence for its beneficial effects supplied by research into the value of low-glycaemic index (GI) foods in diabetes control. While trialling this approach it became evident that professionals and patients had previously misunderstood the index leading to
errors in food choices.
Aim: To explore the importance of the GI for those with T2D and improve understanding of the likely effect of various foods on blood glucose.
Setting: A 9000 patient United Kingdom (UK) primary care practice.
Methods: Relevant supporting studies were examined and data were reviewed from a
previously published case-series with new data relating to the effect of the approach on the whole practice over a period of three years. An improved interpretation of the GI using a ‘teaspoons of sugar equivalent’ was developed as an aide to understanding. We looked at quality markers for diabetes and obesity such as HbA1c and weight.
Results: Our approach was readily understood by patients and staff, helping to achieve significant improvements in diabetes control and weight. The practice as a whole compared to the average for the area was found to have; a significantly better quality of diabetes control, lower obesity prevalence whilst spending around £40 000 less per year on drugs for diabetes.
Conclusion: Greater consideration needs to be given to the harmful effects of high-GI starchy foods in the treatment and prevention of obesity and diabetes. Patient compliance and outcomes justify our approach in a primary care setting.


low-glycaemic index; obesity; low-carbohydrate diet; diabetes


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