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Vol. 49. Núm. 7.
Páginas 232-239 (agosto 2002)
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Vol. 49. Núm. 7.
Páginas 232-239 (agosto 2002)
Acceso a texto completo
Índice glucémico y tratamiento nutricional de las personas con diabetes mellitus
Glycemic Index And Nutritional Treatment In Persons With Diabetes
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L.G. Romero, A.L. Charro, A.L. Calle-Pascual
Autor para correspondencia
acalle@hcsc.insalud.es

Correspondencia: Dr. A.L. Calle-Pascual. Servicio de Endocrinología y Nutrición 1.a S. Hospital Clínico San Carlos. Prof. Martín Lagos, s/n. 28040 Madrid
Servicio de Endocrinología y Nutrición. Hospital Clínico San Carlos. Madrid
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Desde hace más de 20 años ha existido interés en analizar los niveles posprandiales de glucosa después de la ingestión de alimentos ricos en carbohidratos. El objetivo de estos análisis era realizar un listado de alimentos ordenados en función de la respuesta glucémica posprandial. Este parámetro se denominó índice glucémico, que Jenkins definió como la relación entre el área bajo la curva de la respuesta glucémica posprandial producida por la ingestión de 50 g de carbohidratos suministrados por un alimento concreto y un alimento patrón (glucosa o pan), y multiplicado por 100. En teoría, la elección de alimentos con bajo índice glucémico podría ser útil para el tratamiento nutricional de la persona con diabetes. Sin embargo, la utilidad de dicho índice ha sido cuestionada recientemente. Los trabajos disponibles en la actualidad no demuestran ningún beneficio sobre el control de la diabetes en personas con diabetes tipo 1 o tipo 2 cuando reciben alimentos con bajo índice glucémico en comparación con los de alto índice glucémico. El tratamiento nutricional de la persona con diabetes debe basarse en su alimentación habitual y debe utilizarse como la base del tratamiento farmacológico y su estilo de vida. Desde el punto de vista clínico, debe considerarse prioritario seleccionar los alimentos por su contenido en carbohidratos más que por su índice glucémico. En esta revisión analizamos la utilidad del índice glucémico desde la perspectiva de la medicina basada en la evidencia.

Palabras clave:
Índice glucémico
Glucemia posprandial
Diabetes mellitus

For the past twenty years, there has been interest in determining postprandial blood glucose concentrations after the ingestion of carbohydrate-rich foods. The purpose of these determinations was to systematically rank foods according to their quantitative effect on postmeal glucose concentrations. A common way of calculating this was to determine the glycemic index. This index was defined by Jenkins as the area under the glucose curve after a 50 g carbohydrate meal divided by the area under the glucose curve after a meal consisting of a standard reference food (glucose or bread) containing 50 g carbohydrate, multiplied by 100. Theoretically, the ingestion of foods with a low glycemic index could be useful in the dietary management of diabetes mellitus. Recently, the validity and clinical utility of the glycemic index has been called into question. Currently available studies that compared low glycemic index diets with high glycemic index diets showed no benefit in diabetes control in persons with both type 1 and type 2 diabetes mellitus. A meal plan based on the individual's usual food intake should be used as the basis for integrating insulin or oral agent therapy into the usual eating and exercise patterns. From a clinical perspective, the first priority should be given to the total amount of carbohydrate consumed rather than the source of the carbohydrate or its glycemic index. This review analyzes the utility of the glycemic index from the perspective of evidence-based medicine.

Key words:
Glycemic index
Postprandial glycemia
Diabetes mellitus
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Copyright © 2002. Sociedad Española de Endocrinología y Nutrición
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