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The challenges in the management of diabetic patients are not few, requiring constant efforts live patient and live health professional for the best treatment outcome, which is focused on lifestyle changes and medication use.
An important component of this clinical management is the live analysis of the dietary profile in these patients, a relevant issue and less prominent than the evolution or creation of new pharmacological therapies.
With this perspective in mind, a recent systematic review and meta-analysis of randomized clinical trials was performed by British Scientific Journal, aiming at the impact of a diet consisting of foods with low glycemic index and load (GI and GL) on glycated hemoglobin values and other markers of glycemic control, in addition to relevant factors of cardiometabolic outcomes such as lipid profile, adiposity, pressure arterial and inflammation.
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A systematic review and meta-analysis of randomized clinical trials was carried out, using the Medline, Embase and Cochrane Library platforms as sources.
Two independent reviewers were allocated for data extraction and live risk of bias observation and to assess certainty and classification of evidence. GRADE approach used (grading of suggestions, evaluate, pattern, and review).
Results and discussion
In the entire 29 clinical trials, totaling 1617 participants, it was observed that diets with low GI and GL resulted in a relevant reduction in glycated hemoglobin (primary outcome) when compared to standard diet used as a control, mean difference of -0.31% (95% CI -0.42% a -0.19%) , high certainty of evidence.
This dietary profile also showed moderate reduction in non-HDL cholesterol levels (mean difference -0 .20 mmol / L (95% CI -0.33 a -0.07) and reductions also impose significant, but lower, in LDL-C levels (-0.17 mmol/L (-0.25 to -0, 08), apo B (-0.05 g / L (-0.09 a -0.01), triglycerides (- 0.09 mmol / L (-0.17 a -0.01), body weight (-0.66 kg (- 0.90 a -0.42), BMI (-0.38 (-0.64 a -0.13). The reduction in fasting blood glucose and in the inflammatory profile by measuring C-reactive protein did not stand out in magnitude.
No a statistically significant reduction was found when the impact of the diet on serum insulin, HDL-C, waist circumference and blood pressure was observed.
The systematic live diet profile analysis with these studied points is very relevant since they comprise risk factors for severe cardiometabolic outcomes such as live acute myocardial infarction and stroke
The stimulus for a dietary profile that significantly improves the metabolic profiles of the disease is of great importance when associated with pharmacological therapies, culminating in an important possibility of being reached, more easily and even with less dosage drug, the therapeutic targets in patients.
According to Socie’s recommendations In the Brazilian Diabetes region, dietary plans for diabetics should also follow a balanced profile when analyzing the proportions of macro and micronutrients (for example, carbohydrates between 45-60% and fats between 20-35%).
Being foremost an individualized proposal with the reality of live patient life, with gradual changes and using tools such as manuals to illustrate food portions and list of equivalent food substitutions.
Read too: Gestational diabetes mellitus: what is the treatment? Practical message
The study shows the relevance of live dietary effect with low glycemic index and load in therapeutic goals and metabolic control, directly implicated in the cardiovascular outcomes of patients.
It is highlighted in this the form, the live importance of the food profile as a central component of the live management of diabetic patients, as well as the well-studied impacts of physical activity and the undisputed benefits of pharmacological therapy.
It is essential to note that dietary intervention is something complex as it relates to personal, cultural and socioeconomic convictions, and must be conducted in a tireless manner and with multidisciplinary support.
*This article was reviewed by the medical team at PEBMED
Undergraduate in Medicine at Universidade Federal Fluminense ⦁ Medical Semiology video display ⦁ Director of the academic league of Clinical Medicine at UFF (LAC UFF) – 2019 ⦁ Student member of the Brazilian Academy of Neurology and American Academy of Neurology
- Chiavaroli L, Lee D, Ahmed A, Cheung A, Khan TA, Blanco S et al. Secure of low glycaemic index or load dietary patterns on glycaemic alter and cardiometabolic factors in diabetes: systematic overview and meta-diagnosis of randomized controlled trials BMJ 2021; 374:n1651. doi: https://doi.org/10.1136/bmj.n1651
- SBD – Brazilian Society of Diabetes. Guidelines of the Brazilian Society of Diabetes 2019-2020. Clannad, 2019. 419p. Available at: http://www.saude.ba.gov.br/wp-reveal material/uploads/2020/02/Diretrizes-Sociedade-Brasileira-de-Diabetes-2019-2020.pdf