You hear a lot about the Glycemic Index these days, but how helpful is it for diabetics really. Some people swear by it, and some (like me) not so much.
First let’s explain what it is:
It was developed by Dr. David J. Jenkins and colleagues in 1980–1981 at the University of Toronto in their research to find out which foods were best for people with diabetes.
A lower glycemic index suggests slower rates of digestion and absorption of the foods’ carbohydrates and may also indicate greater extraction from the liver and other areas that process carbohydrate digestion. A lower glycemic response usually equates to a lower insulin demand but not always, and may improve long-term blood glucose control and cholesterol. The insulin index is also useful for providing a direct measure of the insulin response to a food, some people think even better than the glycemic index.
The glycemic index of a food is defined as the incremental area under the two-hour blood glucose response curve (AUC) (area under the curve) following a 12-hour fast and eating a food with a certain quantity of available carbohydrate (usually 50 g). The AUC of the test food is divided by the AUC of the standard (either glucose or white bread, giving two different definitions) and multiplied by 100. The average GI value is calculated from data collected in 10 human subjects. Both the standard and test food must contain an equal amount of available carbohydrate. The result gives a relative ranking for each tested food
So first we see that this was a very limited sample group, 10 people. They were also not diabetic but healthy subjects. Tests were not done at normal “peak” (or highest glucose numbers reached) but at the 2 hour post-prandial levels. The foods contained in the index are also not defined by culture, so many foods are not represented.
Here’s an example of the index:
Low GI=55 or less, Med GI= 56-69, High GI=70 or more.
The idea is that low-GI foods will release glucose more slowly and steadily, which leads to lower post-prandial (after meal) blood glucose readings. The problem with this is that most people don’t eat just one food at a time, they eat a mixture of carbs, protein, and fat in a meal. Protein and fat slows the absorption rate of the carbs eaten depending on the amounts. Most people aren’t test subjects. 
Another problem is that all people are more sensitive to carbs at different times of the day. Both diabetics and non-diabetics are usually more sensitive to carbs in the morning when cortisol and other hormones are highest and usually less sensitive as the day goes on. So a food eaten at breakfast might cause a much larger spike in glucose numbers than the same food eaten at dinner.
Then there’s the fact that every person is different and their response is different. I, for example, can eat a good amount of potato where other diabetics I know can’t even eat a few spoonfuls without spiking to high numbers. Everyone is different, even at different times of the day.
The glycemic value of a food can be altered by the type of food, its ripeness, processing, the length of storage, cooking methods, and the variety of the food. A very ripe piece of fruit for instance has a higher glucose level than one less ripe, the length of time pasta is cooked determines the glycemic value it has as well. Did you know that cold potato has a different effect on BG levels than hot potato? It’s true because of the way the starch is processed by your body.
The amount of a food eaten has more impact than the GI value usually. Many people eat half a piece of fruit to stay within their glucose level range. Very few people eat 50 grams of a vegetable at one time.
Many have tried to get around the problems with the GI by using the concept of glycemic load.
Here’s some more about that from my friend Andy Weil:
My position on the issue is that the GI Index is perhaps a good starting point, but I wouldn’t rely on it for food choice alone. As a matter of fact I’m a believer in the KISS method: Keep It Simple Stupid. 
I say develop your own personal GI Index that works for your body by using the Testing 101 method. That way you can have the most accurate information geared just for you and not 10 “healthy” subjects in a study. It’s also one less chart to look up and less math.
That’s my choice.
Lizzy
© EMO 5/12
Knowledge is Power
When I was diagnosed, close to 11 years ago, I was told “you are diabetic”, given a prescription for some medication, and told to wait for a nurse to come in and give me an insulin shot. When I picked up the prescription I was given a 10-page booklet telling me “All About How to Mange Diabetes”, and sent on my way. That was the extent of my “education”. 
Thank you so much for your web site. It helped me a lot!
I wonder, what effect of carb, if any, if I eat those foods that have calories but 0 carb? I’m sure there is a relationship somewhere?
Thanks!
-mike-
Many people have found Mike that when they just concentrate on carbs the calories take care of themselves. They can eat until they’re full but not gain weight. When you’re diabetic the carbs process differently in your body and it often leads to weight gain. Cut the carbs and the weight doesn’t pile up the same way. See if it works that way for you.
After all how many steaks can you eat at a time.
Lizzy
I was just diagnosed on July 9,2012, I take metformin 500 am and 500 pm, my ac1 was 6.9, I need to know what r safe levels, I have no insurance and its going to be some time before I make it to a dr. like today in the am I was 160 and at supper I was 70. not sure where the happy point is here.
Thank you,
Debbie
Debbie,
I’m going to give you the links within this blog which will answer your questions. I suggest that you will have to do a lot more testing to keep the levels stable but this link has a table of BG goals by agency as well as testing info. and what to eat: http://lizzysdlounge.com/2012/04/14/getting-started/
You don’t say the timing of the numbers you give either. A 70 is on the low side, but was that before you ate? It’s not dangerously low, just a little low but it means you need to eat something very soon.
There’s also a link with information on options for people who have no insurance: target="_blank">http://lizzysdlounge.com/2012/03/19/financial-assistance-for-insurance-and-medications/
You might be able to find some help for yourself on that.
I hope you can find a clinic resource there, lots of people have.
Lizzy
Hi Lizzy and Hello Marlene, I am so glad that you asked about the dreamfields pasta as I have been wondering about it myself. I am sure that it is probably like every other food ……my milage may vary…… but I am willing to give it a try because I LOVE pasta!!!!
Have a great day!
Susan D
I am interested in knowing anyones experience with the Dreamfield pasta. I really miss this part of my diet and am wondering if it is as low in carbs as the advertisements state.
thanks so much for the blog I am newly diagnosed Feb this year. I have reduced my A1C from 6.6 to 6.3 with diet and exercise.
Hi Marlene,
I use Dreamfields all of the time and love it. The carb counts look the same but they have a special “protected” process that makes them not really enter your system the same way. You have to be careful to not overcook it though, just read the instructions on the link. I highly recommend it, it’s good to be able to eat pasta again.
Great job on the A1C reduction.:-)
Lizzy
Lizzy
I am new Diabetic (3 weeks,) have not taken any classes, so I am still trying to figure all this out.
I goggled Dreamfield, and the 2nd search results was this link about Dreamfield fraud.
http://www.dietdoctor.com/the-dreamfields-pasta-fraud
After reading the article and all the replies and find it all very interesting, but could not come to any conclusion. I wonder how many of the “pro Dreamfield” bloggers actually work for Dreamfield.
I believe you when you say that every ones body is different. Being neutral myself, I would appreciate you feed back on the above blog. Personally I am curious enough to give it a try and run the test myself.
John
I’ve seen that link before. I use Dreamfields and have spoken to many others who have as well. It works fine for me, but I under cook it even more than the instruction say. I also don’t reheat it.
The only thing I can tell you is try it for yourself. It’s fine for me and I’m not a radical low carb person. It’s “real” enough for me too.
Lizzy
OMG PUPPIES!!!!!!!!
. Due to life circumstances we are not ready for another dog….YET, but we are moving in that direction.
I can maybe get my blood glucose levels within reason if I work VERY hard, but I can NEVER get over a case of puppy fever!
Congrats and best wishes to you and Yumi
Hi Susan,
I have a permanent case of puppy love myself! A few puppy views a day keep the diabetes demons away.
Lizzy
Lizzy,
I am soooo glad that I found your blog. I got a late start to the dietician, but had been scrambling around trying get the numbers down – my doc liked the numbers, the dietician said I wasn’t eating enough carbs. When I went by what the dietician said – I was miserable and my BG was spiking everywhere. I cut the carbs back down, went back to eating every two hours and my numbers leveled out and I feel much better. I’m not saying it would work for everyone – but it works for me. Thank you for showing that diabetes is a very individual disease & knowing yourself/your body is the best way to manage it!!
Hi Patricia,
My main problem with most dieticians is the amount of carbs they insist most people eat. It’s waaaay to many in almost every case. It’s been proven time after time by person after person that you don’t need a certain amount of carbs to be healthy. Almost all people experience high numbers when they listen to the advise they give. Most of the time their answer is “take more medication”, but there are a lot of people trying to manage on just diet and exercise alone.
Every now and then a person gets one who gives a carb count as a starting point, to be adjusted with testing. This is very rare though. In most cases they act like your brain will fall off if you don’t eat 60 or so grams of carbs per meal.
The saddest part is that a lot of people take their word as the all-time authority and suffer from much higher numbers and even complications because of it. Glad you weren’t one of them!
Lizzy
Hi Lizzy, hope you and all your Shiba’s are doing well. Thank you again for an article that answered a TON of questions for me!
Keep it up girlfriend, us newbies need your wisdom.
Hi Susan,
I got great news last week. Yumi is expecting in June and there will be a new litter of puppies to watch!!!!! Made my day, I can’t wait.
I’m trying to write about things I see the most comments about from newbies, and some oldies as well. There’s so many things that are not represented fully or honestly on the net, I try to do my part to clear things up whenever possible.
Lizzy