I had a three hour glucose tolerance test in 1968 at age 18. The diagnosis was pre-diabetic. Since standards have changed over the years, I wonder if it makes me a type 1 or a type 2 diabetic. My doctor did not know. I have been on both insulin injections and oral medications for about 12 years and only, within the last nine months, after discovering a book called Sugar Busters, have had my blood sugar levels at a 7.0. I am very happy to have finally heard of glycemic index, etc. and wonder why, since I have been through the “classes” three times (the latest in 1998) no one ever mentioned this before.

The glycemic index, as a concept, has been around a long time. It has not been as popular making into the practical diabetes literature because of several issues. First, it is a relatively difficult concept to teach and implement. It refers to the ability of food to raise blood glucose levels after a meal. Second, it is controversial as to whether it makes a difference with many people seeing that the absolute content of carbohydrate is a much more important issue than its glycemic index. Third, there are a number of other issues that determine the rise in blood glucose following a meal, besides a food’s glycemic index. This includes such issues as fiber content, alterations in stomach emptying, effect of cooking, effect of medications, macronutrient content of the meal, among others. My understanding is that the American Diabetes Association will be publishing a technical review this year on the subject that will be published in the journal Diabetes Care. You can look forward to seeing this evaluation of the concept of glycemic index by other nutritional scientists with interest in the care of diabetes.

JTL