***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS To compare the effects of lifestyle modification programs that prescribe low-glycemic load ( GL ) vs. low-fat diets in a r and omized trial . METHODS Seventy-nine obese adults with type 2 diabetes received low-fat or low-GL dietary instruction , delivered in 40-week lifestyle modification programs with identical goals for calorie intake and physical activity . Changes in weight , HbA(1c ) , and other metabolic parameters were compared at weeks 20 and 40 . RESULTS Weight loss did not differ between groups at week 20 ( low-fat : -5.7±3.7 % ; low-GL : -6.7±4.4 % , p=.26 ) or week 40 ( low-fat : -4.5±7.5 % ; low-GL : -6.4±8.2 % , p=.28 ) . Adjusting for changes in antidiabetic medications , subjects on the low-GL diet had larger reductions in HbA(1c ) than those on the low-fat diet at week 20 ( low-fat : -0.3±0.6 % ; low-GL : -0.7±0.6 % , p=.01 ) , and week 40 ( low-fat : -0.1±1.2 % ; low-GL : -0.8±1.3 % ; p=.01 ) . Groups did not differ significantly on any other metabolic outcomes ( p≥.06 ) . CONCLUSIONS Results suggest that targeting GL , rather than dietary fat , in a low-calorie diet can significantly enhance the effect of weight loss on HbA(1c ) in patients with type 2 diabetes OBJECTIVE A lower glycaemic index ( GI ) diet is associated with a reduction in glycosylated Hb ( HbA(1c ) ) in people with diabetes . Yet , little research has been conducted to determine the effects of specific goals regarding consumption of low GI ( LGI ) foods on diabetes outcomes . The present study evaluated a behavioural intervention on  dietary intake , weight status and HbA(1c ) , which included a goal to consume either six or eight servings of LGI foods daily . DESIGN A parallel two-group design was used . Following the 5-week intervention , participants were r and omly assigned to the group of six ( n 15 ) or eight ( n 20 ) servings of LGI foods daily and followed up for 8 weeks . Dietary intake was assessed using the mean of 4 d food records . SETTING A metropolitan community in the USA . SUBJECTS Individuals aged 40 - 65 years with type 2 diabetes of ≥1 year and HbA(1c ) ≥ 7·0 % were eligible . RESULTS There was no significant difference between goal difficulty groups with regard to GI servings at the end of the study . However , mean consumption of LGI foods increased by 2·05 ( SE 0·47 ) and 1·65 ( SE 0·40 ) servings per 4184 kJ in the six ( P < 0·001 ) and eight ( P < 0·001 ) LGI serving groups , respectively . For all participants combined , there were significant decreases in mean HbA(1c ) ( -0·58 ( SE 0·21 ) % ; P = 0·01 ) , weight ( -2·30 ( SE 0·78 ) kg ; P = 0·01 ) , BMI ( -0·80 ( SE 0·29 ) kg/m(2 ) ; P = 0·01 ) and waist circumference ( -2·36 ( SE 0·81 ) cm ; P = 0·01 ) . CONCLUSIONS An intervention including a specific goal to consume six to eight servings of LGI foods daily can improve diabetes outcomes . Clinicians should help patients set specific targets for dietary change and identify ways of achieving those goals BACKGROUND The circumstances under which the glycemic index ( GI ) and glycemic load ( GL ) are derived do not reflect real-world eating behavior . Thus , the ecologic validity of these constructs is incompletely known . OBJECTIVE This study examined the relation of  dietary intake to glycemic response when foods are consumed under free-living conditions . DESIGN Participants were 26 overweight or obese adults with type 2 diabetes who participated in a r and omized trial of lifestyle modification . The current study includes baseline data , before initiation of the intervention . Participants wore a continuous glucose monitor and simultaneously kept a food diary for 3 d. The dietary  variables  included  GI , GL , and intakes of energy , fat , protein , carbohydrate , sugars , and fiber .  The glycemic response variables included AUC , mean and SD of continuous glucose monitoring ( CGM ) values , percentage of CGM values in euglycemic and hyperglycemic ranges , and mean amplitude of glycemic excursions . Relations between daily dietary intake and glycemic outcomes were examined . RESULTS Data were available from 41 d of monitoring . Partial correlations , controlled for energy intake , indicated that GI or GL was significantly associated with each glycemic response outcome . In multivariate analyses , dietary GI accounted for 10 % to 18 % of the variance in each glycemic variable , independent of energy and carbohydrate intakes ( P < 0.01 ) . CONCLUSIONS The data support the ecologic validity of the GI and GL constructs in free-living obese adults with type 2 diabetes . GI was the strongest and most consistent independent predictor of glycemic stability and variability IMPORTANCE Foods that have similar carbohydrate content can differ in the amount they raise blood glucose . The effects of this property , called the glycemic index , on risk factors for cardiovascular disease and diabetes are not well understood . OBJECTIVE To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes . DESIGN , SETTING , AND PARTICIPANTS R and omized crossover-controlled feeding trial conducted in research units in academic medical centers , in which 163 overweight adults ( systolic blood pressure , 120 - 159 mm Hg ) were given 4 complete diets that contained all of their meals , snacks , and calorie-containing beverages , each for 5 weeks , and completed at least 2 study diets . The first participant was enrolled April 1 , 2008 ; the last participant finished December 22 , 2010 . For any pair of the 4 diets , there were 135 to 150 participants contributing at least 1 primary outcome measure . INTERVENTIONS ( 1 ) A high-glycemic index ( 65 % on the glucose scale ) , high-carbohydrate diet ( 58 % energy ) ; ( 2 ) a low-glycemic index ( 40 % ) , high-carbohydrate diet ; ( 3 ) a high-glycemic index , low-carbohydrate diet ( 40 % energy ) ; and ( 4 ) a low-glycemic index , low-carbohydrate diet . Each diet was based on a healthful DASH-type diet . MAIN OUTCOMES AND MEASURES The 5 primary outcomes were insulin sensitivity , determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test ; levels of low-density lipoprotein ( LDL ) cholesterol , high-density lipoprotein ( HDL ) cholesterol , and triglycerides ; and systolic blood pressure . RESULTS At high dietary carbohydrate content , the low- compared with high-glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units ( -20 % , P = .002 ) ; increased LDL cholesterol from 139 to 147 mg/dL ( 6 % , P ≤ .001 ) ; and did not affect levels of HDL cholesterol , triglycerides , or blood pressure . At low carbohydrate content , the low- compared with high-glycemic index level did not affect the outcomes except for decreasing triglycerides from 91 to 86 mg/dL ( -5 % , P = .02 ) . In the primary diet contrast , the low-glycemic index , low-carbohydrate diet , compared with the high-glycemic index , high-carbohydrate diet , did not affect insulin sensitivity , systolic blood pressure , LDL cholesterol , or HDL cholesterol but did lower triglycerides from 111 to 86 mg/dL ( -23 % , P ≤ .001 ) . CONCLUSIONS AND RELEVANCE In this 5-week controlled feeding study , diets with low glycemic index of dietary carbohydrate , compared with high glycemic index of dietary carbohydrate , did not result in improvements in insulin sensitivity , lipid levels , or systolic blood pressure . In the context of an overall DASH-type diet , using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00608049 AIMS The aim of this study is to compare the efficacy of low glycaemic index ( GI ) vs. conventional carbohydrate exchange ( CCE ) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes . METHODS A total of 104 patients with type 2 diabetes were r and omly assigned to either a low GI ( GI ) or CCE dietary advice over a 12-week period . The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c ( HbA1c ) , fructosamine level and plasma glucose . The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure , lipid profile and insulin levels . The oral antidiabetic medications remained unchanged throughout the duration of the study . RESULTS A low-GI diet was associated with significant changes in the fructosamine level ( DeltaGI = -0.20 + /- 0.03 ; DeltaCCE = -0.08 + /- 0.03 mmol/l , p < 0.01 ) and waist circumference ( DeltaGI group = -1.88 + /- 0.30 cm ; DeltaCCE group : -0.36 + /- 0.4 cm , p < 0.05 ) at week 4 . At week 12 , the changes in fasting glucose ( DeltaGI = -0.03 + /- 0.3 ; DeltaCCE = 0.7 + /- 0.3 mmol/l ; p < 0.05 ) and waist circumference ( DeltaGI = -2.35 + /- 0.47 cm ; DeltaCCE group = -0.66 + /- 0.46 cm ; p < 0.05 ) in the GI group was significantly lower than the CCE group . With the low-GI diet , the changes in postpr and ial glycaemia at time 0 , 60 , 150 and 180 min after consuming the st and ard test meal was lower than with the CCE diet ( p < 0.05 ) . No significant differences were found between the groups for the remaining parameters that were measured . CONCLUSIONS Use of a low-GI diet result ed in significant changes of serum fructosamine level , plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet . The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit BACKGROUND The optimal source and amount of dietary carbohydrate for managing type 2 diabetes ( T2DM ) are unknown . OBJECTIVE We aim ed to compare the effects of altering the glycemic index or the amount of carbohydrate on glycated hemoglobin ( HbA1c ) , plasma glucose , lipids , and C-reactive protein ( CRP ) in T2DM patients . DESIGN Subjects with T2DM managed by diet alone ( n=162 ) were r and omly assigned to receive high-carbohydrate , high-glycemic-index ( high-GI ) , high-carbohydrate , low-glycemic-index ( low-GI ) , or low-carbohydrate , high-monounsaturated-fat ( low-CHO ) diets for 1 y. RESULTS The high-GI , low-GI , and low-CHO diets contained , respectively , 47 % , 52 % , and 39 % of energy as carbohydrate and 31 % , 27 % , and 40 % of energy as fat ; they had GIs of 63 , 55 , and 59 , respectively . Body weight and HbA1c did not differ significantly between diets . Fasting glucose was higher ( P=0.041 ) , but 2-h postload glucose was lower ( P=0.010 ) after 12 mo of the low-GI diet . With the low-GI diet , overall mean triacylglycerol was 12 % higher and HDL cholesterol 4 % lower than with the low-CHO diet ( P<0.05 ) , but the difference in the ratio of total to HDL cholesterol disappeared by 6 mo ( time x diet interaction 
    Output:
    
The low-GI diet is more effective in controlling glycated haemoglobin and fasting blood glucose compared with a higher-GI diet or control in patients with type 2 diabetes