The effect of low-glycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease

The insulin resistance syndrome has recently been implicated in the etiology of coronary heart disease, with a possible metabolic defect at the level of the adipocyte. We report the effects of a low- versus high-glycemic-index (LGI and HGI, respectively) diet on insulin and glucose response as assessed by oral glucose tolerance test (OGTT) and insulin-stimulated glucose uptake in isolated adipocytes in a group of 32 patients with advanced coronary heart disease. The area under the insulin curve following OGTT was significantly reduced after 4 weeks in the LGI group (P<.03), but not in the HGI group. Insulin-stimulated glucose uptake in isolated adipocytes harvested from a presternal fat biopsy was significantly greater following the LGI diet (P<.05). This study demonstrates that simple short-term dietary measures can improve insulin sensitivity in patients with coronary heart disease. Copyright (C) 1996 by W.B. Saunders Company.