Abstract
Nearly 30% of diabetics in India are undernourished (UND) and have to consume a higher calorie diet where the bulk comes from cereal-based carbohydrates (CHO). In Orissa, parboiled rice, flaked rice (chuda) and broken cream of wheat (suji) are most commonly used. Glycaemic and insulinogenic responses to these were assessed in six patients, each with malnutrition-related diabetes (MRDM), and six undernourished non insulin-dependent diabetics (lean NIDDM), along with 10 healthy controls. Serum levels of insulin (IRI), both basal and in response to glucose, were lowest in MRDM. In spite of severe hyperglycaemia, IRI values in lean NIDDM were more or less similar to controls, indicating a high degree of insulin resistance in the former. Insulin glucose indices (IG index) were lowest in MRDM. In controls, the glycaemic index (GI) of rice was lowest (43.8±11.6) as compared with chuda (74.9±11.1) and suji (64.9±20.3). In UND rice showed higher GI compared with controls, and suji and chuda even higher GI. However, the insulinogenic response was dissimilar in the different groups. Rice revealed a uniform response in all groups. Thus, various CHO-rich items of diet are handled differently by the UND patients. While parboiled rice appears to be most suitable for all, wheat products should be used with reservation in UND patients, and in MRDM in particular.