Abstract
Measures of glycaemic impact (e.g. postprandial glucose (PPG), oral glucose tolerance test (OGTT) and glycaemic index (GI)) are used by government health and regulatory agencies and public health associations around the world. The objective of this global review was to identify similarities and differences in the use of glycaemic impact measures for potential considerations for harmonisation. A literature and internet search was conducted to identify country government agencies and health associations that provide guidance or recommendations for PPG, OGTT, GI and glycaemic load. Based on this global review, the use of GI for food labelling (e.g. low GI) is limited and its use is voluntary. The application of OGTT as a diagnostic measurement of diabetes and gestational diabetes is widely used and in a consistent manner among the different regions of the world. Time-specific (e.g. 2 h) PPG is commonly used as a target not to exceed in individuals with diabetes and gestational diabetes. PPG is used by regulatory agencies for the substantiation of food labelling. There are differences, however, among regulatory agencies in the specific measure of PPG (i.e. PPG AUC v. peak PPG). Maximum targets for 2-h PPG for individuals with diabetes and gestational diabetes, ranging between 6 and 10 mmol/l, across countries suggest a potential consideration to harmonise PPG targets. There is general consistency in the use and/or target levels of glycaemic impact measures; however, there is a potential need to investigate harmonisation strategies on certain aspects of glycaemic impact measures.
Highlights
Glycaemic impact is the effect that a meal, food or nutrient has on short-term blood glucose levels after consumption
This paper examines the working definition and measurement of available carbohydrate, and based on a global review, examines the use of the glycaemic impact measurements across different regions of the world and provides an overall summary of the similarities and differences of each measurement’s application, including food labelling, dietary guidance and clinical recommendations
Based on the global review of the use of glycaemic impact measurements, it can be seen that different measures are used, but when comparing specific measures, the cut-off levels are generally consistent
Summary
Glycaemic impact is the effect that a meal, food or nutrient has on short-term blood glucose levels after consumption. This paper examines the working definition and measurement of available carbohydrate, and based on a global review, examines the use of the glycaemic impact measurements across different regions of the world and provides an overall summary of the similarities and differences of each measurement’s application, including food labelling, dietary guidance and clinical recommendations.
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