(P22-036-24) Adopting a Low Glycemic Index Diet for Glycemic Control in Individuals With Spinal Cord Injury: A Case Series Study

Objectives: Individuals with spinal cord injury (SCI) experience significant physiological and lifestyle changes, such as increased adiposity, muscle atrophy, and physical inactivity, which collectively contribute to increased risks of developing insulin resistance and type 2 diabetes. The purpose of this study is to determine the impact of consuming a low-glycemic index (GI) diet on glycemic control in individuals with chronic ( >1-year post-injury) SCI using continuous glucose monitoring devices (CGM).

Methods: In a case-series design, two individuals with SCI were recruited (Participant A: a 32-year-old male with a C5 incomplete injury, and Participant B: a 49-year-old female with a C6 incomplete injury). They each completed two 3-day study trials in a randomized order: i) low GI diet (GI=52), and ii) high GI diet (GI=95). Each trial comprised one in-lab meal test and 2 days of free-living monitoring. Study meals corresponding to their assigned diet were provided. In the 2-day free-living portion, blood glucose levels were monitored using CGM (Dexcom Pro6) every 5 minutes. Mealtime was recorded to identify the 2-hour postprandial period. Glycemic parameters were compared between the diets, such as postprandial peak glucose, daily average glucose, glucose time in range (70-180mg/mL), and above range (high:>180 and ≤250, very high: >250mg/dL).

Results: Compared to the high GI diet, during the low GI trial: 1) average postprandial peak glucose concentrations were 21% lower (high vs. low GI: Participant A: 183 vs. 146.5, Participant B: 191 vs. 167.5mg/dL); 2) average day-long glucose concentrations were 9% higher (high GI vs. low GI: subject A: 138 vs. 127.5mg/dL, subject B: 150.5 vs. 136.5mg/dL); 3) percentage time above range was lower (high vs. low GI: subject A: 7% vs. 0% in the high range, subject B: 1.5% vs. 0% in every high range; both 7% in the high range).

Conclusions: Our study showed preliminary evidence that adopting a low-GI diet may be a promising strategy in individuals with SCI and warrants future larger-scale investigation.

Funding Sources: The Ohio State University