Glycemic index and diabetes

Not all carbohydrates work the same in the body. Some trigger a quick spike in blood sugar, while others work more slowly, avoiding large or rapid rises in blood sugar. The glycemic index addresses these differences by assigning a number to foods that reflects how quickly they increase blood glucose compared to pure glucose (sugar).

The GI scale goes from 0 to 100. Pure glucose has the highest GI and is given a value of 100.

Eating low GI foods can help you gain tighter control over your blood sugar. Paying attention to the GI of foods can be another tool to help manage diabetes, along with carbohydrate counting. Following a low-GI diet also may help with weight loss.

Low GI foods (0 to 55):

• Bulgar, barley
• Pasta, parboiled (converted) rice
• Quinoa
• High-fiber bran cereal
• Oatmeal, steel-cut or rolled
• Carrots, non-starchy vegetables, greens
• Apples, oranges, grapefruit, and many other fruits
• Most nuts, legumes, and beans
• Milk and yogurt

Moderate GI foods (56 to 69):

• Pita bread, rye bread
• Couscous
• Brown rice
• Raisins

High GI foods (70 and higher):

• White bread and bagels
• Most processed cereals and instant oatmeal, including bran flakes
• Most snack foods
• Potatoes
• White rice
• Honey
• Sugar
• Watermelon, pineapple

When planning your meals:

• Choose foods that have a low to medium GI.
• When eating a high GI food, combine it with low GI foods to balance the effect on your glucose levels. The GI of a food, and its impact on people with diabetes may change when you combine it with other foods.

The GI of a food is affected by certain factors, such as the ripeness of a piece of fruit. So, you need to think about more than the GI of a food when making healthy choices. When choosing meals, it's a good idea to keep these issues in mind.

• Portion size still matters because calories still matter, and so does the amount of carbohydrates. You need to keep an eye on the portion size and number of carbohydrates in the meal you are having, even if it has low GI foods.
• In general, processed foods have a higher GI. For example, fruit juice and instant potatoes have a higher GI than whole fruit and whole baked potatoes.
• Cooking can affect the GI of a food. For example, al dente pasta has lower GI than soft-cooked pasta.
• Foods higher in fat or fiber tend to have a lower GI.
• Certain foods from the same class of foods can have different GI values. For example, converted long-grain white rice has a lower GI than brown rice. And short-grain white rice has a higher GI than brown rice. Likewise, quick oats or grits have a high GI but whole oats and whole-grain breakfast cereals have a lower GI.
• Choose a variety of healthy foods keeping in mind the nutritional value of the whole meal as well as the GI of foods.
• Some high GI foods are high in nutrients. So balance these with lower GI foods.

For many people with diabetes, carbohydrate counting, or carb counting, helps limit carbohydrates to a healthy amount. Carb counting along with choosing healthy foods and maintaining a healthy weight may be enough to control diabetes and lower the risk for complications. But if you have trouble controlling your blood sugar or want tighter control, you should talk with your health care provider about using the glycemic index as part of your action plan.

ElSayed NA, Aleppo G, Aroda VR, et al, on behalf of the American Diabetes Association. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S68-S96. PMID: 36507648 pubmed.ncbi.nlm.nih.gov/36507648/.

MacLeod J, Franz MJ, Handu D, et al. Academy of Nutrition and Dietetics Nutrition practice guideline for type 1 and type 2 diabetes in adults: nutrition intervention evidence reviews and recommendations. J Acad Nutr Diet. 2017;117(10)1637-1658. PMID: 28527747 pubmed.ncbi.nlm.nih.gov/28527747/.

Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.