For existing designs, you could tie in the existing dimensions to a spreadsheet. However, the only thing you can do is to change the dimensions of the associated geometry and not change the type. I am not sure how to or how you want to automate a new design from scratch? In other words, do you want to define the planes, sketches and the extrusions from the excel spreadsheet? Are you expecting it to be alike a LISP functionality? You probably be better off creating a standalone application or macro to perform this.
Create the spread sheet with required values. Now model the part (yes you'll have to model it) and then link the dimension using the design table. Of course you need to follow the rules for design table.