Influence of dietary protein on postprandial blood glucose levels in individuals with Type 1 diabetes mellitus using intensive insulin therapy

M A Paterson, C E M Smart, P E Lopez, P McElduff, J Attia, C Morbey, B R King, M A Paterson, C E M Smart, P E Lopez, P McElduff, J Attia, C Morbey, B R King

Abstract

Aim: To determine the effects of protein alone (independent of fat and carbohydrate) on postprandial glycaemia in individuals with Type 1 diabetes mellitus using intensive insulin therapy.

Methods: Participants with Type 1 diabetes mellitus aged 7-40 years consumed six 150 ml whey isolate protein drinks [0 g (control), 12.5, 25, 50, 75 and 100] and two 150 ml glucose drinks (10 and 20 g) without insulin, in randomized order over 8 days, 4 h after the evening meal. Continuous glucose monitoring was used to assess postprandial glycaemia.

Results: Data were collected from 27 participants. Protein loads of 12.5 and 50 g did not result in significant postprandial glycaemic excursions compared with control (water) throughout the 300 min study period (P > 0.05). Protein loads of 75 and 100 g resulted in lower glycaemic excursions than control in the 60-120 min postprandial interval, but higher excursions in the 180-300 min interval. In comparison with 20 g glucose, the large protein loads resulted in significantly delayed and sustained glucose excursions, commencing at 180 min and continuing to 5 h.

Conclusions: Seventy-five grams or more of protein alone significantly increases postprandial glycaemia from 3 to 5 h in people with Type 1 diabetes mellitus using intensive insulin therapy. The glycaemic profiles resulting from high protein loads differ significantly from the excursion from glucose in terms of time to peak glucose and duration of the glycaemic excursion. This research supports recommendations for insulin dosing for large amounts of protein.

© 2015 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Figures

Figure 1
Figure 1
CONSORT diagram showing the attrition of participants from recruitment to data analysis. 55 participants were assessed for eligibility. 32 participants were randomized with 5 participants withdrawing from the intervention. A total of 211 study days were analysed.
Figure 2
Figure 2
Mean postprandial glycaemic excursions for 27 participants following consumption of 8 test drinks containing 0, 12.5, 25, 50, 75 and 100 g of protein; with two glucose (CHO) test drinks given for comparison, in amounts of 10 and 20 g without insulin. Compared with 0, 75 and 100 g protein loads produced significantly higher glycaemic excursions from 180‐240 min (P = 0.002) and 240–300 min (P < 0.001). Glucose levels from 75 and 100 g protein were similar to that of 20 g CHO given without insulin however the shape of the response was different. CHO, carbohydrate.

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Source: PubMed

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