Comparison of the ability of bread versus bread plus meat to treat and prevent subsequent hypoglycemia in patients with insulin-dependent diabetes mellitus.

Abstract

We sought to determine whether treatment of hypoglycemia with a snack containing both protein and carbohydrate results in more prolonged protection against subsequent hypoglycemia than ingestion of carbohydrate alone. We studied six insulin-dependent diabetic subjects on two occasions. On both occasions subjects received a variable overnight insulin infusion to achieve euglycemia followed by a constant insulin infusion (approximately 0.5 mU x kg(-1) x min(-1)) designed to produce hypoglycemia. When glucose reached 50 mg/dL, subjects were fed a snack consisting of either bread (approximately 85 kcal) or bread plus meat (approximately 205 kcal). Both contained 15 g of carbohydrate. The insulin infusion was continued for the next 3 h or until glucose again fell to 50 mg/dL. Although bread plus meat resulted in a more marked rise (P < 0.05) in glucagon than did bread alone, neither the post treatment peak glucose concentration (73 +/- 4 vs. 70 +/- 6 mg/dL) nor the subsequent rate of fall of glucose (0.42 +/- 0.10 us. -0.35 +/- 0.07 mg/dL/min) differed. The present study shows that the rate of redevelopment of hypoglycemia does not differ after eating bread or bread plus meat. Therefore treatment of hypoglycemia with a protein-enriched snack merely adds calories rather prolonged protection against subsequent hypoglycemia.

Meats, Processed Meats, Obesity, Weight Gain and Occurrence of Diabetes among Adults: Findings from Adventist Health Studies

“…Evidence also links the low polyunsaturated to saturated fat ratio in meats, particularly red meats, to diabetes incidence [44] . More recent evidence also raises the possibility of a pathway where insulin resistance is produced from chronically elevated levels of glucagon and cortisol [11,12] -hormones that have been found to be associated with higher meat intake [13][14][15] . Our null findings for fish intake may have resulted from a protective effect caused from -3 fatty acids and are also consistent with studies indicating that those consuming fish are less likely to develop chemically induced diabetes [45,46] .…”

“…More recent evidence also raises the possibility that some of the diet-diabetes relation is mediated through pathways related to chronic inflammation [10] or chronically elevated levels of glucagon and cortisol [11,12] . Furthermore, higher levels of these hormones have been found to be associated with animal product intake [13][14][15] . Interestingly, meat protein has been implicated in diabetic renal disease due to its effect on the glomerular filtration rate [16] .…”

Assessment and management of hypoglycemia in children and adolescents with diabetes

“…Including protein in the bedtime snack seems to provide better overnight protection from hypoglycemia than simple carbohydrates alone (62). However, one study in adults indicated that the addition of protein (bread with meat) did not give better protection against hypoglycemia 3 h after the snack (63). Extra slowly absorbed complex carbohydrate at bedtime may be helpful especially following strenuous exercise in the afternoon or evening (59, 64–67).…”

Treatment of Mild Hypoglycemia

“…21,23,24 There is no clear consensus regarding the effect of protein on blood glucose levels in type 1 diabetes. 25,26 Therefore, protein ingestion is not recommended for the treatment or prevention of hypoglycemia.…”