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

Abstract

AimTo 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.MethodsParticipants 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.ResultsData 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.ConclusionsSeventy‐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.

Impact of Fat, Protein, and Glycemic Index on Postprandial Glucose Control in Type 1 Diabetes: Implications for Intensive Diabetes Management in the Continuous Glucose Monitoring Era

“…Seven studies examining the effect of dietary protein on postprandial glycemia in 125 subjects with type 1 diabetes (range 8-33 subjects) were identified (5,8,11,13,(15)(16)(17). All studies kept carbohydrate content consistent, with six adding protein to the test meal, thereby concurrently increasing the energy content.…”

“…Paterson et al (13) was the only study examining the effect of protein only (in the absence of carbohydrates and fat) and found that the addition of 12.5-50 g protein did not significantly affect glycemia, although the addition of 75 and 100 g significantly increased glucose concentrations, reaching a peak at the conclusion of the 5-h study and causing an increase in glucose concentrations similar to that of 20 g carbohydrates given without insulin. These results suggest that protein has differential effects when consumed with and without carbohydrates.…”

“…When protein was the only macronutrient consumed, glucose concentrations began to rise after 100 min for protein loads of $75 g (13). For meals where carbohydrates were also consumed, increased glucose concentrations were noted after 3-4 h (11,15,17).…”

“…The impact on 3-h postprandial glucose concentrations of the addition of 35 g fat and 40 g protein to a meal (37) is equivalent to that resulting from the consumption of 20 g carbohydrates without insulin (13). The addition of 50 g fat to a meal can increase insulin requirements by more than twofold (19).…”

The Effect of Fat, Protein and Glycemic Index on Blood Glucose in Type 1 Diabetes and Their Usage in Insulin Administration: Review

“…Protein içeriği yüksek öğünlerin 2-5 saatlik postprandiyal periyotta daha yüksek glisemik seyre neden olduğu saptanmıştır. 5,13,23,27,28 Peters ve ark.nın ça-lışmasında, protein eklenmiş öğün sonrası erken glukoz yanıt standart öğün ile benzer bulunur iken, geç glukoz yanıtta artış gözlenmiştir. Ayrıca, protein eklenmiş öğün sonrası geç insülin ihtiyacı daha fazla bulunmuştur.…”