Low-Protein, Low-Phosphorus Diet and Tissue Insulin Sensitivity in Insulin-Dependent Diabetic Patients with Chronic Renal Failure

Abstract

Tissue insulin sensitivity was measured by the glucose clamp technique in 8 uremic insulin-dependent diabetic patients before and after 3 months on a low-protein diet (LPD) providing daily 35 kcal/kg body weight, 60% of the caloric supply being obtained from carbohydrates. An improvement in tissue insulin sensitivity was observed for each steady state of the clamp and daily insulin requirements decreased significantly from 38.3 ± 3.2 to 28.2 ± 2.5 units (p < 0.01) in spite of an increased carbohydrate intake. It is suggested that LPD lowers the production and accumulation of uremic toxins interfering with insulin sensitivity.

Effect of long-term dietary protein intake on glucose metabolism in humans

“…Glycerol's contribution to gluconeogenesis is not included in these estimates. Studies with H, [3][4][5][6][7][8][9][10][11][12][13][14] C]-lactate have shown that equilibrium of the hydrogen bound to carbon 6 with that in body water was 80±90 % complete, so that gluconeogenesis is underestimated by 10±20 % [13]. This corresponds to our results and implies that the 13C-glucose method is valid under the conditions of the experimental design of our study.…”

“…Manipulation of protein ingestion has been used to slow down diabetic nephropathy [1]. Furthermore, epidemiological studies indicate that the quantity and quality of protein ingestion affects the expression of Type I (insulin-dependent) diabetes mellitus [2,3]. We have previously shown that a high protein diet accelerates the progression of the autoimmune loss of endogeneous insulin secretion in patients with Type I diabetes [4,5].…”

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

“…Interestingly, meat protein has been implicated in diabetic renal disease due to its effect on the glomerular filtration rate [16] . Also, when people with diabetic nerve damage switch to a vegan diet (no meat, dairy or eggs), evidence has supported improvements in renal function [17,18] and glucose tolerance [19] .…”

Could Low-Protein Diet Modulate Nrf2 Pathway in Chronic Kidney Disease?

“…74 Prospective studies and a recent meta-analysis demonstrate that reducing the dietary protein content reduces the accumulation of uremic toxins and phosphate and may improve symptoms and metabolic derangements. 67,75 In a Cochrane review, Fouque et al 76 observed that in CKD patient Stages 4-5 that follow an LPD, the progression to end-stage kidney disease was arrested.…”