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

• Published in: Diabetic medicine Vol. 33; no. 5; pp. 592 - 598
• Main Authors: Paterson, M. A., Smart, C. E. M., Lopez, P. E., McElduff, P., Attia, J., Morbey, C., King, B. R.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.05.2016; Wiley Subscription Services, Inc; John Wiley and Sons Inc
• Subjects: Adolescent; Adult; Beverages; Blood Glucose - analysis; Child; Combined Modality Therapy - adverse effects; Cross-Over Studies; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - diet therapy; Diabetes Mellitus, Type 1 - drug therapy; Diet, Diabetic - adverse effects; Dietary Proteins - administration & dosage; Dietary Proteins - adverse effects; Female; Humans; Hyperglycemia - etiology; Hyperglycemia - prevention & control; Hypoglycemia - etiology; Hypoglycemia - prevention & control; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin - administration & dosage; Insulin - adverse effects; Insulin - therapeutic use; Male; Monitoring, Ambulatory; Patient Dropouts; Research: Care Delivery; Snacks; Whey Proteins - administration & dosage; Young Adult
• ISSN: 0742-3071; 1464-5491; 1464-5491
• DOI: 10.1111/dme.13011

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. What's new? This research looks at the postprandial glycaemic impact of dietary protein alone, without carbohydrate or fat, in people Type 1 diabetes mellitus. Thirty‐two subjects were recruited; 16 were < 18 years of age. To our knowledge, there are no published studies regarding this. The results indicate that large amounts of protein consumed alone cause delayed and sustained postprandial glycaemic excursions 3–5 h after the meal. Findings support recommendations to consider additional insulin doses for large amounts of protein.