increase in dietary protein improves the blood glucose response in persons with type 2 diabetes

• Published in: The American journal of clinical nutrition Vol. 78; no. 4; pp. 734 - 741
• Main Authors: Gannon, Mary C, Nuttall, Frank Q, Saeed, Asad, Jordan, Kelly, Hoover, Heidi
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01.10.2003
• Subjects: Adult; adverse effects; Aged; amino acids; Biological and medical sciences; blood; blood glucose; Blood Glucose - drug effects; Body Weight; Body Weight - drug effects; c-peptide; C-Peptide - blood; Case-Control Studies; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 2 - drug therapy; dietary protein; Dietary Proteins; Dietary Proteins - metabolism; Dietary Proteins - therapeutic use; drug effects; drug therapy; Endocrine glands; fasting; fatty acid composition; Female; gluconeogenesis; glucose; Glycated Hemoglobin; Glycated Hemoglobin A - metabolism; glycohemoglobin; high protein diet; Humans; Insulin; Insulin - blood; Lipids; Lipids - blood; Male; Medical sciences; metabolism; Middle Aged; noninsulin-dependent diabetes mellitus; people; Postprandial Period; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); therapeutic use; triacylglycerols; Endocrinopathy; Type 2 diabetes; Human; glycemic index; Pancreatic hormone; triacylglycerol; Dietary protein; Supplemented diet; Glucose; Metabolism; Insulin; Protein; Feeding; Diet therapy; glycated hemoglobin; glucagon; Carbohydrate; diet; Hb A1c; Macronutrient; diabetes; Glycemia
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/78.4.734

Background: In single-meal studies, dietary protein does not result in an increase in glucose concentrations in persons with or without type 2 diabetes, even though the resulting amino acids can be used for gluconeogenesis. Objective: The metabolic effects of a high-protein diet were compared with those of the prototypical healthy (control) diet, which is currently recommended by several scientific organizations. Design: The metabolic effects of both diets, consumed for 5 wk each (separated by a 2-5-wk washout period), were studied in 12 subjects with untreated type 2 diabetes. The ratio of protein to carbohydrate to fat was 30:40:30 in the high-protein diet and 15:55:30 in the control diet. The subjects remained weight-stable during the study. Results: With the fasting glucose concentration used as a baseline from which to determine the area under the curve, the high-protein diet resulted in a 40% decrease in the mean 24-h integrated glucose area response. Glycated hemoglobin decreased 0.8% and 0.3% after 5 wk of the high-protein and control diets, respectively; the difference was significant (P < 0.05). The rate of change over time was also significantly greater after the high-protein diet than after the control diet (P < 0.001). Fasting triacylglycerol was significantly lower after the high-protein diet than after the control diet. Insulin, C-peptide, and free fatty acid concentrations were not significantly different after the 2 diets. Conclusion: A high-protein diet lowers blood glucose postprandially in persons with type 2 diabetes and improves overall glucose control. However, longer-term studies are necessary to determine the total magnitude of response, possible adverse effects, and the long-term acceptability of the diet.