Reducing protein in the diabetic diet.
Long-term protein intake may have pathogenic influence on development of late diabetic complications. A review of the latest results in insulin-dependent diabetic patients shows that short-term lowering of protein intake reduces the characteristic early glomerular hyperfiltration as well as microalbuminuria and proteinuria in diabetic nephropathy. A sustained beneficial effect on the progression rate of nephropathy may be achieved. Based on this evidence it is advisable to avoid the traditionally high protein intake in diabetes. We suggest a protein-controlled diet--with protein comprising 14 energy %--as a goal in uncomplicated diabetes. In patients with progressive albuminuria or proteinuria prescription of a low-protein diet with 10% protein should be considered as supplementation to antihypertensive treatment. At present we do not find sufficient evidence for suggesting an intake of 10% protein (corresponding approximately to recent recommendations on 0.8 g prot/kg body weight) also in uncomplicated diabetes. Both a 10 and 14% protein diet will differ somewhat from the diet of the background population and the present diet of many diabetic patients. Therefore the introduction of such diets requires a careful individualized diet therapy in which repetitive evaluation and estimation of compliance are performed. A reduction of protein intake to 10 energy % represents a profound diet intervention.
Pedersen
M M
MM
Medical Department M (Diabetes and Endocrinology), Aarhus Kommunehospital, Denmark.
Winther
E
E
Mogensen
C E
CE
D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy; D003928:Diabetic Nephropathies / Q000209:etiology / Q000517:prevention & control*; D003927:Diet, Diabetic; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007677:Kidney Function Tests; D010349:Patient Compliance / Q000523:psychology
D004044:Dietary Proteins