Co-ingestion of a protein hydrolysate and amino acid mixture with carbohydrate improves plasma glucose disposal in patients with type 2 diabetes.
BACKGROUND
Although insulin secretion after carbohydrate ingestion is severely impaired in patients with type 2 diabetes, amino acid and protein co-ingestion can substantially increase plasma insulin responses.


OBJECTIVE
We investigated insulin responses and the subsequent plasma glucose disposal rates after the ingestion of carbohydrate alone (CHO) or with a protein hydrolysate and amino acid mixture (CHO+PRO) in patients with a long-term diagnosis of type 2 diabetes.


METHODS
Ten type 2 diabetic patients [mean (+/-SEM) age: 62 +/- 2 y; body mass index (kg/m(2)): 27 +/- 1] and 9 healthy control subjects (age: 58 +/- 1 y; body mass index: 27 +/- 1) participated in 2 trials in which the plasma insulin response was measured after the ingestion of 0.7 g carbohydrate . kg(-1) . h(-1) with or without 0.35 g . kg(-1) . h(-1) of a mixture that contained a protein hydrolysate, leucine, and phenylalanine. Continuous infusions with [6,6-(2)H(2)]glucose were then given to investigate plasma glucose disposal.


RESULTS
Plasma insulin responses were higher by 299 +/- 64% and 132 +/- 63% in the CHO+PRO trial than in the CHO trial in the diabetic patients and the matched control subjects, respectively (P < 0.001). The subsequent plasma glucose responses were reduced by 28 +/- 6% and 33 +/- 3% in the CHO+PRO trial than in the CHO trial in the diabetic patients and the matched control subjects, respectively (P < 0.001). The reduced plasma glucose response in the diabetic patients was attributed to a 13 +/- 3% increase in glucose disposal (P < 0.01).


CONCLUSIONS
The combined ingestion of carbohydrate with a protein hydrolysate and amino acid mixture significantly increases de novo insulin production in patients with a long-term diagnosis of type 2 diabetes. The increased insulin response stimulates plasma glucose disposal and reduces postprandial glucose concentrations.
Manders
Ralph J F
RJ
Departments of Human Biology and Internal Medicine, Maastricht University Hospital, Maastricht, Netherlands. r.manders@hb.unimaas.nl
Wagenmakers
Anton J M
AJ
Koopman
René
R
Zorenc
Antoine H G
AH
Menheere
Paul P C A
PP
Schaper
Nicolaas C
NC
Saris
Wim H M
WH
van Loon
Luc J C
LJ
D001786:Blood Glucose / Q000187:drug effects*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000378:metabolism; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004347:Drug Interactions; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D007930:Leucine / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010649:Phenylalanine / Q000008:administration & dosage / Q000627:therapeutic use; D011492:Protein Hydrolysates / Q000008:administration & dosage / Q000627:therapeutic use*
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin; D011492:Protein Hydrolysates; D010649:Phenylalanine; D007930:Leucine