Effect of insulin with oral nutrients on whole-body protein metabolism in growing pubertal children with type 1 diabetes.
Insulin treatment of children with insulin-dependent diabetes mellitus improves whole body protein balance. Our recent study, conducted in pubertal children with type 1 diabetes with provision of both insulin and amino acids, indicated a positive effect of insulin on protein balance, primarily through decreased protein degradation. The current study was undertaken to assess the effect of insulin on protein metabolism in adolescents with type 1 diabetes during oral provision of a complete diet. Whole-body protein metabolism in six pubertal children (13-17 y) with type 1 diabetes mellitus was assessed with L-[1-13C]leucine during a basal (insulin-withdrawn) period and during infusion of 0.15 U/kg/h regular insulin with hourly meals to meet protein and energy requirements. Net leucine balance was significantly higher with insulin and nutrients (13.1 +/- 6.3 micromol leucine/kg/h) than in the basal state (-21.4 +/- 2.8, p < 0.01) with protein degradation decreased from 138 +/- 5.6 mumol leucine/kg/h to 108 +/- 5.9 (p < 0.01) and no significant change in protein synthesis. Even with an ample supply of nutrients, insulin does not increase whole-body protein synthesis in pubertal children with type 1 diabetes mellitus and positive protein balance is solely due to a substantial reduction in the rate at which protein is degraded.
Braziuniene
Ieva
I
Department of Pediatrics, Stony Brook University Medical Center, Stony Brook, New York 11794-8191, USA.
Garlick
Jeremy
J
Mileva
Izolda
I
Desikan
Vardhini
V
Wilson
Thomas A
TA
McNurlan
Margaret
M
D000293:Adolescent; D000596:Amino Acids / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy* / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000378:metabolism; D004041:Dietary Fats / Q000008:administration & dosage / Q000378:metabolism; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000097:blood; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D007332:Insulin Infusion Systems; D007700:Kinetics; D008297:Male; D009752:Nutritional Status; D011506:Proteins / Q000378:metabolism*; D011627:Puberty / Q000378:metabolism*; D016896:Treatment Outcome
D000596:Amino Acids; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D007004:Hypoglycemic Agents; D007328:Insulin; D011506:Proteins