title: Hydrolyzed casein decreases postprandial glucose concentrations in T2DM patients irrespective of leucine content.
abstract: Lifestyle modifications, including diet, are important in the prevention and management of type 2 diabetes mellitus (T2DM). However, limited information is available on the effects of single doses of meal replacements, particularly with regard to their effect on postprandial glucose. Therefore, a study was performed comparing the effects of a single meal replacement in T2DM patients on postprandial serum glucose, insulin, and glucagon. This randomized, double-blind, partial cross-over study was performed in 36 T2DM patients who continued their oral anti-diabetic medication. Each patient received three out of four treatments separated by 7 days. The treatments were a proprietary casein hydrolysate (insuVida™) alone or with additional leucine, unhydrolyzed casein, or placebo. Blood sampling was done for 4 hr. Treatments were compared using repeated measures ANOVA. Results are given as an estimate of the difference (%) for the 4-hr epoch. Glucose concentrations were lowered by -4.7% by insuVida and insuVida plus added leucine compared to placebo (95% CI: -1.6 to -7.7%), while the effect of unhydrolyzed casein was -1.7% (-4.8 to 1.5%). Addition of leucine to insuVida induced the greatest increase in insulin (i.e., 51.8%; 41.1 to 63.4%). All three treatments increased glucagon concentrations by 14% (8 to 20%) compared to placebo. A single dose of insuVida™ with or without addition of leucine significantly lowered plasma glucose compared to placebo and intact casein in T2DM patients. This is most likely due to an insulinotropic effect of insuVida. The data suggest that this type of intervention may be a viable treatment strategy in T2DM.
authors.affiliation: Centre for Human Drug Research (CHDR)/Leiden University Medical Center (LUMC), Leiden, Netherlands.
authors.forename: Bart F
authors.initials: BF
authors.lastname: Geerts
authors.forename: Marloes G J
authors.initials: MG
authors.lastname: van Dongen
authors.forename: Baukje
authors.initials: B
authors.lastname: Flameling
authors.forename: Matthijs M
authors.initials: MM
authors.lastname: Moerland
authors.forename: Marieke L
authors.initials: ML
authors.lastname: de Kam
authors.forename: Adam F
authors.initials: AF
authors.lastname: Cohen
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Cindy C
authors.initials: CC
authors.lastname: Gerhardt
authors.forename: Joris
authors.initials: J
authors.lastname: Kloek
authors.forename: Jacobus
authors.initials: J
authors.lastname: Burggraaf
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D002364:Caseins / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy*; D004311:Double-Blind Method; D005260:Female; D005934:Glucagon / Q000097:blood*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007328:Insulin / Q000097:blood*; D007930:Leucine / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D011492:Protein Hydrolysates / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D002364:Caseins; D007004:Hypoglycemic Agents; D007328:Insulin; D011492:Protein Hydrolysates; D005934:Glucagon; D007930:Leucine