Influence of dietary protein on postprandial blood glucose levels in individuals with Type 1 diabetes mellitus using intensive insulin therapy.
OBJECTIVE
To determine the effects of protein alone (independent of fat and carbohydrate) on postprandial glycaemia in individuals with Type 1 diabetes mellitus using intensive insulin therapy.


METHODS
Participants with Type 1 diabetes mellitus aged 7-40 years consumed six 150 ml whey isolate protein drinks [0 g (control), 12.5, 25, 50, 75 and 100] and two 150 ml glucose drinks (10 and 20 g) without insulin, in randomized order over 8 days, 4 h after the evening meal. Continuous glucose monitoring was used to assess postprandial glycaemia.


RESULTS
Data were collected from 27 participants. Protein loads of 12.5 and 50 g did not result in significant postprandial glycaemic excursions compared with control (water) throughout the 300 min study period (P > 0.05). Protein loads of 75 and 100 g resulted in lower glycaemic excursions than control in the 60-120 min postprandial interval, but higher excursions in the 180-300 min interval. In comparison with 20 g glucose, the large protein loads resulted in significantly delayed and sustained glucose excursions, commencing at 180 min and continuing to 5 h.


CONCLUSIONS
Seventy-five grams or more of protein alone significantly increases postprandial glycaemia from 3 to 5 h in people with Type 1 diabetes mellitus using intensive insulin therapy. The glycaemic profiles resulting from high protein loads differ significantly from the excursion from glucose in terms of time to peak glucose and duration of the glycaemic excursion. This research supports recommendations for insulin dosing for large amounts of protein.
Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Rankin Park, NSW, Australia.|Faculty of Health, School of Medicine, University of Newcastle, NSW, Australia.
M A
MA
Paterson
Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Rankin Park, NSW, Australia.|Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, NSW, Australia.
C E M
CE
Smart
Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Rankin Park, NSW, Australia.|Faculty of Health, School of Medicine, University of Newcastle, NSW, Australia.
P E
PE
Lopez
Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Rankin Park, NSW, Australia.
P
P
McElduff
Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Rankin Park, NSW, Australia.
J
J
Attia
Aim Diabetes Management Centre, Newcastle, NSW, Australia.
C
C
Morbey
Faculty of Health, School of Medicine, University of Newcastle, NSW, Australia.|Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, NSW, Australia.
B R
BR
King
D000293:Adolescent; D000328:Adult; D001628:Beverages; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D003131:Combined Modality Therapy / Q000009:adverse effects; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000178:diet therapy* / Q000188:drug therapy; D003927:Diet, Diabetic / Q000009:adverse effects; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D018670:Monitoring, Ambulatory; D010352:Patient Dropouts; D062410:Snacks; D000067816:Whey Proteins / Q000008:administration & dosage; D055815:Young Adult
D001786:Blood Glucose; D004044:Dietary Proteins; D007004:Hypoglycemic Agents; D007328:Insulin; D000067816:Whey Proteins