title: Increasing the protein quantity in a meal results in dose-dependent effects on postprandial glucose levels in individuals with Type 1 diabetes mellitus.
abstract: To determine the glycaemic impact of increasing protein quantities when consumed with consistent amounts of carbohydrate in individuals with Type 1 diabetes on intensive insulin therapy.
  
  
  
  Participants with Type 1 diabetes [aged 10-40 years, HbA1c≤ 64 mmol/mol (8%), BMI ≤ 91st percentile] received a 30-g carbohydrate (negligible fat) test drink daily over 5 days in randomized order. Protein (whey isolate 0 g/kg carbohydrate, 0 g/kg lipid) was added in amounts of 0 (control), 12.5, 25, 50 and 75 g. A standardized dose of insulin was given for the carbohydrate. Postprandial glycaemia was assessed by 5 h of continuous glucose monitoring.
  
  
  
  Data were collected from 27 participants (15 male). A dose-response relationship was found with increasing amount of protein. A significant negative relationship between protein dose and mean excursion was seen at the 30- and 60-min time points (P = 0.007 and P = 0.002, respectively). No significant relationship was seen at the 90- and 120-min time points. Thereafter, the dose-response relationship inverted, such that there was a significant positive relationship for each of the 150-300-min time points (P < 0.004). Mean glycaemic excursions were significantly greater for all protein-added test drinks from 150 to 300 min (P < 0.005) with the 75-g protein load, resulting in a mean excursion that was 5 mmol/l higher when compared with the control test drink (P < 0.001).
  
  
  
  Increasing protein quantity in a low-fat meal containing consistent amounts of carbohydrate decreases glucose excursions in the early (0-60-min) postprandial period and then increases in the later postprandial period in a dose-dependent manner.
authors.affiliation: Hunter Medical Research Institute, School of Medicine and Public Health, New Lambton Heights, Newcastle.|Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle.
authors.forename: M A
authors.identifier: 0000-0003-2478-341X
authors.initials: MA
authors.lastname: Paterson
authors.affiliation: Hunter Medical Research Institute, School of Medicine and Public Health, New Lambton Heights, Newcastle.|Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle.
authors.forename: C E M
authors.initials: CEM
authors.lastname: Smart
authors.affiliation: Hunter Medical Research Institute, School of Medicine and Public Health, New Lambton Heights, Newcastle.|Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle.
authors.forename: P E
authors.initials: PE
authors.lastname: Lopez
authors.affiliation: School of Mathematics and Physical Sciences/Statistics, University of Newcastle, Callaghan.
authors.forename: P
authors.initials: P
authors.lastname: Howley
authors.affiliation: School of Mathematics and Physical Sciences/Statistics, University of Newcastle, Callaghan.
authors.forename: P
authors.initials: P
authors.lastname: McElduff
authors.affiliation: Hunter Medical Research Institute, School of Medicine and Public Health, New Lambton Heights, Newcastle.
authors.forename: J
authors.initials: J
authors.lastname: Attia
authors.affiliation: Aim Diabetes Management Centre, Newcastle, New South Wales, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Morbey
authors.affiliation: Hunter Medical Research Institute, School of Medicine and Public Health, New Lambton Heights, Newcastle.|Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle.
authors.forename: B R
authors.initials: BR
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D004044:Dietary Proteins / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D062407:Meals; D019518:Postprandial Period / Q000187:drug effects*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D004044:Dietary Proteins; D007004:Hypoglycemic Agents; D007328:Insulin