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Isolated protein consumption increases postprandial glucose in type 1 diabetes

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January 6, 2016

Children and adults with type 1 diabetes who consumed more than 75 g liquid protein alone experienced a late and sustained rise in postprandial glucose compared with those who drank water, according to research in Diabetic Medicine.

Megan A. Paterson, of the Hunter Medical Research Institute and the School of Medicine and Public Health at the University of Newcastle, Australia, and colleagues analyzed data from 27 children and adults with type 1 diabetes on either insulin pump therapy or multiple daily injections, with HbA1c of 8.5% or less and a healthy BMI (16 girls and women; mean age, 22 years; mean diabetes duration, 7.8 years; mean BMI, 21 kg/m²; 14 using pump therapy). Participants consumed five premeasured test drinks of whey isolate protein and water (12.5 g, 25 g, 50 g, 75 g and 100 g), plus one control drink of water, as well as two 150 mL glucose drinks (10 g and 20 g) without insulin. Researchers assigned beverages in a randomized order over 8 days and 4 hours after consuming an evening meal standardized for the amount and type of carbohydrate, fat and protein. Participants fasted for 5 hours after the consumption of test drinks and used continuous glucose monitoring (Dexcom G4 Platinum) to assess postprandial glucose levels.

Researchers found that participants experienced a delayed and sustained rise in postprandial glucose 3 to 5 hours after consuming the 75 g or 100 g protein drinks, with higher mean excursions of 0.71 mmol/L and 1.06 mmol/L, respectively, during the 180- to 240-minute time interval, and higher mean excursions of 1.65 mmol/L and 1.72 mmol/L, respectively, during the 240- to 300-minute time interval. During the 60- to 120-minute time interval, only the 20 g glucose drink produced a statistically significant glycemic increase (1.97 mmol/L; P < .001). Researchers did not observe a significant postprandial glucose excursion at any point following consumption of either the 12.5 g or 50 g protein drinks.

“This supports suggestions that insulin for protein-rich meals should ideally be administered using an extended, dual-wave bolus for those using insulin pump therapy” the researchers wrote. “Reduced postprandial glycemic excursions have previously been demonstrated using this bolus function.” – by Regina Schaffer

Disclosure: The study was supported by a competitive Novo Nordisk Regional Support Scheme Grant, administered by the Australian Pediatric Endocrine Group. The researchers report no relevant financial disclosures.

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