(08-07-11) An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes1,2,3

Mary C Gannon, Frank Q Nuttall, Asad Saeed, Kelly Jordan and Heidi Hoover
1 From the Metabolic Research Laboratory and the Section of Endocrinology, Metabolism, and Nutrition, Department of Veterans Affairs Medical Center, Minneapolis (MCG, FQN, AS, KJ, and HH), and the Departments of Food Science and Nutrition (MCG) and Medicine (MCG, FQN, and AS), University of Minnesota, Minneapolis.
Correspondence: 3 Address reprint requests to MC Gannon, Metabolic Research Laboratory (111G) Veterans Affairs Medical Center, Minneapolis, MN 55417. E-mail: [email protected].
Background: In single-meal studies, dietary protein does not result in an increase in glucose concentrations in persons with or without type 2 diabetes, even though the resulting amino acids can be used for gluconeogenesis.
Objective: The metabolic effects of a high-protein diet were compared with those of the prototypical healthy (control) diet, which is currently recommended by several scientific organizations.
Design: The metabolic effects of both diets, consumed for 5 wk each (separated by a 2?5-wk washout period), were studied in 12 subjects with untreated type 2 diabetes. The ratio of protein to carbohydrate to fat was 30:40:30 in the high-protein diet and 15:55:30 in the control diet. The subjects remained weight-stable during the study.
Results: With the fasting glucose concentration used as a baseline from which to determine the area under the curve, the high-protein diet resulted in a 40% decrease in the mean 24-h integrated glucose area response. Glycated hemoglobin decreased 0.8% and 0.3% after 5 wk of the high-protein and control diets, respectively; the difference was significant (P < 0.05). The rate of change over time was also significantly greater after the high-protein diet than after the control diet (P < 0.001). Fasting triacylglycerol was significantly lower after the high-protein diet than after the control diet. Insulin, C-peptide, and free fatty acid concentrations were not significantly different after the 2 diets.
Conclusion: A high-protein diet lowers blood glucose postprandially in persons with type 2 diabetes and improves overall glucose control. However, longer-term studies are necessary to determine the total magnitude of response, possible adverse effects, and the long-term acceptability of the diet.

Source: American Journal of Clinical Nutrition, Vol. 78, No. 4, 734-741, October 2003

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