M Evans1,2, C E M Smart3,4, N Paramalingam1,2,5, G J Smith2, T W Jones1,2,6, B R King3,4,7, E A Davis1,2,6. 1. Princess Margaret Hospital for Children, Perth, WA, Australia. 2. Telethon Kids Institute, University of Western Australia, Perth, WA, Australia. 3. John Hunter Children's Hospital, Newcastle, NSW, Australia. 4. Hunter Medical Research Institute, Newcastle, NSW, Australia. 5. School of Human Sciences, University of Western Australia, Perth, WA, Australia. 6. Division of Paediatrics within School of Medicine, University of Western Australia, Perth, WA, Australia. 7. School of Medicine, University of Newcastle, Newcastle, NSW, Australia.
Abstract
AIM: To quantify the insulin requirement for a high-protein meal compared with a low-protein meal, controlling for carbohydrate and fat content. METHODS: In this crossover study, young people with Type 1 diabetes were randomized to consume a high- (60 g) or low-protein meal (5 g), each containing 30 g carbohydrate and 8 g fat. A variation of the insulin clamp technique was used to determine the insulin requirements to maintain euglycaemia for the following 5 h. RESULTS: A total of 11 participants (mean ±sd age 16.5 ± 2.7 years, HbA1c 52 ± 8.7 mmol/mol [6.9 ± 0.8%], diabetes duration 6.9±5.1 years) completed the study. The mean insulin requirements for the high-protein meal were higher than for the low-protein meal [10.3 (CI 8.2, 12.57) vs 6.7 units (CI 4.7, 8.8); P=0.001], with inter-individual requirements ranging from 0.9 to six times the low-protein meal requirement. Approximately half the additional insulin [1.1 units/h (CI 0.5, 1.8; P=0.001)] was given in the first 2 h, compared with an additional 0.5 units/h (CI -0.2, 1.2; P=0.148) in the second 2 h and 0.1 units (CI -0.6, 0.8; P=0.769) in the final hour. CONCLUSIONS: A high-protein meal requires ~50% more insulin to maintain euglycaemia than a low-protein meal that contains the same quantity of carbohydrate. The majority is required within the first 2 h. Inter-individual differences exist in insulin requirements for dietary protein.
RCT Entities:
AIM: To quantify the insulin requirement for a high-protein meal compared with a low-protein meal, controlling for carbohydrate and fat content. METHODS: In this crossover study, young people with Type 1 diabetes were randomized to consume a high- (60 g) or low-protein meal (5 g), each containing 30 g carbohydrate and 8 g fat. A variation of the insulin clamp technique was used to determine the insulin requirements to maintain euglycaemia for the following 5 h. RESULTS: A total of 11 participants (mean ± sd age 16.5 ± 2.7 years, HbA1c 52 ± 8.7 mmol/mol [6.9 ± 0.8%], diabetes duration 6.9±5.1 years) completed the study. The mean insulin requirements for the high-protein meal were higher than for the low-protein meal [10.3 (CI 8.2, 12.57) vs 6.7 units (CI 4.7, 8.8); P=0.001], with inter-individual requirements ranging from 0.9 to six times the low-protein meal requirement. Approximately half the additional insulin [1.1 units/h (CI 0.5, 1.8; P=0.001)] was given in the first 2 h, compared with an additional 0.5 units/h (CI -0.2, 1.2; P=0.148) in the second 2 h and 0.1 units (CI -0.6, 0.8; P=0.769) in the final hour. CONCLUSIONS: A high-protein meal requires ~50% more insulin to maintain euglycaemia than a low-protein meal that contains the same quantity of carbohydrate. The majority is required within the first 2 h. Inter-individual differences exist in insulin requirements for dietary protein.
Authors: Mark Evans; Antonio Ceriello; Thomas Danne; Christophe De Block; J Hans DeVries; Marcus Lind; Chantal Mathieu; Kirsten Nørgaard; Eric Renard; Emma G Wilmot Journal: Diabetes Obes Metab Date: 2019-06-19 Impact factor: 6.577
Authors: Emily Bell; Sabrina Binkowski; Elaine Sanderson; Barbara Keating; Grant Smith; Amelia J Harray; Elizabeth A Davis Journal: Nutrients Date: 2021-11-19 Impact factor: 5.717