Journal Article

Protein Ingestion in Reducing the Risk of Late-Onset Post-Exercise Hypoglycemia: A Pilot Study in Adolescents and Youth with Type 1 Diabetes

Paramalingam, Nirubasini, Roberts, Alison G., Horowitz, Michael, Keating, Barbara L., Chetty, Tarini, O’Dea, Joanne M., Davis, Elizabeth A., Jones, Timothy W., Fournier, Paul A., Soon, Wayne H. K.

2023

Overview

Dietary protein causes dose-dependent hyperglycemia in individuals with type 1 diabetes (T1D). This study investigated the effect of consuming 50 g of protein on overnight blood glucose levels (BGLs) following late-afternoon moderate-intensity exercise. Six participants (3M:3F) with T1D, HbA1c 7.5 ± 0.8% (58.0 ± 8.7 mmol/mol) and aged 20.2 ± 3.1 years exercised for 45 min at 1600 h and consumed a protein drink or water alone at 2000 h, on two separate days. A basal insulin euglycemic clamp was employed to measure the mean glucose infusion rates (m-GIR) required to maintain euglycemia on both nights. The m-GIR on the protein and water nights during the hypoglycemia risk period and overnight were 0.27 ± 043 vs. 1.60 ± 0.66 mg/kg/min (p = 0.028, r = 0.63) and 0.51 ± 0.16 vs. 1.34 ± 0.71 mg/kg/min (p = 0.028, r = 0.63), respectively. Despite ceasing intravenous glucose infusion on the protein night, the BGLs peaked at 9.6 ± 1.6 mmol/L, with a hypoglycemia risk period mean of 7.8 ± 1.5 mmol/L compared to 5.9 ± 0.4 mmol/L (p = 0.028) on the water night. The mean plasma glucagon levels were 51.5 ± 14.1 and 27.2 ± 10.1 ng/L (p = 0.028) on the protein and water night, respectively. This suggests that an intake of protein is effective at reducing the post-exercise hypoglycemia risk, potentially via a glucagon-mediated stimulation of glucose production. However, 50 g of protein may be excessive for maintaining euglycemia.

• Publisher: MDPI AG,MDPI
• Subject: Adolescent / Amino acids / blood glucose / Blood Glucose - metabolism / Brief Report / Carbohydrates / Complications and side effects / Diabetes / Diabetes Mellitus, Type 1 / Diet therapy / dietary protein / dose response / Eating / Exercise / Exercise - adverse effects / Glucagon / Glucose / Health aspects / Humans / hyperglycemia / Hypoglycemia / Hypoglycemia - prevention & control / ingestion / Insulin / insulin-dependent diabetes mellitus / intravenous injection / Laboratories / Pediatric research / Peptides / Pilot Projects / Prevention / Proteins / Proteins in human nutrition / risk / Risk factors / Teenagers / Type 1 diabetes / Young Adult / youth