Department of Dietetics and Nutrition Sciences, Harokopio University, Athens, Greece.
J Hum Nutr Diet. 2010 Apr;23(2):183-9. doi: 10.1111/j.1365-277X.2009.01020.x. Epub 2010 Jan 22.
When substituted for carbohydrate in a meal, dietary protein enhances glycaemic control in subjects with type 2 diabetes (DM2). It is unknown whether the effect is a result of increased protein or reduced carbohydrate. The present study aimed to compare the effects of two meals differing in protein to fat ratios on post-prandial glucose and insulin responses.
This was a crossover, blind study in which obese subjects with (n = 23) and without (n = 26) DM2 consumed two meals in random order with equal amounts of energy (3.1 MJ, 741 kcal), fibre and carbohydrates and a 1-week washout period. Meals were a high protein, low fat (30% protein, 51% carbohydrates, 19% fat) meal and a low protein, high fat (15% protein, 51% carbohydrates, 34% fat) meal. Subjects were matched for age and body mass index. Plasma glucose and insulin were measured at fasting, 30, 60, 90, 120 min post-prandially. Insulin resistance and insulin sensitivity were assessed.
There was no significant meal effect on glucose and insulin responses within groups. Glucose response was higher in diabetic (120 min 11 +/- 0.7 mmol L(-1)) compared to nondiabetic (120 min 5 +/- 0.2; P < 0.001) subjects. Diabetic subjects had significantly higher insulin resistance (P < 0.001) and lower insulin sensitivity (P < 0.001) than nondiabetics. Although peak insulin levels, 60 min post-prandially, did not differ between groups (81 +/- 9 pmol L(-1) for diabetic versus 79 +/- 7 pmol L(-1) for nondiabetic subjects), they were achieved much later, 90 min post-prandially, in diabetic, (99 +/- 8 pmol L(-1)) compared to nondiabetic (63 +/- 7 pmol L(-1), P = 0.002) subjects.
Manipulating protein to fat ratio in meals does not affect post-prandial plasma blood glucose or insulin responses in obese people with and without DM2.
当在餐食中替代碳水化合物时，膳食蛋白质可改善 2 型糖尿病（DM2）患者的血糖控制。尚不清楚这种效果是由于蛋白质增加还是碳水化合物减少所致。本研究旨在比较两种蛋白质与脂肪比例不同的餐食对餐后血糖和胰岛素反应的影响。
这是一项在肥胖的 DM2 患者（n=23）和非 DM2 患者（n=26）中进行的交叉、盲法研究，这些患者以随机顺序摄入两种能量（3.1MJ，741kcal）、膳食纤维和碳水化合物相等的餐食，且每种餐食之间有 1 周洗脱期。这些餐食的蛋白质与脂肪比例分别为高蛋白、低脂肪（30%蛋白质、51%碳水化合物、19%脂肪）和低蛋白、高脂肪（15%蛋白质、51%碳水化合物、34%脂肪）。这些患者的年龄和体重指数相匹配。空腹和餐后 30、60、90、120min 时测量血浆葡萄糖和胰岛素。评估胰岛素抵抗和胰岛素敏感性。
组内两种餐食对血糖和胰岛素反应均无显著影响。与非糖尿病患者相比，糖尿病患者（120min 11±0.7mmol/L）的血糖反应更高（120min 5±0.2；P＜0.001）。与非糖尿病患者相比，糖尿病患者的胰岛素抵抗显著更高（P＜0.001），胰岛素敏感性显著更低（P＜0.001）。尽管餐后 60min 的胰岛素峰值在两组间无差异（糖尿病患者 81±9pmol/L，非糖尿病患者 79±7pmol/L），但糖尿病患者的胰岛素峰值出现得更晚，在餐后 90min（糖尿病患者 99±8pmol/L，非糖尿病患者 63±7pmol/L，P=0.002）。
在有或没有 DM2 的肥胖患者中，改变餐食中的蛋白质与脂肪比例不会影响餐后血浆血糖或胰岛素反应。
