每日三次食用含有低剂量乳清蛋白的新型餐前小食可增加 2 型糖尿病患者在 7 天自由生活中处于血糖正常状态的时间。
Thrice daily consumption of a novel, premeal shot containing a low dose of whey protein increases time in euglycemia during 7 days of free-living in individuals with type 2 diabetes.
机构信息
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Health and Performance Nutrition, Arla Foods Ingredients Group P/S, Viby J, Denmark.
出版信息
BMJ Open Diabetes Res Care. 2022 May;10(3). doi: 10.1136/bmjdrc-2022-002820.
INTRODUCTION
During acute feeding trials, consuming a large dose of whey protein (WP) before meals improves postprandial glucose regulation in people with type 2 diabetes. It is unclear if the reported benefits of premeal WP supplementation are translatable to everyday care or are associated with clinically meaningful, real-world glycemic outcomes. This study examined the application of a novel, premeal shot containing a low dose of WP on parameters of free-living glycemic control in people with type 2 diabetes.
RESEARCH DESIGN AND METHODS
In a randomized, placebo-controlled, single-blind crossover design, 18 insulin naive individuals with type 2 diabetes ((mean±SD) age, 50±6 years; HbA (glycated hemoglobin), 7.4%±0.8%; duration of diabetes, 6±5 years) consumed a ready-to-drink WP shot (15 g of protein) or a nutrient-depleted placebo beverage 10 min before breakfast, lunch, and dinner over a 7-day free-living period. Free-living glucose control was measured by blinded continuous glucose monitoring and determined by the percentage of time spent above range (>10 mmol/L), in euglycemic range (3.9-10.0 mmol/L), below range (<3.9 mmol/L) and mean glucose concentrations.
RESULTS
Mealtime WP supplementation reduced the prevalence of daily hyperglycemia by 8%±19% (30%±25% vs 38%±28%, p<0.05), thereby enabling a 9%±19% (~2 hours/day) increase in the time spent in euglycemia (p<0.05). Mean 24-hour blood glucose concentrations were 0.6±1.2 mmol/L lower during WP compared with placebo (p<0.05). Similar improvements in glycemic control were observed during the waken period with premeal WP supplementation (p<0.05), whereas nocturnal glycemic control was unaffected (p>0.05). Supplemental compliance/acceptance was high (>98%), and no adverse events were reported.
CONCLUSIONS
Consuming a novel premeal WP shot containing 15 g of protein before each main meal reduces the prevalence of daily hyperglycemia, thereby enabling a greater amount of time spent in euglycemic range per day over 7 days of free-living in people with type 2 diabetes.
TRIAL REGISTRATION NUMBER
ISRCTN17563146; www.isrctn.com/ISRCTN17563146.
简介
在急性喂养试验中，餐前进食大量乳清蛋白（WP）可改善 2 型糖尿病患者的餐后血糖调节。目前尚不清楚餐前 WP 补充的益处是否适用于日常护理，或者是否与有临床意义的实际血糖结果相关。本研究旨在检验一种新型、餐前 WP 小剂量注射对 2 型糖尿病患者自由生活血糖控制参数的应用。
研究设计和方法
在一项随机、安慰剂对照、单盲交叉设计中，18 名胰岛素初治的 2 型糖尿病患者（（平均±标准差）年龄 50±6 岁；糖化血红蛋白（HbA）7.4%±0.8%；糖尿病病程 6±5 年）在 7 天的自由生活期间，于餐前 10 分钟分别饮用含 15g 蛋白质的 WP 射液或营养耗尽的安慰剂饮料，分别用于早餐、午餐和晚餐。通过盲法连续血糖监测测量自由生活中的血糖控制，并通过时间百分比表示：血糖高于范围（>10mmol/L）、血糖处于正常范围（3.9-10.0mmol/L）、血糖低于范围（<3.9mmol/L）和平均血糖浓度。
结果
餐时 WP 补充使每日高血糖的发生率降低 8%±19%（30%±25% vs 38%±28%，p<0.05），从而使血糖正常时间增加 9%±19%（约 2 小时/天）（p<0.05）。与安慰剂相比，WP 使 24 小时平均血糖浓度降低 0.6±1.2mmol/L（p<0.05）。餐前 WP 补充也可改善觉醒期的血糖控制（p<0.05），而对夜间血糖控制无影响（p>0.05）。补充的顺应性/接受度很高（>98%），且未报告不良事件。
结论
在 2 型糖尿病患者中，每天每餐前摄入含 15g 蛋白质的新型 WP 射液可降低每日高血糖的发生率，从而使 7 天自由生活中每天有更多的时间处于血糖正常范围。
临床试验注册号
ISRCTN84762544；www.isrctn.com/ISRCTN84762544。
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