Whelehan Gráinne, Dirks Marlou L, West Sam, Abdelrahman Doaa R, Murton Andrew J, Finnigan Tim J A, Wall Benjamin T, Stephens Francis B
Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands.
Diabetes Obes Metab. 2025 Mar;27(3):1143-1152. doi: 10.1111/dom.16100. Epub 2024 Nov 27.
High-protein diets have been recognized as a potential strategy in the nutritional management of type 2 diabetes (T2D). Mycoprotein is a high-fibre, high-protein food ingredient previously shown to improve acute glycaemic control. We determined whether incorporating mycoprotein into a high-protein vegan diet would improve glycaemic control to a greater extent than an isonitrogenous omnivorous diet in people with T2D.
Seventeen adults (f = 5, age = 58.3 ± 8.3 years, BMI = 32.9 ± 4.7 kg∙m, HbA1c = 60 ± 15 mmol∙mol) with T2D were randomly allocated to a 5-week eucaloric high-protein (30% energy from protein) diet, either an omnivorous diet (OMNI; 70% protein from omnivorous sources) or an isonitrogenous, mycoprotein-rich, vegan diet (VEG; 50% protein from mycoprotein). Glycaemic control was assessed using a two-step hyperinsulinaemic-euglycaemic clamp (HEC) with D-[6,6-H] glucose infusion, a mixed-meal tolerance test (MMTT) and continuous glucose monitoring.
The rate of glucose disappearance (RdT), glucose disposal rate and endogenous glucose production, as well as postprandial time-course of blood glucose, serum insulin and C-peptide were assessed during the HEC and MMTT, respectively. Both groups had improved peripheral insulin sensitivity (intervention effect, p = 0.006; increased RdT/Insulin of 1.0 ± 0.6 and 1.0 ± 0.3 mg kg min in OMNI and VEG, respectively), HbA1c (intervention; p = 0.001) and glycaemic variability (intervention; p = 0.040; increased time in-range of 11.8 ± 9.3% and 23.3 ± 12.9% in OMNI and VEG). There were no improvements in hepatic insulin sensitivity or in postprandial blood glucose and serum C-peptide (p > 0.05) during the MMTT.
High-protein diets, whether predicated on vegan or omnivorous proteins, can improve glycaemic control by increasing peripheral insulin sensitivity in people with T2D.
高蛋白饮食已被视为2型糖尿病（T2D）营养管理的一种潜在策略。真菌蛋白是一种高纤维、高蛋白的食物成分，此前已证明其可改善急性血糖控制。我们确定，对于T2D患者，在高蛋白纯素饮食中加入真菌蛋白是否比等氮杂食饮食能在更大程度上改善血糖控制。
17名患有T2D的成年人（女性 = 5名，年龄 = 58.3 ± 8.3岁，BMI = 32.9 ± 4.7 kg∙m，糖化血红蛋白 = 60 ± 15 mmol∙mol）被随机分配到一种为期5周的等热量高蛋白（蛋白质提供30%能量）饮食中，要么是杂食饮食（OMNI；70%的蛋白质来自杂食来源），要么是等氮、富含真菌蛋白的纯素饮食（VEG；50%的蛋白质来自真菌蛋白）。使用两步高胰岛素 - 正常血糖钳夹技术（HEC）并输注D-[6,6-H]葡萄糖、混合餐耐量试验（MMTT）和持续葡萄糖监测来评估血糖控制情况。
分别在HEC和MMTT期间评估葡萄糖消失率（RdT）、葡萄糖处置率和内源性葡萄糖生成，以及餐后血糖、血清胰岛素和C肽的时间进程。两组的外周胰岛素敏感性均有所改善（干预效应，p = 0.006；OMNI组和VEG组的RdT/胰岛素分别增加1.0 ± 0.6和1.0 ± 0.3 mg kg min）、糖化血红蛋白（干预；p = 0.001）和血糖变异性（干预；p = 0.040；OMNI组和VEG组血糖在目标范围内的时间分别增加11.8 ± 9.3%和23.3 ± 12.9%）。在MMTT期间，肝胰岛素敏感性、餐后血糖和血清C肽均无改善（p > 0.05）。
高蛋白饮食，无论是基于纯素蛋白还是杂食蛋白，均可通过提高T2D患者的外周胰岛素敏感性来改善血糖控制。
