Premeal whey protein supplement reduces time spent in hyperglycemia in type 2 diabetes
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Adults with type 2 diabetes who drank a low-dose premeal shot of whey protein before each meal spent less time in hyperglycemia and more time in range compared with placebo, according to study findings.
“There is increasing evidence that demonstrates the importance of measuring glucose control at the day-to-day level on patient quality of life, but also in regard to the risks associated with diabetes,” Kieran Smith, PhD, research assistant in the Population Health Sciences Institute, faculty of medical sciences at Newcastle University in the U.K., told Healio. “Our data demonstrates that consuming a small amount of whey protein before each main meal reduces overall daily hyperglycemia without increasing the risk of hypoglycemia. This enables people with type 2 diabetes to achieve more time spent within ideal and desirable blood glucose ranges. Presenting a whey protein preload in the format of a small, palatable, ready-to-drink shot is an effective way to implement this mealtime strategy in the type 2 diabetes community.”
Smith and colleagues conducted a single-blind, placebo-controlled crossover study assessing the impact of a whey protein drink shot containing 15.6 g of dietary protein on glycemic control in 18 adults aged 30 to 60 years with type 2 diabetes (28% women). Participants were randomly assigned to drink either the whey protein shot or a protein-depleted placebo shot 10 minutes before each main meal during a 7-day free-living period. After 7 days, participants switched to the other treatment regimen. Glycemic control was measured through a blinded Dexcom G6 continuous glucose monitor. Time spent in hyperglycemia with a blood glucose of 10 mmol/L was the primary outcome. Researchers also assessed time in range with a blood glucose between 3.9 mmol/L and 10 mmol/L, time below range with a blood glucose of 3.8 mmol/L or less, postprandial glucose events, peak incremental change in glucose and inter-day and intraday glycemic variability. Glycemic management indicator, which approximates HbA1c based on average glucose levels collected by CGM, was calculated.
The findings were published in BMJ Open Diabetes Research & Care.
During the placebo phase of the study, participants spent 38.1% of time in hyperglycemia. Time spent in hyperglycemia decreased 8.3% with the premeal whey protein drink, resulting in 117 minutes less time in hyperglycemia per 24 hours (P = .024). Time in range increased from 60.9% with placebo to 69.6% with the whey protein drink (P = .035).
Glucose management indicator was 2.9 mmol/mol lower in participants drinking whey protein compared with placebo (P = .045). Mean 24-hour glucose concentrations were 0.6 mmol/L lower in adults drinking whey protein compared with placebo (P = .045). Glycemic variability markers were similar between the two treatments.
During awake hours of 6 a.m. to 11:55 p.m., mean glucose was 0.7 mmol/L lower (P = .023) and time in range 8.7% higher (P = .048) in the whey protein group compared with placebo. There were no differences in glycemic control during the nocturnal period from midnight to 5:55 a.m. The number of postprandial events were similar between treatments and no significant differences in energy intake or physical activity were observed.
Smith said longer-term interventions of at least 12 weeks are needed to analyze the impact of whey protein on glucose control and other markers of metabolic health, including body weight, body fat distribution, plasma lipids and vascular function.
“We also need to refine the most optimal dose of premeal whey protein taking into consideration the energy associated with the supplement,” Smith said. “It is also important to establish the most realistic dosing frequency of premeal whey supplementation that aligns with daily living whilst still producing benefits in glucose control.”
For more information:
Kieran Smith, PhD, can be reached at k.smith21@newcastle.ac.uk.
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