Protein Ingestion in Reducing the Risk of Late-Onset Post-Exercise Hypoglycemia: A Pilot Study in Adolescents and Youth with Type 1 Diabetes.
Protein Ingestion in Reducing the Risk of Late-Onset Post-Exercise Hypoglycemia: A Pilot Study in Adolescents and Youth with Type 1 Diabetes.
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DOI：
10.3390/nu15030543
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发表时间：
2023-01-20
期刊：
影响因子：
5.9
通讯作者：
Davis EA
中科院分区：
文献类型：
--
作者：
Paramalingam N;Keating BL;Chetty T;Fournier PA;Soon WHK;O'Dea JM;Roberts AG;Horowitz M;Jones TW;Davis EA
膳食蛋白质导致1型糖尿病（T1 D）患者出现剂量依赖性高血糖。这项研究调查了下午晚些时候中等强度运动后摄入50 g蛋白质对夜间血糖水平（BGL）的影响。6名T1 D受试者（3名男性：3名女性），HbA 1c 7.5 ± 0.8%（58.0 ± 8.7 mmol/mol），年龄20.2 ± 3.1岁，在1600 h运动45分钟，并在2000 h单独饮用蛋白质饮料或水。采用基础胰岛素正葡萄糖钳夹法测量两晚维持血糖正常所需的平均葡萄糖输注速率（m-GIR）。低血糖风险期间蛋白质和水夜间和夜间的m-GIR分别为0.27 ± 043 vs. 1.60 ± 0.66 mg/kg/min（p = 0.028，r = 0.63）和0.51 ± 0.16 vs. 1.34 ± 0.71 mg/kg/min（p = 0.028，r = 0.63）。尽管在蛋白质之夜停止静脉葡萄糖输注，但BGL峰值为9.6 ± 1.6 mmol/L，低血糖风险期平均值为7.8 ± 1.5 mmol/L，而水之夜为5.9 ± 0.4 mmol/L（p = 0.028）。蛋白质和水夜晚的平均血浆胰高血糖素水平分别为51.5 ± 14.1和27.2 ± 10.1 ng/L（p = 0.028）。这表明摄入蛋白质可有效降低运动后低血糖风险，可能是通过胰高血糖素介导的葡萄糖产生刺激。然而，50 g蛋白质对于维持正常可能是过量的。
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.
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