Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-07-20 Cooperative journals: 《中国全科医学》
Abstract： Objective: To evaluate whether a protein preload before a meal effectively lowers the postprandial glycaemic excursion in type 1 diabetes mellitus(T1DM) patients. Methods: A randomized, open-label, within-subject crossover study was conducted. Twenty-six patients aged 18 to 45 years diagnosed with T1DM for > one year consumed two isocaloric meals (with similar composition) in random order. In 1 meal, the protein part was consumed 10 minutes before the carbohydrates (protein-preload meal). In the other meal, all macronutrients were consumed together (mixed meal). Continuous glucose monitoring systems were used to assess multiple glucose levels during a 5-hour postprandial period. Average blood glucose levels, the area under the blood glucose curve（AUC）, mean amplitude of glycemic excursion(MAGE), and hypoglycemia events were analyzed. Results: Overall, mean glucose levels were 2 mmol/L lower during 180 minutes following the protein-preload meal compared to the mixed meal (7.38±0.50 mmol/L vs 9.38±0.64 mmol/L, P<0.05); the positive increments under the curve of postprandial glucose (iAUC 0-180) decreased by 42.30%(862.97±169.98 mmol/L×300 min vs 1495.57±170.40mmol/L×300 min, P<0.05); glucose excursions were lower at 30,60,120 and 210minutes after the protein-preload meal(-0.27±0.21 mmol/L vs 1.14±0.43 mmol/L，0.06±0.35 mmol/L vs 1.53±0.49 mmol/L，1.15±0.32 mmol/L vs -0.08±0.23 mmol/L，0.35±0.32 mmol/L vs -0.48±0.21mmol/L，P<0.05). Compared to the mixed meal, no significant difference in average blood glucose, peak glucose, AUC, and MAGE was found during 300 minutes after the protein-preload meal.Increased hypoglycemia was found in protein-preload meals than in mixed meals (3.89±1.72% vs. 0%， P<0.05). Conclusions: This study shows that protein consumption before carbohydrates results in lower postprandial glucose levels and reduced glycemic variability in adults with T1DM.
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