Effects of Dietary Fat and Protein on Glucoregulatory Hormones in Adolescents and Young Adults With Type 1 Diabetes
Dietary fat and protein impact postprandial hyperglycemia in people with type 1 diabetes, but the underlying mechanisms are poorly understood. Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect. Investigate the effects of fat and protein on glucago...
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| creator | Harray, Amelia J Binkowski, Sabrina Keating, Barbara L Horowitz, Michael Standfield, Scott Smith, Grant Paramalingam, Nirubasini Jones, Timothy King, Bruce R Smart, Carmel E M Davis, Elizabeth A |
| description | Dietary fat and protein impact postprandial hyperglycemia in people with type 1 diabetes, but the underlying mechanisms are poorly understood. Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect.
Investigate the effects of fat and protein on glucagon-like peptide (GLP-1), glucagon-dependent insulinotropic polypeptide (GIP) and glucagon secretion.
2 crossover euglycemic insulin clamp clinical trials at 2 Australian pediatric diabetes centers. Participants were 12-21 years (n = 21) with type 1 diabetes for ≥1 year. Participants consumed a low-protein (LP) or high-protein (HP) meal in Study 1, and low-protein/low-fat (LPLF) or high-protein/high-fat (HPHF) meal in Study 2, all containing 30 g of carbohydrate. An insulin clamp was used to maintain postprandial euglycemia and plasma glucoregulatory hormones were measured every 30 minutes for 5 hours. Data from both cohorts (n = 11, 10) were analyzed separately. The main outcome measure was area under the curve of GLP-1, GIP, and glucagon.
Meals low in fat and protein had minimal effect on GLP-1, while there was sustained elevation after HP (80.3 ± 16.8 pmol/L) vs LP (56.9 ± 18.6), P = .016, and HPHF (103.0 ± 26.9) vs LPLF (69.5 ± 31.9) meals, P = .002. The prompt rise in GIP after all meals was greater after HP (190.2 ± 35.7 pmol/L) vs LP (152.3 ± 23.3), P = .003, and HPHF (258.6 ± 31.0) vs LPLF (151.7 ± 29.4), P < .001. A rise in glucagon was also seen in response to protein, and HP (292.5 ± 88.1 pg/mL) vs LP (182.8 ± 48.5), P = .010.
The impact of fat and protein on postprandial glucose excursions may be mediated by the differential secretion of glucoregulatory hormones. Further studies to better understand these mechanisms may lead to improved personalized postprandial glucose management. |
| doi_str_mv | 10.1210/clinem/dgab614 |
| format | Article |
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Investigate the effects of fat and protein on glucagon-like peptide (GLP-1), glucagon-dependent insulinotropic polypeptide (GIP) and glucagon secretion.
2 crossover euglycemic insulin clamp clinical trials at 2 Australian pediatric diabetes centers. Participants were 12-21 years (n = 21) with type 1 diabetes for ≥1 year. Participants consumed a low-protein (LP) or high-protein (HP) meal in Study 1, and low-protein/low-fat (LPLF) or high-protein/high-fat (HPHF) meal in Study 2, all containing 30 g of carbohydrate. An insulin clamp was used to maintain postprandial euglycemia and plasma glucoregulatory hormones were measured every 30 minutes for 5 hours. Data from both cohorts (n = 11, 10) were analyzed separately. The main outcome measure was area under the curve of GLP-1, GIP, and glucagon.
Meals low in fat and protein had minimal effect on GLP-1, while there was sustained elevation after HP (80.3 ± 16.8 pmol/L) vs LP (56.9 ± 18.6), P = .016, and HPHF (103.0 ± 26.9) vs LPLF (69.5 ± 31.9) meals, P = .002. The prompt rise in GIP after all meals was greater after HP (190.2 ± 35.7 pmol/L) vs LP (152.3 ± 23.3), P = .003, and HPHF (258.6 ± 31.0) vs LPLF (151.7 ± 29.4), P < .001. A rise in glucagon was also seen in response to protein, and HP (292.5 ± 88.1 pg/mL) vs LP (182.8 ± 48.5), P = .010.
The impact of fat and protein on postprandial glucose excursions may be mediated by the differential secretion of glucoregulatory hormones. Further studies to better understand these mechanisms may lead to improved personalized postprandial glucose management.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/clinem/dgab614</identifier><identifier>PMID: 34410410</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Adult ; Analysis ; Australia - epidemiology ; Biomarkers - blood ; Blood Glucose - analysis ; C-Peptide - blood ; Cross-Over Studies ; Dextrose ; Diabetes Mellitus, Type 1 - physiopathology ; Diet therapy ; Dietary fat ; Dietary Fats - administration & dosage ; Dietary Proteins - administration & dosage ; Female ; Follow-Up Studies ; Gastric Emptying ; Gastric Inhibitory Polypeptide - blood ; Glucagon ; Glucagon - blood ; Glucagon-Like Peptide 1 - blood ; Glucose ; Humans ; Hyperglycemia ; Hyperglycemia - blood ; Hyperglycemia - epidemiology ; Hyperglycemia - pathology ; Hyperglycemia - prevention & control ; Insulin - blood ; Male ; Meals ; Prognosis ; Teenagers ; Type 1 diabetes ; Youth</subject><ispartof>The journal of clinical endocrinology and metabolism, 2022-01, Vol.107 (1), p.e205-e213</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2022 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3083-ee2052d859f9f1e383feb51cb1868978129e2c18833b59c064a793fe175ea1c03</cites><orcidid>0000-0002-7989-1998 ; 0000-0002-1534-467X ; 0000-0002-8958-7404 ; 0000-0002-0942-0306 ; 0000-0003-3104-8800 ; 0000-0003-4244-5473 ; 0000-0002-2701-6016 ; 0000-0002-4435-472X ; 0000-0002-0584-1875</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34410410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harray, Amelia J</creatorcontrib><creatorcontrib>Binkowski, Sabrina</creatorcontrib><creatorcontrib>Keating, Barbara L</creatorcontrib><creatorcontrib>Horowitz, Michael</creatorcontrib><creatorcontrib>Standfield, Scott</creatorcontrib><creatorcontrib>Smith, Grant</creatorcontrib><creatorcontrib>Paramalingam, Nirubasini</creatorcontrib><creatorcontrib>Jones, Timothy</creatorcontrib><creatorcontrib>King, Bruce R</creatorcontrib><creatorcontrib>Smart, Carmel E M</creatorcontrib><creatorcontrib>Davis, Elizabeth A</creatorcontrib><title>Effects of Dietary Fat and Protein on Glucoregulatory Hormones in Adolescents and Young Adults With Type 1 Diabetes</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Dietary fat and protein impact postprandial hyperglycemia in people with type 1 diabetes, but the underlying mechanisms are poorly understood. Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect.
Investigate the effects of fat and protein on glucagon-like peptide (GLP-1), glucagon-dependent insulinotropic polypeptide (GIP) and glucagon secretion.
2 crossover euglycemic insulin clamp clinical trials at 2 Australian pediatric diabetes centers. Participants were 12-21 years (n = 21) with type 1 diabetes for ≥1 year. Participants consumed a low-protein (LP) or high-protein (HP) meal in Study 1, and low-protein/low-fat (LPLF) or high-protein/high-fat (HPHF) meal in Study 2, all containing 30 g of carbohydrate. An insulin clamp was used to maintain postprandial euglycemia and plasma glucoregulatory hormones were measured every 30 minutes for 5 hours. Data from both cohorts (n = 11, 10) were analyzed separately. The main outcome measure was area under the curve of GLP-1, GIP, and glucagon.
Meals low in fat and protein had minimal effect on GLP-1, while there was sustained elevation after HP (80.3 ± 16.8 pmol/L) vs LP (56.9 ± 18.6), P = .016, and HPHF (103.0 ± 26.9) vs LPLF (69.5 ± 31.9) meals, P = .002. The prompt rise in GIP after all meals was greater after HP (190.2 ± 35.7 pmol/L) vs LP (152.3 ± 23.3), P = .003, and HPHF (258.6 ± 31.0) vs LPLF (151.7 ± 29.4), P < .001. A rise in glucagon was also seen in response to protein, and HP (292.5 ± 88.1 pg/mL) vs LP (182.8 ± 48.5), P = .010.
The impact of fat and protein on postprandial glucose excursions may be mediated by the differential secretion of glucoregulatory hormones. Further studies to better understand these mechanisms may lead to improved personalized postprandial glucose management.</description><subject>Adult</subject><subject>Analysis</subject><subject>Australia - epidemiology</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - analysis</subject><subject>C-Peptide - blood</subject><subject>Cross-Over Studies</subject><subject>Dextrose</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Diet therapy</subject><subject>Dietary fat</subject><subject>Dietary Fats - administration & dosage</subject><subject>Dietary Proteins - administration & dosage</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastric Emptying</subject><subject>Gastric Inhibitory Polypeptide - blood</subject><subject>Glucagon</subject><subject>Glucagon - blood</subject><subject>Glucagon-Like Peptide 1 - blood</subject><subject>Glucose</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - blood</subject><subject>Hyperglycemia - epidemiology</subject><subject>Hyperglycemia - pathology</subject><subject>Hyperglycemia - prevention & control</subject><subject>Insulin - blood</subject><subject>Male</subject><subject>Meals</subject><subject>Prognosis</subject><subject>Teenagers</subject><subject>Type 1 diabetes</subject><subject>Youth</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkUuLFDEUhYMoTju6dSkBN25qJjepR7Js5ikM6GJEXYVU6qaNpJK2klrMvzdNt66GBAIn3zlc7iHkPbAL4MAubfAR58tpZ8Ye2hdkA6rtmgHU8JJsGOPQqIH_OCNvcv7NGLRtJ16TM9G2wOrdkHzjHNqSaXL02mMxyxO9NYWaONGvSyroI02R3oXVpgV3azAlVeQ-LXOKmGn93k4pYLYYa8rB9jOtcVfVNVThuy-_6OPTHinUfDNiwfyWvHImZHx3es_Jt9ubx6v75uHL3eer7UNjBZOiQeSs45PslFMOUEjhcOzAjiB7qQYJXCG3IKUQY6cs61szqMrA0KEBy8Q5-XTM3S_pz4q56NnXOUMwEdOaNe96LrkC4BX9eER3JqD20aWyGHvA9XZgnMuh79tKXTxD1TPh7G3dh_NVf85gl5Tzgk7vFz_XHWtg-tCfPvanT_1Vw4fTyOs44_Qf_1eY-At8YJaW</recordid><startdate>20220101</startdate><enddate>20220101</enddate><creator>Harray, Amelia J</creator><creator>Binkowski, Sabrina</creator><creator>Keating, Barbara L</creator><creator>Horowitz, Michael</creator><creator>Standfield, Scott</creator><creator>Smith, Grant</creator><creator>Paramalingam, Nirubasini</creator><creator>Jones, Timothy</creator><creator>King, Bruce R</creator><creator>Smart, Carmel E M</creator><creator>Davis, Elizabeth A</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7989-1998</orcidid><orcidid>https://orcid.org/0000-0002-1534-467X</orcidid><orcidid>https://orcid.org/0000-0002-8958-7404</orcidid><orcidid>https://orcid.org/0000-0002-0942-0306</orcidid><orcidid>https://orcid.org/0000-0003-3104-8800</orcidid><orcidid>https://orcid.org/0000-0003-4244-5473</orcidid><orcidid>https://orcid.org/0000-0002-2701-6016</orcidid><orcidid>https://orcid.org/0000-0002-4435-472X</orcidid><orcidid>https://orcid.org/0000-0002-0584-1875</orcidid></search><sort><creationdate>20220101</creationdate><title>Effects of Dietary Fat and Protein on Glucoregulatory Hormones in Adolescents and Young Adults With Type 1 Diabetes</title><author>Harray, Amelia J ; 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Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect.
Investigate the effects of fat and protein on glucagon-like peptide (GLP-1), glucagon-dependent insulinotropic polypeptide (GIP) and glucagon secretion.
2 crossover euglycemic insulin clamp clinical trials at 2 Australian pediatric diabetes centers. Participants were 12-21 years (n = 21) with type 1 diabetes for ≥1 year. Participants consumed a low-protein (LP) or high-protein (HP) meal in Study 1, and low-protein/low-fat (LPLF) or high-protein/high-fat (HPHF) meal in Study 2, all containing 30 g of carbohydrate. An insulin clamp was used to maintain postprandial euglycemia and plasma glucoregulatory hormones were measured every 30 minutes for 5 hours. Data from both cohorts (n = 11, 10) were analyzed separately. The main outcome measure was area under the curve of GLP-1, GIP, and glucagon.
Meals low in fat and protein had minimal effect on GLP-1, while there was sustained elevation after HP (80.3 ± 16.8 pmol/L) vs LP (56.9 ± 18.6), P = .016, and HPHF (103.0 ± 26.9) vs LPLF (69.5 ± 31.9) meals, P = .002. The prompt rise in GIP after all meals was greater after HP (190.2 ± 35.7 pmol/L) vs LP (152.3 ± 23.3), P = .003, and HPHF (258.6 ± 31.0) vs LPLF (151.7 ± 29.4), P < .001. A rise in glucagon was also seen in response to protein, and HP (292.5 ± 88.1 pg/mL) vs LP (182.8 ± 48.5), P = .010.
The impact of fat and protein on postprandial glucose excursions may be mediated by the differential secretion of glucoregulatory hormones. Further studies to better understand these mechanisms may lead to improved personalized postprandial glucose management.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>34410410</pmid><doi>10.1210/clinem/dgab614</doi><orcidid>https://orcid.org/0000-0002-7989-1998</orcidid><orcidid>https://orcid.org/0000-0002-1534-467X</orcidid><orcidid>https://orcid.org/0000-0002-8958-7404</orcidid><orcidid>https://orcid.org/0000-0002-0942-0306</orcidid><orcidid>https://orcid.org/0000-0003-3104-8800</orcidid><orcidid>https://orcid.org/0000-0003-4244-5473</orcidid><orcidid>https://orcid.org/0000-0002-2701-6016</orcidid><orcidid>https://orcid.org/0000-0002-4435-472X</orcidid><orcidid>https://orcid.org/0000-0002-0584-1875</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | The journal of clinical endocrinology and metabolism, 2022-01, Vol.107 (1), p.e205-e213 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Analysis Australia - epidemiology Biomarkers - blood Blood Glucose - analysis C-Peptide - blood Cross-Over Studies Dextrose Diabetes Mellitus, Type 1 - physiopathology Diet therapy Dietary fat Dietary Fats - administration & dosage Dietary Proteins - administration & dosage Female Follow-Up Studies Gastric Emptying Gastric Inhibitory Polypeptide - blood Glucagon Glucagon - blood Glucagon-Like Peptide 1 - blood Glucose Humans Hyperglycemia Hyperglycemia - blood Hyperglycemia - epidemiology Hyperglycemia - pathology Hyperglycemia - prevention & control Insulin - blood Male Meals Prognosis Teenagers Type 1 diabetes Youth |
| title | Effects of Dietary Fat and Protein on Glucoregulatory Hormones in Adolescents and Young Adults With Type 1 Diabetes |
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