A new study shows that the level of protein in a meal can significantly affect how much insulin needs to be taken at meal times for people with type 1 diabetes.
Many people with type 1 diabetes are advised to count carbohydrate but not protein when calculating insulin doses.
The new research showed that higher amounts of protein in meals increased the amount of insulin needed by about 50 per cent. The results also showed that the amount of extra insulin needed varied significantly between different individuals.
The findings suggest that the way protein in a meal can affect blood glucose levels deserves more attention. To date, the effects of protein on glucose levels has not been investigated by research as thoroughly as the effects of carbohydrate.
While in the UK, protein is not typically considered within insulin doses calculatio, some doctors in other countries have raised the need for protein to be considered. In Poland, a system of protein and fat exchanges has been developed by Professor Ewa Pańkowska to complement carbohydrate counting and improve blood glucose levels. US physician, Dr Richard Bernstein has recommended considering protein within mealtime insulin calculations as well.
The study, partly funded by JDRF, was carried out by researchers from Australia. 11 young participants with type 1 diabetes took part in the trial.
Within the study, participants ate two different meals and insulin was infused according to blood glucose levels which were monitored over a five-hour period. Both meals included 30g of carbohydrate and 8g of fat. One of the meals had 5g of protein and the other had 60g of protein.
The average insulin need for the low-protein meal was 6.7 units compared with 10.3 for the high-protein meal. This represents around a 50% greater insulin need for the higher-protein meal compared with the lower-protein meal.
The study showed that more of the additional insulin need for the protein was required within the first 2 hours. However, there was a smaller but significant need for insulin 2-5 hours after eating too.
As noted above, the researchers noted that there were significant differences between individuals in terms of the additional insulin required for the protein.
The fact that at least one of the participants been diagnosed for less than two years may explain why some participants needed much less additional insulin for protein than others. This is because people with type 1 diabetes can keep producing a small but significant amount of insulin within the first few years of a diagnosis.
The study, which was a small study and limited to participants within a 5-year age range, suggests that more research is needed to better understand how to best balance insulin needs with protein intake.
Results of the study are published in the Diabetic Medicine journal.

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