Postprandial effects of a whey protein-based multi-ingredient nutritional drink compared with a normal breakfast on glucose, insulin, and active GLP-1 response among type 2 diabetic subjects: a crossover randomised controlled trial

J Nutr Sci. 2021 Jul 12:10:e49. doi: 10.1017/jns.2021.41. eCollection 2021.

Abstract

Postprandial hyperglycaemia is recognised as an important target in type 2 diabetes management. Dietary pattern, meal composition, and amount of food intake are major factors for maintaining postprandial blood glucose levels. The aim of this study was to investigate the effect of consuming a whey protein-based multi-ingredient nutritional drink (WD) on postprandial glycaemic, insulinaemic, and active glucagon-like peptide-1 (GLP-1) responses in comparison to a typical breakfast, which is boiled white rice with chicken (BC) in patients with type 2 diabetes mellitus (T2DM). Fifteen subjects with T2DM participated in a randomised, controlled, cross-over study. Two isocaloric diets with similar nutrient composition were randomly tested with at least 7 d in between. Glucose, insulin, and active GLP-1 were measured by standard methods with blood samples collected with a venous catheter for 240 min during a kinetic test. The incremental area under the curve (iAUC0-240 min) for plasma glucose was significantly lower after the consumption of WD (WD: 3551 ± 546; BC: 9610 ± 848 mg min/dl; P < 0⋅01), while insulinaemic response tended to be lesser (iAUC0-240 min) than those of BC. In addition, higher iAUC0-240 min for active GLP-1 was obtained with WD diet (WD: 2230 ± 441; BC: 925 ± 183 pM min/ml; P < 0⋅01). This study showed that WD can be used to replace a regular breakfast for improving postprandial glucose response and active GLP-1 levels in people with T2DM. Further studies are required to elucidate the clinical efficacy of WD on long-term glycaemic control in people with T2DM.

Keywords: Acute glycaemic response; BC, boiled white rice with chicken; BMI, body mass index; Breakfast meal; GLP-1, glucagon-like peptide-1; Glucagon-like peptide-1; T2DM, type 2 diabetes mellitus; WD, whey protein-based multi-ingredient nutritional drink; Whey protein; Xylitol; iAUC, incremental area under the curve; min, minute; sem, standard error of the mean.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose*
  • Breakfast
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2*
  • Glucagon-Like Peptide 1 / blood*
  • Humans
  • Insulin* / blood
  • Postprandial Period
  • Whey Proteins / administration & dosage*

Substances

  • Blood Glucose
  • Insulin
  • Whey Proteins
  • Glucagon-Like Peptide 1