The effects of protein intake in people with diabetes mellitus

Weight loss is recommended for obese people with type 2 diabetes mellitus (T2D) because obesity is closely linked to insulin resistance, high blood sugar, dyslipoproteinemia and hypertension, and to their associated complications. High protein diets are highly recommended by some diabetes experts as a strategy to facilitate weight loss compared to other energy restriction strategies. Surprisingly, neither the previous nor recently published nutritional guidelines on diabetes in Britain, the United States, and Canada deal in detail with the role of protein, leaving experts uninitiated in this question practically very relevant. Three meta-analyzes of the published literature have appeared recently, but all three have significant shortcomings which limit their usefulness as a basis for nutritional recommendations. the diabetes nutrition task force therefore recognized the need to update its own guidelines from 2004 and to examine the available evidence using the GRADE procedure (a grading procedure used for quality of evidence and strength of recommendations) to comply with current standards.

Protein intake of 10% to 20% of energy intake (E%) or about 0.8 to 1.3 g / kg of body weight in people under 65, and 15% to 20% of E% in people over 65 seemed safe under stable weight conditions. No intervention studies have examined metabolic effects, mortality or cardiovascular events over extended periods. Body weight is closely linked to metabolic control and high protein diets are often recommended. Weight loss diets that include 23% to 32% E% as protein for up to a year reduced blood pressure and body weight slightly but significantly more than lower protein diets, while blood lipids, Fasting blood sugar and HbA1c improved in the same way with higher rates. or lower protein intakes in participants with a glomerular filtration rate (GFR)> 60 ml / min / 1.73 m2. Patients with GFR <60 ml / min / 1.73 m2 did not show a more rapid decline in GFR or renal function with protein intakes of approximately 0.8 g / kg body weight compared to to lower intakes, thus pleading against a restriction. The effects of protein intake on diabetic eye or nerve disease have not been reported. There are a number of studies that have compared different types of animal protein (milk, chicken, beef, pork and fish) or compared animals to vegetable protein in diabetic patients and have reported a greater reduction in serum cholesterol with vegetable proteins. In summary, the suggested range of protein intake seems safe and can be adapted according to personal dietary preferences.

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