High-Protein Diets and Diabetes

Not Applicable

Recruiting

Brief Summary: High-protein (HP) diets are popular and evidence indicates they are more likely to be adhered to and produce more sustained weight loss, particularly under ad libitum conditions. They also improve glucose control and so may be helpful for treatment of Type 2 Diabetes (T2D), particularly in the short-term, possibly via an improvement in insulin secretion. Indeed, HP diets may be uniquely effective at promoting insulin secretion in T2D, but further research is needed to understand why HP. Thus, there is an urgent need to determine how HP diets affect T2D pathophysiology of insulin secretion and action using direct measures of β-cell dysfunction and insulin sensitivity. It is also imperative to know how the type of protein (animal vs. non-animal) affects insulin secretion in order to ultimately obtain an environmentally and economically sustainable HP diet that can improve glucose control and T2D pathophysiology in the long-term as well as providing patients with a greater choice for dietary management of T2D.

Recruitment & Eligibility

Inclusion Criteria

Aged 40-70 y
Body-mass index of 27-45 kg/m2
Diagnosed with T2D with their most recent HbA1c value greater than 6.0% (>43 mmol/mol) and receiving dietary advice and/or antidiabetic medication (metformin, DPP-4 inhibitors only).
Males and females

Exclusion Criteria

Habitual dietary intake of <0.6 or >1.2 g/kg/day protein (determined from dietary history interview given at screening)
Current use of insulin
HbA1c of 12% or more (≥108 mmol/mol)
Weight loss of more than 5 kg within the past 6 months
A recent estimated glomerular filtration rate (eGFR) of less than 30 mL/min,
Heart failure,
Participation in another clinical research trial, substance abuse, known cancer, myocardial infarction within the previous 6 months, current treatment with anti-obesity drugs, pregnancy or consideration of pregnancy, and hospital admission for depression or use of antipsychotic drugs.

Arm && Interventions

Group	Intervention	Description
Animal	Dietary Intervention	Arm of the study consuming a high-protein diet from animal sources.
Non-animal	Dietary Intervention	Arm of the study consuming a high-protein diet from non-animal sources.

Primary Outcome Measures

Name	Time	Method
Insulin sensitivity	Change from Baseline insulin sensitivity after 5-week controlled diet	Rate of disappearance (Rd) during the hyperinsulinaemic-euglycaemic clamp from participants on each diet, a measure of insulin sensitivity.

Secondary Outcome Measures

Name	Time	Method
β-cell function	Change from Baseline β-cell function after 5-week controlled diet	β-cell function measured by modelling of glucose, insulin and c-peptide during MMTT
Branched-chain amino acid (BCAA) metabolism	Change from Baseline BCAA after 1, 2, 3, 4 and 5 weeks of controlled diet	BCAA metabolism measured by plasma BCAA concentration.
Glucose control	Change from Baseline glucose control after 5-week controlled diet	Glucose control measured by fasting glucose, 2 hour MMTT glucose, 24-hour glucose profile using continuous glucose monitoring probe and HbA1c.
Diabetes treatment satisfaction measured by the diabetes treatment satisfaction questionnaire	Change from Baseline treatment satisfaction after 5-week controlled diet	Treatment satisfaction measured by the diabetes treatment satisfaction questionnaire (DTSQ).

Locations (1): Nutritional Physiology Research Unit
🇬🇧
Exeter, Devon, United Kingdom

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