Effect Of Fat And Protein On Glucose Response
ISPAD recommends taking fat and protein into account when calculating bolus insulin but gives neither a threshold for these macronutrients nor a specific insulin dosage algorithm but refers to a number of reviewed articles .
In the course of research, the definition of high fat was a dietary recommendation concerning daily intake at 3035% but no definition per single meal . All author focused on fat as a predominant nutrient, but Van der Hoogt et al. used 30 g and more as a definition of high fat, with a maximum of 52 g . Van der Hoogt et al. defined 15.3 g ± 4.03 g in their age adjusted meal as high fat . Except for two high fat only studies, all fat was part of a mixed meal . Authors do not declare the type of fat .
ISPAD gives clear recommendations for daily intake based on age but no intake per meal . No unified definition for high protein exists in literature. Definitions of high protein ranged between 40 g of protein and 60 g total . In high protein only test meals Paterson et al. used 75 g in one study population and found significantly increased blood glucose levels between minutes 150 to 300 postprandially . This suggests even longer monitoring for high protein meals .
Bell et al. wrote that 230 g of a lean steak with salad may require a different insulin dosing strategy than for protein and carbohydrate meals . Evans et al. found that 50% more insulin is necessary to maintain euglycaemia after a high protein meal .
5.1.3. Mixed Meals
Biophysical Characterization Of A Protein For Structure Comparison: Methods For Identifying Insulin Structural Changes
Although protein structure has been studied for many decades it remains the case that we cannot state with confidence whether two samples have the same molecular structure, particularly in solution. The increasing number of biosimilar biopharmaceutical drugs that are being tested means this is not an academic exercise. In this work we consider how four well-established techniques: dynamic light scattering , circular dichroism , nuclear magnetic resonance spectroscopy , and molecular modelling can be combined to provide information about the supposedly well-understood protein insulin. A goal of this work was to establish a systematic means of detecting differences between insulin samples as a function of pH, temperature, and the presence or absence of zinc, all of which are known to change the oligomerisation state and to affect molecular structure. We used the recently developed Secondary Structure Neural Network circular dichroism algorithm to facilitate analysis of the CD spectra. Externally publishedContinue reading > >
Research Design And Methods
Seventeen type 2 diabetic patients and 23 control subjects were admitted to the Clinical Investigation Unit of the MUHC/Royal Victoria Hospital . Consent was obtained according to the institutional research ethics board. Subjects were screened by medical and dietary history, physical examination, and laboratory evaluation to assure the absence of hepatic, hematologic, renal, pulmonary, thyroid, and cardiovascular dysfunction. Inclusion criteria were that subjects be nonsmokers and have stable weight for 6 months and protein intakes within the Dietary Reference Intakes . Control subjects took no medications that affected metabolism and underwent a 75-g oral glucose tolerance test . The groups within each sex were matched for anthropometric variables. Diabetes medications were stopped for 1 week and lipid-lowering medications upon admission, but antihypertensive agents were continued in four subjects.
Subjects consumed an isoenergetic, protein-controlled liquid formula for 7 days in control and 8 days in type 2 diabetic subjects, with or without additional energy as canola oil and a glucose polymer . Total energy intakes were 1.5 times resting energy expenditure , by indirect calorimetry , with 60% from carbohydrate, 25% from fat, and 15% from protein.
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How Much Protein Do You Need
How much protein you need depends on your age, sex, health, and physical activity. On average, people with diabetes eat about the same amount of protein as the general public, which is 15-20% of their daily calories . The American Diabetes Association does not recommend a specific amount of protein, but if you currently get less than 15-20% of your calories from protein, this is a good range to aim for. If you eat 2,000 calories per day, then about 300-400 of those calories would come from protein, which is about 75-100 grams of protein.
If you dont keep track of your daily total calories, you can use the kilogram formula above to make sure you are getting enough protein. First, divide your weight in pounds by 2.2. If you weigh 170 pounds, that is equal to 77 kilograms . That number is also the minimum number of grams of protein recommended for you. Then, multiply 77 by 1.5, and you get a maximum number of 116 grams of protein per day. For instance:
A 170-pound person would eat about 77-116 grams of protein each day.
A 200-pound person would eat about 90-136 grams of protein each day.
How Do You Take Insulin Without A Syringe
- Insulin pens look like large writing pens and can help prevent under- and overdosing. They also dont require refrigeration, are conveniently prefilled, and are more durable than syringes.
- Insulin pumps are attached to a thin tube thats implanted under your skin. Pumps are computerized or motorized, and some models also act as glucose monitors. They deliver insulin before each meal along with small amounts through the course of the day. In the US, about 60% of people with diabetes use some form of insulin pump.
- Jet injection devices are a good option if you hate needles. A jet injector holds several doses of insulin. After placing it against your skin, you press a button, and the insulin is pushed through.
- Inhalable insulin comes in a premeasured inhaler and was first approved in 2014. Its short-acting and usually not covered by insurance, which makes it more cost prohibitive than other types of insulin for most people with diabetes.
Unless you have an insulin pump that also works as a glucose monitor, insulin dosing is based on self-monitoring your blood glucose levels. You can check them by doing finger pricks or wearing a device that continuously monitors them for you.
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What Are The 8 Types Of Protein
1) Hormonal Protein. Hormones are protein-based chemicals secreted by the cells of the endocrine glands. Usually transported through the blood, hormones act as chemical messengers that transmit signals from one cell to another. Each hormone affects certain cells in your body, known as target cells. Such cells have specific receptors on which the hormone attaches itself to transmit the signals. An example of a hormonal protein is insulin, which is secreted by the pancreas to regulate the levels of blood sugar in your body.
2) Enzymatic Protein. Enzymatic proteins accelerate metabolic processes in your cells, including liver functions, stomach digestion, blood clotting and converting glycogen to glucose. An example is digestive enzymes that break down food into simpler forms that your body can easily absorb.
3) Structural Protein. Also known as fibrous proteins, structural proteins are necessary components of your body. They include collagen, keratin and elastin. Collagen forms the connective framework of your muscles, bones, tendons, skin and cartilage. Keratin is the main structural component in hair, nails, teeth and skin.
4) Defensive Protein. Antibodies, or immunoglobulin, are a core part of your immune system, keeping diseases at bay. Antibodies are formed in the white blood cells and attack bacteria, viruses and other harmful microorganisms, rendering them inactive.
Bolusing Methods For Protein And Fat
Optimal dosing strategies for protein and/or fats is not known due to the limited studies available, the quality of the studies and the small number of patients in each. It’s also important to note there are significant inter-individual glycemic effects of proteins and fat. The methods below are simply a starting point and personalized adjustments must be made based on glucose responses. It is expected other formulas and tools will emerge over time.
Before adjusting insulin dose for the fat and protein content of meals, it is important to first assist patients in optimizing their basal rates, carbohydrate counting, insulin-to-carbohydrate ratios as well as their treatment and prevention of hypoglycemia. Then, if ingestion of high fat and/or high protein meals is associated with delayed hyperglycemia the methods below could assist in calculating and administering extra insulin. Ensure patients demonstrate comfort and competency in the required math, which may include the use of .
Method A: Percent Increase and Dual Boluses
If eating > 40 g fat and > 25 g protein with a carbohydrate meal increase the calculated ICR meal dose by 30-35%
- For insulin pump: deliver 50% of this new dose as a normal pre-meal bolus and 50% as square/extended wave over 2 – 2.5 hours
- For MDI: administer 50% of this new dose as pre-meal bolus and 50% as post-meal bolus 1 – 1.5 hours after the meal.
Assess the glycemic response and adjust the following as required:
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Proteinprotein Interaction In Insulin Signaling And The Molecular Mechanisms Of Insulin Resistance
Insulin is an anabolic hormone with powerful metabolic effects. The events after insulin binds to its receptor are highly regulated and specific. Defining the key steps that lead to the specificity in insulin signaling presents a major challenge to biochemical research, but the outcome should offer new therapeutic approaches for treatment of patients suffering from insulin-resistant states, including type 2 diabetes.
Schematic illustration of major signaling pathways of insulin action. The phosphorylated insulin receptor binds and phosphorylates IRS proteins and Shc, which bind differentially to various downstream signaling proteins. PI3-kinase is critical for metabolic actions of insulin, such as glucose transport, glycogen synthesis, and protein synthesis, whereas Grb-2/SOS complex, which activates the MAP kinase cascade, is critical in mitogenic response. PI3-kinase probably modulates the mitogenic response as well.
How Much Protein Do We Need
People need to eat the right amount of protein each day.
From the age of 19 years, the 20152020 Dietary Guidelines for Americans recommend a protein intake of between each day depending on the persons age and sex. Protein intake for adults should account for 10 to 35 percent of their daily calories.
Protein intake is not the same as protein-rich food intake.
According to Choose My Plate, these protein recommendations equate to between 5 and 6.5 ounces of protein-rich food each day. One ounce could be, for example, one egg, one ounce of meat or fish, or a tablespoon of peanut butter.
Research suggests that endurance athletes may need more protein than healthy adults who do not exercise.
One study has proposed that people who do endurance training should consume 1.2 g to 1.4 g of protein per kilogram of body weight each day.
Some bodybuilders and athletes consume extra protein to increase muscle composition, but protein alone does not increase muscle. People have to do the work in the gym to see any result.
Protein shakes can help athletes maintain their protein levels, whether or not they have diabetes.
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The Role Of Diets Daytime Of Consumption And Order Of Nutrients
In the studies we read, the increased interest of children and adolescents in specialised diets was discussed but not investigated. The same is true for the influence of the time of day the meal is consumed and the order in which macronutrients are consumed. This is even more important for children who can be picky eaters and results in switching meals. The Grill study by Neu et al. put an emphasis on the diurnal variation in insulin sensitivity. The authors stated that consuming the same meal on various times of the day may result in different amounts of needed bolus insulin . Various authors showed that consuming carbohydrates at the beginning of a meal leads to lower levels of ghrelin, shortened period of satiety and increased risk for obesity. On the other hand, consuming fat before carbohydrates leads to a delay in gastric emptying resulting in postponed elevation of glucose levels rising .
How Much Protein Should A Person With Diabetes Eat
Protein itself does not have much of an effect on blood sugar levels, though the food the protein is in may. Typically, people with diabetes don’t need any more protein than people who don’t have diabetes. There are, however, times when less protein is better.
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The 7 Best Types Of Protein Powder
Protein powders are very popular among health-conscious people.
There are numerous types of protein powder made from a wide variety of sources.
As there are so many options, it can be difficult to determine which will provide optimal results.
Here are 7 of the best types of protein powder.
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Heres our process.
What Are The Different Types Of Insulin
The American Diabetes Association characterizes insulin by how fast it works. But everyones body is different. If you have diabetes, you should expect deviations in the amount of time any medication takes to reach your bloodstream. Here are a few useful terms related to how fast and how long insulin acts in your body:
- Onset is defined as the length of time before insulin hits your bloodstream and begins to lower blood glucose.
- Peak is the time during which insulin is at its maximum effectiveness at lowering your blood glucose levels.
- Duration is the length of time insulin continues to lower your blood glucose levels.
These are the five main types of insulin that doctors prescribe:
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Intact Protein V Protein Hydrolysate
Mixed-design analysis showed that SPI induced significantly higher total AUC for insulin than SPH . Further analyses revealed that the difference over time between SPI and SPH was due to a difference in the initial rise in insulin concentrations . No significant interaction terms were found. Total AUC for glucagon was also significantly higher after SPI compared with SPH while the interaction between protein form and amount of protein was not significant . Further analyses showed that, like for insulin, SPI induced a faster increase in glucagon compared with SPH . With respect to total AUC for glucose, no overall effect of protein form was found for soya .
Fig. 1 Total areas under the curve for insulin , glucagon and glucose after ingestion of intact protein or protein hydrolysate at 0·3 , 0·4 or 0·6 g/kg body weight with soya or whey as the protein source. Values are means, with their standard errors represented by vertical bars. * Mean value is significantly different from that for 0·6 g/kg BW . Mean value is significantly different from that for 0·4 g/kg BW . Mean values are significantly different from those for the hydrolysed protein .
Fig. 2 Insulin , glucagon and glucose responses after ingestion of intact and hydrolysed soya or whey protein . , Intact proteins , hydrolysed proteins. Values are means, with their standard errors represented by vertical bars. * Significantly different slope from the corresponding hydrolysed protein .
Insulin And Protein Metabolism
F D W Lukens Insulin and Protein Metabolism. Diabetes 1 September 1964 13 : 451461.
The present status of protein synthesis within cells has been outlined. Protein is formed in the absence of insulin the net formation of protein is accelerated by insulin. The effects of insulin on protein metabolism take place independently of the transport of glucose or amino acids into the cell of glycogen synthesis and of the stimulation of high energy phosphate formation. In the case of protein metabolism, as in certain studies on the pathways of glucose and fat metabolism, these observations reveal striking intracellular effects of insulin in many tissues. Within most tissues the effect of insulin appears to find expression predominantly at the microsomal level. Incidentally, other hormones which affect protein metabolism such as growth or sex hormones appear to act at the microsomes. The fact that insulin exerts effects on protein metabolism at other intracellular sites as well as the above independent effects leads one to agree that its action consists of a stimulation of multiple, seemingly unrelated, metabolic events.
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Pheb24 Stabilizes Native Self
- Whittaker J.
- Weiss M.A.
J. Biol. Chem.
|Analog||Proteins were made 0.6 mm in a zinc-free buffer and applied to the SEC column as described under Experimental procedures masses were calculated from Fig. S9.|
|min ± S.D.|
|1.2 ± 0.2||4.9|
Pharm. Res.Annu. Rev. Biophys.
- Whittaker J.
- Weiss M.A.
J. Biol. Chem.Structure.Structure.
Insulin And Insulin Analogues
Insulin is a hormone secreted by -islets of Langerhans. It is a polypeptide with a molecular weight of 6000 Da, consisting of two amino acid chains A and B linked by two disulfide bridges. The A and B chain contains 21 and 30 amino acids, respectively . Insulin was the first therapy used in the treatment of DM regardless of the types . In order to enhance its effectivity, stability, and duration of action, number of insulin analogues were prepared and tested, for example, first generation rapid-acting insulin analogues such as insulin lispro and insulin aspart , second generation basal insulin analogues such as insulin glargine and insulin detemir , and third generation rapid-acting insulin analogues such as insulin glulisine .
Compared to human insulin preparations, the rapid-acting analogues dissociate more rapidly, and therefore, have a more rapid onset of action, with higher peak serum concentration, and a more rapid tailing off effect. The longer duration of action of the insulin analogues, relative to protaminated or zinc-retarded human insulin, potentially offers a better coverage in between-meal period. Their flatter pharmacodynamic profile, with a much lower peak of action, reduced the risk of hypoglycemia . However, with all such advancement in the preparation of insulin analogues, there was no discernable clinical advantage over the classical insulin preparation .
Figure 2. Assembling nature of human insulin: proinsulin, insulin and its derivatives.
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