Whey protein supplementation aids in blood sugar control in T2D

Drinking a little amount of whey protein before meals helps keep a lid on blood glucose levels of individuals with type 2 diabetes (T2D), as shown in a study.

Compared with a nutrient-depleted placebo beverage, a ready-to-drink whey protein shot (15 g of protein) lowered the prevalence of daily hyperglycaemia by 8 percent (30 percent vs 38 percent; p<0.05). This enabled patients to achieve a 9-percent increase, which translates to 2 hours, in the time spent in euglycaemia (p<0.05). [BMJ Open Diabetes Res Care 2022;10:e002820]

Furthermore, mean 24-hour blood glucose concentrations decreased by 0.6 mmol/L with whey protein vs placebo (p<0.05). There were similar improvements in glycaemic control during the waken period (06:00–23:55 hours; p<0.05), but nocturnal glycaemic control was unaffected (24:00–05:55 hours; p>0.05).

“These results occurred without a change in patient medication, dietary intake, or physical activity levels, thereby demonstrating the utility of premeal whey protein supplementation for the management of hyperglycaemia,” according to the investigators.

“This is of importance given our analysis clearly demonstrates that the prevalence of hyperglycaemia is an underappreciated problem for people with controlled T2D treated with available oral medications,” they added.

The investigators believe that premeal whey protein supplementation represents an opportunity to optimize glycaemic control in a cost-effective manner, as the costs of glucose-lowering medications have become a barrier to diabetes treatment. [Diabetologia 2020;63:2112-2122]

Benefit for vascular complications

The present study expands on previous acute laboratory work that highlighted the potential postprandial glucose (PPG)-lowering efficacy of premeal whey protein for patients with T2D, but it also is the first to report the translatability and reproducibility of these findings under real-world and free-living conditions, according to the investigators. [Am J Clin Nutr 2018;107:550-557; Diabetes Care 2016;39:511-517; Clin Nutr 2019;38:2827-2832]

They pointed out that an increase in time spent in euglycemic range (TIR) of 9 percent is substantial and may translate to a reduction in the risk of developing vascular complications. This is in light of previous studies reporting that each 10-percent decrease in TIR could raise the risk of developing retinopathy by 64 percent, microalbuminuria by 40 percent, and peripheral neuropathy by 25 percent in people with long-standing T2D. [Diabetes Technol Ther 2019;21:81-85; Diabetes Care 2019;42:400-405; Diabetes Technol Ther 2021;23:434-442; BMJ Open Diabetes Res Care 2020;8:e000991]

“We believe the whey protein works in two ways, firstly, by slowing down how quickly food passes through the digestive system and secondly, by stimulating a number of important hormones that prevent the blood sugars climbing so high,” principal investigator Dr Daniel West of Newcastle University said in a statement.

Favoured by patients

In the study, a total of 18 insulin-naïve T2D patients (mean age 50 years, HbA1c 7.4 percent, duration of diabetes 6 years) were randomized to consume a ready-to-drink whey protein shot or a nutrient-depleted placebo beverage 10 min before breakfast, lunch, and dinner over a 7-day free-living period.

The investigators measured free-living glucose control by blinded continuous glucose monitoring and determined by the percentage of time spent above range (>10 mmol/L), in euglycemic range (3.9–10.0 mmol/L), below range (<3.9 mmol/L), and mean glucose concentrations.

Supplemental compliance/acceptance was high at >98 percent, and there were no adverse events documented.

“People were able to stick to the regimen and liked the idea of having a convenient, tasty, small premade drink that could be carried with them and taken before meals,” one of the study investigators, Newcastle University PhD student Kieran Smith, pointed out.

West, along with Smith and the rest of the team, plans to take the research further by conducting a larger scale study with a longer follow-up period of up to 6 months. They also want to look at alternative proteins, such as those that come from plant sources like peas, fungi, and potatoes, to open options for vegan and religious dietary needs.