Protein and diabetes: much advice, little research.

In persons with diabetes, moderate hyperglycemia can contribute to an increased turnover of protein. To maintain body composition and nitrogen balance requires metabolic control and sufficient protein and energy intakes. However, because most adults eat at least 50% more protein than is required, people with diabetes appear to be protected from protein malnutrition when consuming a usual diet. Although nonessential amino acids undergo hepatic gluconeogenesis, peripheral glucose concentrations do not increase after protein ingestion. The fate of produced glucose is unknown. Protein does not contribute to sustained elevations of glucose levels, slow absorption of carbohydrate, or help in the treatment of hypoglycemia--advice often given to persons with diabetes. Protein is, however, just as potent a stimulant of insulin secretion as glucose. No long-term research is available to document that high-protein, low-carbohydrate diets are continued long-term or that weight lost initially is maintained better from these diets than from traditional weight loss diets. Furthermore, in persons with type 2 diabetes, weight loss is reported to be related to energy restriction and not to the protein-to-carbohydrate ratio of the diet.