Luckily, we have an arsenal of medicinal treatments that can enable good control over blood sugar, blood pressure and lipids – and it certainly appears that a Type 2 diabetic can live just as long as someone without the disease.
There’s no doubt that Type 2 diabetes has a strong genetic component, but what’s causing the many new cases of the disease? Ninety-five percent of all new cases can be attributed to overweight and lack of exercise. A number of randomised studies have demonstrated that diet and exercise can prevent pre-diabetics from developing the disease, and that it’s possible for patients to recover from the disease if they lose weight and increase their amount of exercise.
Revisiting diabetic diets
For many years, the medical profession recommended that Type 2 diabetics should follow the same dietary recommendations as the rest of the population in order to reduce weight and blood sugar levels. In Denmark, I’ve been part of developing these recommendations, which focus on reducing fat and eating more carbohydrate-heavy foods such as bread, rice, pasta, potatoes, preferably with plenty of fibre and whole grains. The recommendations have worked well for a large portion of the population, but more recent research has indicated that nutrition plans with reduced carbohydrate content are more effective in decreasing weight and blood sugar levels in Type 2 diabetes patients than are plans that aim to reduce fat content.
Where’s the quality of life?
In 2014, together with American colleagues, I reviewed the entire body of scientific literature around the determination of the most effective nutrition/diet for Type 2 diabetics, comparing the results to a physiological understanding of the metabolic changes that accompany the development of diabetes. The results, supported by a number of subsequent meta-analyses of randomized trials, clearly showed that carbohydrate restriction should be in focus, with the most dramatic effects occurring when carbohydrates are almost non-existent (around 10 percent).
There is, however, a problem. We humans aren’t really set up to reduce carbohydrate intake so extremely. Almost completely avoiding bread, rice, pasta, fruit and berries simply isn’t something that comes naturally or easily to us. And it’s important for quality of life to be able to look forward to meal times. Positive management effects are, however, achievable at less severe levels of restriction, and more work is currently being undertaken to determine nutrition plans that combine Type 2-friendly food choices with human-friendly eating lifestyles.
What about protein?
Of course, if carbohydrates are to be reduced in nutrition plans for Type 2 diabetics, what should take their place? How much fat and how much protein? At this stage, it’s not perfectly clear. And, unfortunately, research funding to answer questions about diet-based disease management is far more difficult to drum up than for the development of new pharmaceuticals.
One bright spot on the horizon may be whey protein - one of the protein sources that best match human protein found in the muscles, organs and tissues.
In recent years, there has been a lot of discussion about whey protein and its potential benefits for Type 2 diabetes patients. According to the US National Dairy Council, whey protein assists with curbing hunger, recovering quickly from exercise, and losing fat while maintaining lean body mass. All of these properties are potentially useful for Type 2 diabetes patients. And, from a diabetes management perspective, there may be even more specific advantages. In fact, a growing body of research has proposed that whey protein or its amino acids can, for example:
- Support patients whose altered diets may not be providing enough high-quality protein.
- Aid in increasing fat loss.
- Reduce the oxidative stress thought to be responsible for a number of the complications of diabetes.
- When added to a meal, increase insulin secretion and decrease post-meal blood sugar by slowing the absorption of carbohydrates, such as glucose, into the bloodstream.
- Slow down gastric emptying and stimulate GLP-1 and GIP gut hormones to influence the appearance of sugar in the blood after a meal.
- Suppress the inflammatory activity present in anyone with diabetes that makes controlling blood sugar levels and weight loss even more difficult.
The research behind such conclusions does, however, come with limitations that still need to be addressed. For example, much of the research is based on trials with healthy subjects rather than diabetes patients. And more long-term trials are called for, too.
Effects such as those described above should also be expected to vary from patient to patient – and a range of details, such as the types and amounts of foods consumed together with the whey protein supplement or the bioavailability of differing grades of supplement, will also regulate any positive effects.
From what researchers have discovered thus far, however, whey protein as a dietary component seems likely to have a range of useful effects in the management of Type 2 diabetes. Further research into protein supplements in connection with diabetes is welcome, and of course, as with any significant change to patient diets, the applicability of whey protein to individuals would need to be determined as part of a systematic treatment regime.
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