饮食蛋白对1型糖尿病餐后血糖控制和胰岛素需求的影响：系统评价。,Diabetic Medicine

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饮食蛋白对1型糖尿病餐后血糖控制和胰岛素需求的影响：系统评价。
Diabetic Medicine ( IF 3.2 ) Pub Date : 2019-10-10 , DOI: 10.1111/dme.14119
M A Paterson _{1,

2} , B R King _{1,

2} , C E M Smart _{1,

2} , T Smith ₁ , J Rafferty ₁ , P E Lopez ₂

Affiliation

AIM餐后高血糖对于1型糖尿病患者是一项挑战。除了碳水化合物外，膳食蛋白质还被证明有助于餐后血糖波动，建议在计算进餐时间胰岛素剂量时考虑蛋白质。这篇综述的目的是鉴定和综合有关饮食蛋白和胰岛素需求对1型糖尿病患者的血糖影响的证据。方法对相关生物医学数据库进行系统的文献检索，以鉴定对1型糖尿病患者单独食用以及与其他大量营养素合用时饮食蛋白质的血糖影响的研究。结果评价包括1992年至2018年的14篇公开研究，包括单独研究蛋白质（n = 2）和混合餐中蛋白质（n = 12）的影响的研究。当单独食用蛋白质时，直到≥75 g才观察到血糖作用。在含碳水化合物的膳食中，≥12.5 g的蛋白质会影响餐后葡萄糖。高蛋白餐中包含脂肪会增强血糖反应，并进一步增加胰岛素需求。饮食蛋白产生血糖作用的时间范围为90至240分钟。研究表明，当单独或与碳水化合物和/或脂肪一起食用蛋白质时，餐后血糖反应和胰岛素对蛋白质的需求是不同的。结论本系统综述提供了饮食蛋白有助于餐后血糖波动和胰岛素需求的证据。

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Impact of dietary protein on postprandial glycaemic control and insulin requirements in Type 1 diabetes: a systematic review.

AIM Postprandial hyperglycaemia is a challenge for people living with Type 1 diabetes. In addition to carbohydrate, dietary protein has been shown to contribute to postprandial glycaemic excursions with recommendations to consider protein when calculating mealtime insulin doses. The aim of this review is to identify and synthesize evidence about the glycaemic impact of dietary protein and insulin requirements for individuals with Type 1 diabetes. METHODS A systematic literature search of relevant biomedical databases was performed to identify research on the glycaemic impact of dietary protein when consumed alone, and in combination with other macronutrients in individuals with Type 1 diabetes. RESULTS The review included 14 published studies dated from 1992 to 2018, and included studies that researched the impact of protein alone (n = 2) and protein in a mixed meal (n = 12). When protein was consumed alone a glycaemic effect was not seen until ≥ 75 g. In a carbohydrate-containing meal ≥ 12.5 g of protein impacted the postprandial glucose. Inclusion of fat in a high-protein meal enhanced the glycaemic response and further increased insulin requirements. The timing of the glycaemic effect from dietary protein ranged from 90 to 240 min. Studies indicate that the postprandial glycaemic response and insulin requirements for protein are different when protein is consumed alone or with carbohydrate and/or fat. CONCLUSIONS This systematic review provides evidence that dietary protein contributes to postprandial glycaemic excursions and insulin requirements. These insights have important implications for the education of people with Type 1 diabetes and highlights the need for more effective insulin dosing strategies for mixed macronutrient meals.

更新日期：2019-11-01

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