The Clinical Application of Mealtime Whey Protein for the Treatment of Postprandial Hyperglycaemia for People With Type 2 Diabetes: A Long Whey to Go

Abstract

Mitigating postprandial hyperglycaemic excursions may be effective in not only enhancing glycaemic control for people with type 2 diabetes but also reducing the onset of diabetes-related complications. However, there are growing concerns over the long-term efficacy of anti-hyperglycaemic pharmacotherapies, which coupled with their rising financial costs, underlines the need for further non-pharmaceutical treatments to regulate postprandial glycaemic excursions. One promising strategy that acutely improves postprandial glycaemia for people with type 2 diabetes is through the provision of mealtime whey protein, owing to the slowing of gastric emptying and increased secretion of insulin and the incretin peptides. The magnitude of this effect appears greater when whey protein is consumed before, rather than with, a meal. Herein, this dietary tool may offer a simple and inexpensive strategy in the management of postprandial hyperglycaemia for people with type 2 diabetes. However, there are insufficient long-term studies that have investigated the use of mealtime whey protein as a treatment option for individuals with type 2 diabetes. The methodological approaches applied in acute studies and outcomes reported may also not portray what is achievable long-term in practice. Therefore, studies are needed to refine the application of this mealtime strategy to maximize its clinical potential to treat hyperglycaemia and to apply these long-term to address key components of successful diabetes care. This review discusses evidence surrounding the provision of mealtime whey protein to treat postprandial hyperglycaemia in individuals with type 2 diabetes and highlights areas to help facilitate its clinical application.

Improvement of Glucose Tolerance by Food Factors Having Glucagon-Like Peptide-1 Releasing Activity

“…Furthermore, oral administration of whey protein stimulated GLP-1 secretion and afforded protection against GLP-1 degradation by DPP-4 in awake rats in experiments comparing GLP-1 responses to whey protein and dextrin with or without DPP-4 conditions [ 68 ]. This hypothesis is supported by similar experimental results observed in a previous mouse study [ 69 ], but it has not been evident in humans [ 70 ]. This could be attributed to the technical limitations of human studies, with only peripheral blood samples are available to assess DPP-4 activity.…”

The Postprandial Glycaemic and Hormonal Responses Following the Ingestion of a Novel, Ready-to-Drink Shot Containing a Low Dose of Whey Protein in Centrally Obese and Lean Adult Males: A Randomised Controlled Trial

“…Indeed, gastric emptying, which is a major determinant of PPG (18,40), was substantially delayed following the WP shot; the latter would also favour the modest insulin responses found (41). Of note, insulin concentrations were elevated immediately postbreakfast (t = 0 min) during the WP trial, which may be in response to an increase in plasma glucagon that can occur following protein feeding (22,23), although the effects of insulin and glucagon on PPG appear counterbalanced (14). Importantly, our WP shot was just as effective at reducing PPG excursions in centrally obese individuals as it was for lean subjects, which may have significance since our obese cohort exhibited several features consistent with the Metabolic Syndrome (32).…”

“…There are few studies that have assessed the long-term application of mealtime WP to regulate glycaemia, which may be in part due to the laborious and inconvenience associated with preparing traditional WP supplements, particularly if these are to be consumed multiple times per day (14). Novel to this study, we used a WP preload created specifically for free-living glycaemic management.…”

“…Several lines of work demonstrate that mealtime whey protein [WP] supplementation may serve as a simple, nonpharmaceutical approach to improve PPG control [as reviewed (14)]. WP is rich in branched-chain amino acids and bioactive peptides [potentially b-lactoglobulin and a-lactalbumin (15)] that upon digestion are rapidly absorbed into circulation.…”

“…It is, therefore, imperative to consider the long-term application of an available treatment and its sustainability to improve metabolic health. To this end, there are several methodological limitations associated with mealtime WP supplementation that have not been addressed in previous studies (14). For instance, it is common practice to present WP preloads as unpalatable, dry-mix powders that require dilution and mixing with flavouring immediately prior to their consumption (20)(21)(22)24).…”