Pre Diabetes Clinical Trial
Official title:
Impact of Whey and Leucine on Glycaemia in Adults Without Diabetes But With Moderately Raised HbA1c
Higher than average blood sugar (glucose) levels are linked to an increased risk of developing type 2 diabetes. As such, there is interest in identifying dietary factors that could lower blood glucose to help reduce the number of people with this disease. Findings from some human studies indicate that dairy products, especially a milk protein (whey), may help the control of blood glucose levels. However, there is a need for further studies to confirm these findings in individuals without diabetes but with higher than average blood glucose levels.
In the UK, more than 700 people are diagnosed with type 2 diabetes each day. Higher than
average (raised) fasting blood sugar (glucose) is a characteristic of those at risk of
developing this disease and as a result there is significant interest in dietary factors that
could reduce levels of blood glucose, lowering the frequency of type 2 diabetes in the
population. Existing scientific evidence suggests an important role of dairy products and
especially of whey protein in the control of blood glucose levels. However, there is a need
for further studies to confirm these findings in individuals without diabetes but with higher
than average blood glucose levels.
Milk contains high quality proteins, of which 80% are caseins and 20% are whey proteins. Whey
proteins are a rich source of branched-chain amino acids (such as leucine) which are thought
to play an important role in regulating blood glucose control and other aspects of
cardiovascular disease development in both healthy and type 2 diabetic subjects. However,
very few studies in non-diabetic subjects with moderately raised HbA1c, characteristic of
long-term poor glucose control, have been performed to investigate how whey protein affects
blood glucose levels in the body especially when consumed over the longer term in the daily
diet. Furthermore, data are limited on whether the leucine content of protein plays an
important role in controlling blood glucose levels.
Study aims The main aims of this study is to investigate in adults without diabetes but with
moderately raised HbA1c (a long- term marker of blood glucose control) whether a protein
obtained from milk and dairy products (whey) has a beneficial effect on fasting and day-long
blood glucose and insulin levels compared with a plant based protein (such as wheat). The
researchers will also determine if leucine, a particular amino acid (building blocks of
protein) found in higher levels in whey protein plays an important role in controlling blood
glucose levels.
A secondary aim will determine whether the protein interventions influence risk markers for
developing heart disease and diabetes including the level of blood lipids, hormones
regulating blood sugar levels and blood vessel health.
This study will test the hypothesis that the incorporation of whey protein (total protein
dose 50 g/d) in the habitual diet for 8 weeks will result in an improvement in fasting and
day-long blood glucose and insulin levels, and other risk markers of heart disease and
diabetes compared with wheat protein (total protein dose 50 g/d), and that the addition of
leucine to wheat (to match the content found in whey protein) will improve blood glucose
control.
Study design This study will be a long term, double-blind, randomised, controlled, three-way,
cross-over study, in which the participants will receive the protein supplements (in random
order) for 8 weeks each, with a 4 week wash-out period between the different protein
treatments. At the beginning and end of each protein intervention, a fasting blood sample
will be collected to determine the longer term effects of the assigned protein supplement on
fasting glycaemic control, insulin sensitivity, endothelial function and other
cardio-metabolic risk markers, as well as non-invasive measures of blood vessel health. At
the beginning of each intervention period, a subset of participants will also undergo a
day-long test meal investigation to determine the short-term (postprandial) effects of the
protein interventions on the study outcome measures in response to standard sequential test
meals containing the assigned protein interventions.
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