Introduction and Objective: Rapid postprandial glucose rises during pregnancy may adversely affect offspring health, while practical dietary advice for gestational diabetes remains limited. In type 2 diabetes, premeal whey protein (WP) reduces postprandial blood glucose. We investigated whether preprandial WP attenuates glucose excursions after carbohydrate intake in pregnant women and explored underlying mechanisms.Methods: In this randomized crossover study, 21 healthy, pregnant women (24+0 – 27+6 weeks` gestation) completed two oral glucose tolerance tests: one preceded by ingestion of 25 g WP 30 min before the start and one without (control=C). Insulin secretion was assessed by disposition index (DI) and insulin sensitivity by non-esterified fatty acid insulin sensitivity index, specifically proposed for pregnancy.Results: Peak glucose occurred after 60 min on the control day (8.2 mmol/L [7.3-8.9]) and was reduced on the day with WP preload (6.0 mmol/L [4.7-6.3]; p<0.0001). Fasting glucose did not differ between days. The area under the glucose curve (AUC0-120 min) was 13% lower at WP day compared to control (p<0.0001).Insulin secretion and insulin sensitivity were higher at WP day (both p=0.01).WP intake increased gut-derived peptide hormones (GLP-1, GIP, glicentin). GLP-1 concentrations at 30 min and the AUC0-30 min were higher following WP preload (p≤0.03). Glucagon levels and corresponding AUCs were higher at 30- and 120-min following WP (all p<0.008). However, between-condition differences in gut hormone responses did not correlate to improvements in glucose tolerance, insulin secretion, or insulin sensitivity.Conclusion: WP markedly reduced glucose excursions after carbohydrate intake in pregnancy. Although gut hormone responses were enhanced, they may not fully explain observed metabolic effects, suggesting additional mechanisms. Preprandial WP intake may offer a simple dietary approach to lower postprandial glycemia in pregnancy; with potential relevance for gestational diabetes and real-world meal settings.
J. Hummel: Speaker’s Bureau; Ended; Eli Lilly and Company. S. Neth: None. R. Spies: None. G. Ufer: Other – speakers fee; Ended; Boehringer Ingelheim International GmbH. R. Sabia: None. R. Wagner: Advisory Panel; Current; Sanofi. Speaker’s Bureau; Ended; Daiichi Sankyo, Novo Nordisk. A. Peter: None. M. Heni: Advisory Panel; Ended; Chiesi USA, Inc. Speaker’s Bureau; Ended; Chiesi USA, Inc. Advisory Panel; Ended; Boehringer Ingelheim International GmbH. Speaker’s Bureau; Ended; Boehringer Ingelheim International GmbH, AstraZeneca, Lilly, Novartis AG, Novo Nordisk, Bayer AG.
German Diabetes Association (DDG)
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