Does Protein Distribution Affect Blood Glucose in Type I Diabetes Mellitus? A Case Report

ABSTRACT

Introduction: Type I diabetes mellitus patients often complain of hunger and suboptimal blood glucose levels. Proper protein distribution might help to improve glucose control and ultimately, carbohydrate distribution. Case presentation A nine-year-old boy (herein the patient) newly diagnosed with Type I diabetes mellitus with diabetic ketoacidosis, presented nocturia, polydipsia, loss of weight and lethargy. During admission, the patient was dehydrated and had decompensate metabolic acidosis with glycated hemoglobin (HbA1c) 14.5%, random blood sugar 26.2 mmol/dL, and ketone 3.2 mmol/dL. The patient was started on insulin therapy and referred to a dietitian on the 2nd day of admission. Although patient complied with the dietitian's plan, his glucose level remained suboptimal and he complained of hunger immediately after meals. Insulin dose and activity level remained same at this moment. Whilst keeping the protein intake constant, protein exchanges were redistributed into snacks and main meals. The patient felt satiety and his blood glucose started to optimise. Pairing protein-rich foods with carbohydrates can help to slow the rise in blood glucose because protein causes slower stomach emptying and helps prevent sharp spikes in blood glucose and takes the edge off hunger. Conclusion: This reported case showed proper protein distribution with even carbohydrate distribution can help to improve glucose control and satiety in type I diabetic mellitus. It is recommended that further investigations be conducted to provide more concrete evidence on the role of protein distribution in blood glucose control of type I diabetes mellitus.