Article Text

Thrice daily consumption of a novel, premeal shot containing a low dose of whey protein increases time in euglycemia during 7 days of free-living in individuals with type 2 diabetes
  1. Kieran Smith1,
  2. Guy S Taylor1,
  3. Lise H Brunsgaard2,
  4. Mark Walker3,
  5. Kelly A Bowden Davies1,4,
  6. Emma J Stevenson1,
  7. Daniel J West1
  1. 1Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
  2. 2Health and Performance Nutrition, Arla Foods Ingredients Group P/S, Viby J, Denmark
  3. 3Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
  4. 4Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
  1. Correspondence to Dr Daniel J West; daniel.west{at}


Introduction During acute feeding trials, consuming a large dose of whey protein (WP) before meals improves postprandial glucose regulation in people with type 2 diabetes. It is unclear if the reported benefits of premeal WP supplementation are translatable to everyday care or are associated with clinically meaningful, real-world glycemic outcomes. This study examined the application of a novel, premeal shot containing a low dose of WP on parameters of free-living glycemic control in people with type 2 diabetes.

Research design and methods In a randomized, placebo-controlled, single-blind crossover design, 18 insulin naive individuals with type 2 diabetes ((mean±SD) age, 50±6 years; HbA1c (glycated hemoglobin), 7.4%±0.8%; duration of diabetes, 6±5 years) consumed a ready-to-drink WP shot (15 g of protein) or a nutrient-depleted placebo beverage 10 min before breakfast, lunch, and dinner over a 7-day free-living period. Free-living glucose control was measured by blinded continuous glucose monitoring and determined by the percentage of time spent above range (>10 mmol/L), in euglycemic range (3.9–10.0 mmol/L), below range (<3.9 mmol/L) and mean glucose concentrations.

Results Mealtime WP supplementation reduced the prevalence of daily hyperglycemia by 8%±19% (30%±25% vs 38%±28%, p<0.05), thereby enabling a 9%±19% (~2 hours/day) increase in the time spent in euglycemia (p<0.05). Mean 24-hour blood glucose concentrations were 0.6±1.2 mmol/L lower during WP compared with placebo (p<0.05). Similar improvements in glycemic control were observed during the waken period with premeal WP supplementation (p<0.05), whereas nocturnal glycemic control was unaffected (p>0.05). Supplemental compliance/acceptance was high (>98%), and no adverse events were reported.

Conclusions Consuming a novel premeal WP shot containing 15 g of protein before each main meal reduces the prevalence of daily hyperglycemia, thereby enabling a greater amount of time spent in euglycemic range per day over 7 days of free-living in people with type 2 diabetes.

  • Diabetes Mellitus, Type 2

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors KS, EJS, and DJW designed the research. KS conducted the research, analyzed the data, and wrote the manuscript. DJW analyzed the data and wrote the manuscript. GST, MW, KABD, LHB and EJS reviewed and edited the manuscript. DJW is the guarantor of this work and takes responsibility for the integrity of the data and the accuracy of data analysis.

  • Funding This work was supported by a grant awarded to DJW and EJS (grant no: BH172513) from Arla Foods Ingredients Group P/S (Viby J, Denmark). Arla Foods Ingredients Group P/S produced whey protein and placebo treatments. Arla Foods Ingredients Group P/S had no role in the collection, analysis, or interpretation of data. CGM equipment were provided by an equipment award to DJW from Dexcom (San Diego, California, USA).

  • Competing interests DJW and EJS have received research funding, travel expenses, and consultancy fees from Arla Foods Ingredients Group P/S. EJS has received research funding from The Dairy Council. LHB is an employee of Arla Foods Ingredients Group P/S.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.