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Open AccessArticle

L-Glutamine and Whole Protein Restore First-Phase Insulin Response and Increase Glucagon-Like Peptide-1 in Type 2 Diabetes Patients

1
Diabetes & Metabolism Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst 2010, Sydney, NSW, Australia
2
Faculty of Medicine, UNSW Australia, High Street, Kensington 2052, Sydney, NSW, Australia
3
NNF Center for Basic Metabolic Research, Department of Biomedical Sciences, University of Copenhagen, Panum Institute, Nørregade 10, DK-1165 Copenhagen, Denmark
4
Department of Endocrinology and Diabetes Center, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst 2010, Sydney, NSW, Australia
*
Author to whom correspondence should be addressed.
Nutrients 2015, 7(4), 2101-2108; https://doi.org/10.3390/nu7042101
Received: 21 January 2015 / Revised: 10 March 2015 / Accepted: 12 March 2015 / Published: 24 March 2015
l-glutamine triggers glucagon-like peptide-1 (GLP-1) release from L cells in vitro and when ingested pre-meal, decreases postprandial glycaemia and increases circulating insulin and GLP-1 in type 2 diabetes (T2D) patients. We aimed to evaluate the effect of oral l-glutamine, compared with whole protein low in glutamine, on insulin response in well-controlled T2D patients. In a randomized study with a crossover design, T2D patients (n = 10, 6 men) aged 65.1 ± 5.8, with glycosylated hemoglobin (HbA1c) 6.6% ± 0.7% (48 ± 8 mmol/mol), received oral l-glutamine (25 g), protein (25 g) or water, followed by an intravenous glucose bolus (0.3 g/kg) and hyperglycemic glucose clamp for 2 h. Blood was frequently collected for analyses of glucose, serum insulin and plasma total and active GLP-1 and area under the curve of glucose, insulin, total and active GLP-1 excursions calculated. Treatments were tested 1–2 weeks apart. Both l-glutamine and protein increased first-phase insulin response (p ≤ 0.02). Protein (p = 0.05), but not l-glutamine (p = 0.2), increased second-phase insulin response. Total GLP-1 was increased by both l-glutamine and protein (p ≤ 0.02). We conclude that oral l-glutamine and whole protein are similarly effective in restoring first-phase insulin response in T2D patients. Larger studies are required to further investigate the utility of similar approaches in improving insulin response in diabetes. View Full-Text
Keywords: glutamine; insulin response; hyperglycemic glucose clamp; type 2 diabetes glutamine; insulin response; hyperglycemic glucose clamp; type 2 diabetes
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Samocha-Bonet, D.; Chisholm, D.J.; Holst, J.J.; Greenfield, J.R. L-Glutamine and Whole Protein Restore First-Phase Insulin Response and Increase Glucagon-Like Peptide-1 in Type 2 Diabetes Patients. Nutrients 2015, 7, 2101-2108.

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