Effect of Insulin With Oral Nutrients on Whole-Body Protein Metabolism in Growing Pubertal Children With Type 1 Diabetes

• Published in: Pediatric research Vol. 65; no. 1; pp. 109 - 112
• Main Authors: Braziuniene, Ieva, Garlick, Jeremy, Mileva, Izolda, Desikan, Vardhini, Wilson, Thomas A, McNurlan, Margaret
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 2009; Lippincott Williams & Wilkins
• Subjects: Adolescent; Amino Acids - blood; Biological and medical sciences; Blood Glucose - metabolism; clinical-investigation; Diabetes Mellitus, Type 1 - diet therapy; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - metabolism; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; Dietary Carbohydrates - administration & dosage; Dietary Carbohydrates - metabolism; Dietary Fats - administration & dosage; Dietary Fats - metabolism; Dietary Proteins - administration & dosage; Dietary Proteins - metabolism; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; General aspects; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - blood; Insulin - administration & dosage; Insulin - blood; Insulin Infusion Systems; Kinetics; Male; Medical sciences; Medicine; Medicine & Public Health; Nutritional Status; Pediatric Surgery; Pediatrics; Proteins - metabolism; Puberty - metabolism; Treatment Outcome; Endocrinopathy; Human; Immunopathology; Puberty; Pediatrics; Pancreatic hormone; Oral administration; Autoimmune disease; Metabolism; Insulin; Protein; Type 1 diabetes; Nutrient; Whole body; Child
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1203/PDR.0b013e3181894911

Insulin treatment of children with insulin-dependent diabetes mellitus improves whole body protein balance. Our recent study, conducted in pubertal children with type 1 diabetes with provision of both insulin and amino acids, indicated a positive effect of insulin on protein balance, primarily through decreased protein degradation. The current study was undertaken to assess the effect of insulin on protein metabolism in adolescents with type 1 diabetes during oral provision of a complete diet. Whole-body protein metabolism in six pubertal children (13-17 y) with type 1 diabetes mellitus was assessed with l-[1-
13
C]leucine during a basal (insulin-withdrawn) period and during infusion of 0.15 U/kg/h regular insulin with hourly meals to meet protein and energy requirements. Net leucine balance was significantly higher with insulin and nutrients (13.1 ± 6.3 μmol leucine/kg/h) than in the basal state (−21.4 ± 2.8,
p
< 0.01) with protein degradation decreased from 138 ± 5.6 μmol leucine/kg/h to 108 ± 5.9 (
p
< 0.01) and no significant change in protein synthesis. Even with an ample supply of nutrients, insulin does not increase whole-body protein synthesis in pubertal children with type 1 diabetes mellitus and positive protein balance is solely due to a substantial reduction in the rate at which protein is degraded.