3.6.0.0 Pro­tein

There is no ev­i­dence that ad­just­ing the daily level of pro­tein in­take (typ­i­cal­ly 1–1.5 g/kg body weight/‍day or 15–20% total calo­ries) will im­prove health in in­di­vid­u­als with­out di­a­bet­ic kid­ney dis­ease, and re­search is in­con­clu­sive re­gard­ing the ideal amount of di­etary pro­tein to op­ti­mize ei­ther glycemic con­trol or car­dio­vas­cu­lar dis­ease (CVD) risk (84,100). There­fore, pro­tein in­take goals should be in­di­vid­u­alized based on cur­rent eat­ing pat­terns. Some re­search has found suc­cess­ful man­age­ment of type 2 di­a­betes with meal plans in­clud­ing slight­ly high­er lev­els of pro­tein (20–30%), which may con­tribute to in­creased sati­ety (58).

Those with di­a­bet­ic kid­ney dis­ease (with al­bu­min­uria and/‍or re­duced es­ti­mat­ed glomeru­lar filtra­tion rate) should aim to main­tain di­etary pro­tein at the rec­om­mend­ed daily al­lowance of 0.8 g/kg body weight/‍day. Re­duc­ing the amount of di­etary pro­tein below the rec­om­mend­ed daily al­lowance is not rec­om­mend­ed be­cause it does not alter glycemic mea­sures, car­dio­vas­cu­lar risk mea­sures, or the rate at which glomeru­lar filtra­tion rate de­clines (101,102).

In in­di­vid­u­als with type 2 di­a­betes, pro­tein in­take may en­hance or in­crease the in­sulin re­sponse to di­etary car­bo­hy­drates (103). There­fore, use of car­bo­hy­drate sources high in pro­tein (such as milk and nuts) to treat or pre­vent hy­po­glycemia should be avoid­ed due to the po­ten­tial concur­rent rise in en­doge­nous in­sulin.