How much protein should people with diabetes consume?

Protein for people with diabetes is always essential, but other factors are involved in an athlete’s well-being. Protein itself has little effect on blood sugar levels; generally, protein for people with diabetes should not differ from that for the general population, whether athletic or sedentary. However, there are times when less protein for people with diabetes is better. Protein is one of the three essential macronutrients for building, repairing, and maintaining most tissues and organs. It is also necessary for maintaining a functional immune system and for some additional physiological processes. As such, protein is the primary functional and structural component of all the body’s cells. The chemical composition and physical structure of dietary and bodily proteins vary considerably. Nevertheless, all proteins for people with diabetes are composed of chains of amino acids containing a required nitrogen amino group.

• Amino acids serve as precursors for many coenzymes, hormones, and nucleic acids, in addition to their role in the various structures of proteins.
• Because amino acids also contain carbon, oxygen, and hydrogen, their residues can enter the tricarboxylic acid cycle to be used as energy after deamination.

Okay, regarding proteins, what is diabetes? Diabetes occurs in two forms: type 1 and type 2.

Type 1 diabetes

In this scenario, people need insulin injections, so it is often referred to as “insulin-dependent diabetes.” Insulin is the hormone responsible for delivering nutrients (carbohydrates, proteins, and fats) to muscle cells and is essential for producing energy from glucose (carbohydrates) obtained from food.

The pancreas is the organ responsible for producing this hormone.

Unfortunately, type 1 diabetes cannot be prevented because it results from an autoimmune reaction that causes the pancreatic cells to stop functioning. This usually happens at an early age, between 8 and 12 years old (although cases in which it occurs much later have been reported).

Type 2 diabetes

This type of diabetes does not require insulin injections, as it is caused by the cells’ reduced ability to let insulin in and do its job.

This condition is called insulin insensitivity or low insulin sensitivity.

When cells reject the hormone insulin, the person not only produces energy poorly but also begins to gain weight because, since nutrients cannot be delivered to the appropriate tissues, they are simply stored, and in this case proteins for diabetics are not individually responsible either. Once the body realizes that the cells are not properly taking in insulin, it begins to increase insulin production in an attempt to compensate. This only worsens the problem, as the cells become even more resistant and body fat continues to increase with whatever food the person consumes.

Protein intake for diabetics

As long as the kidneys are healthy, 20% to 30% of daily calories should come from protein, and this can even reach 35% in cases of intense training programs. This is the same amount suggested for a balanced non-diabetic diet, in which around 45% to 50% of caloric intake should come from carbohydrates and the remainder from fats. Proteins for diabetics can certainly come from some supplements, but also from protein-rich foods such as red meat, fish, seafood, chicken, eggs, dairy products supplemented with legumes, nuts, and seeds.

Choosing proteins for diabetics

When choosing proteins for diabetics, the concern focuses on the fats and carbohydrates contained in whole foods. Some types of carbohydrates, for example, are quickly converted into glucose, which can lead to an imbalance, as well as the risk of weight gain.

Consuming foods high in fat and carbohydrates can lead to poorer control of blood sugar levels.

For example, recognized medical institutions recommend consuming fish as a source of protein at least twice a week, but they also talk about limiting red meat and processed meats such as ham, bacon, and sausages, as they tend to be high in saturated fat. In any case, among the proteins for diabetics, lean meats are the best option in a balanced diet that supports well-being or athletic performance.

High-protein diets for diabetics

Switching to a high-protein diet may seem as though it should make a difference in blood sugar regulation, but in this scenario, protein probably does not help, at least in the long term. Research has shown that increasing the intake of protein for diabetics does not appear to have an appreciable impact on how sugar is digested or absorbed, nor does it have any long-term effect on blood sugar or insulin requirements. This means that if a person with diabetes switches to a high-protein diet, any therapeutic benefit is probably due to the concurrent reduction and stricter regulation of carbohydrate intake, not to a particular protein intake. This is an important foundation for a consistent-carbohydrate diet, which can help manage type 2 diabetes, but it does not mean that high-protein diets are suitable for everyone, since each person has a unique situation and eating habits. In any case, a healthy lifestyle, such as bodybuilding or fitness, can be a powerful ally in the fight against diabetes. In the following section, we will describe the impact of an active lifestyle that requires a certain intake of protein for diabetics and affects insulin sensitivity and glucose (carbohydrate) utilization.

Protein for diabetics as snacks

In all cases, athletes with diabetes should have a snack on hand. Something as simple as 3 glucose tablets followed by a protein bar for diabetics can be essential when an athlete begins to feel hypoglycemic (low blood sugar).

The symptoms of hypoglycemia include hunger, trembling, dizziness, confusion, irritability, and sweating.

If you have diabetes and experience this during exercise, stop and consume some simple sugars (such as 3 glucose tablets), followed by a protein bar 10 minutes later to try to stabilize your blood sugar. Then rest for about 15 more minutes and measure your blood glucose levels again. If it is below 100 mg/dl, do not resume training.

After your workout, don’t forget your protein for diabetics

Post-workout nutrients should consist of complex carbohydrates and diabetic protein. All bodybuilders who know what they are doing understand the importance of nutrition. Immediately after training, the body needs to replenish its glycogen and amino acid stores to begin the recovery, repair, and growth processes. For the diabetic bodybuilder, another reason to consider this timing is to avoid low blood sugar caused by the increased glucose absorption by the muscles that occurs just after training ends.

The body always, always strives to replenish glycogen.

Remember that diabetic protein is simply the protein you already know, since its structure or composition does not depend on the type of person. Which ones?… the best are those with reduced or no added sugars, as pure as possible…

Training and insulin sensitivity

We can state that weight training improves insulin sensitivity and glucose tolerance. It appears that people with type 2 diabetes (around 90% of diabetes cases) benefit more from weight training because it increases insulin sensitivity and therefore directly addresses the underlying problem. Likewise, people with type 1 diabetes also benefit, as most see a reduction in the amount of insulin they need to take each day to control their glucose levels. In either case, diabetic protein or protein for non-diabetics is essential for muscle development and should come from various sources without exceeding individual requirements based on muscle mass, activity level, and other variables.

Training and energy

Any type of training program definitely increases the need to use glucose for energy; even moderate amounts of weight training (such as 30–40 minutes three times a week) increase muscle mass and gradually turn the energy cycle positive.

More muscle means that greater amounts of glucose are used throughout the day and during exercise.

In turn, this helps anyone with type 1 diabetes, as it is possible to reduce the insulin dose (lower glucose levels allow a smaller insulin dose to control the remainder). It should also be taken into account that the cardiovascular exercise component of weight training also helps eliminate glucose, in addition to increasing insulin sensitivity. An interesting study even discusses a reduction in insulin sensitivity after a relatively high-protein, high-fiber diet, when training [1]. This suggests that insulin sensitivity may reflect metabolic adaptations to the dietary composition for maintaining glucose homeostasis, rather than metabolism altered by the training program itself.

Diet when training and blood sugar

A hypertrophy diet is optimal for better blood sugar control because it requires constant blood sugar management, and the best way to achieve this is by following the right diet. Slow-release or high-fiber carbohydrates, such as brown rice, oats, and sweet potatoes, combined with vegetables such as green beans and broccoli, should be the main staple carbohydrates accompanying diabetic-friendly proteins. Small amounts of healthy fats should also be added, such as those found in fish like salmon (fish oils), flaxseed oil, and extra-virgin olive oil, which also help increase insulin sensitivity and control blood sugar. Diabetic athletes can follow a diet consisting of 45–50% carbohydrates, 25–30% protein, and 20% healthy fats, occasionally taking liver-protective supplements and herbal teas during certain periods to offset the protein load. In this type of diet, it is also essential that, instead of large and infrequent meals, the diet consist of smaller, more frequent meals.

The case of diabetic nephropathy

People who have diabetic nephropathy, a kidney disease related to diabetes, often need to eat less protein. In this case, the recommended intake of protein for diabetics is approximately 1 g to 1.5 g per kilogram of body weight. In fact, doctors and nutritionists are the ones who will determine this, since too much protein can be harmful to the kidneys, while too little protein can cause malnutrition and unintended weight loss. Anyone with diabetes can also benefit from personalized advice on protein intake; however, many factors play a role in a balanced diet, because individual needs may differ from general recommendations. That said, although protein does not seem to directly affect blood glucose levels, the other components of foods rich in protein for diabetics may do so. In any case, whole foods low in fat and carbohydrates, such as low-calorie desserts, may be suitable in this case.

Post-workout rest and recovery

In any case, people with diabetes need complete rest and adequate recovery to achieve results, which preserves efficient insulin absorption. Research indicates that lack of sleep when training hard destroys insulin sensitivity to such an extent that «healthy young men with no risk factors can become prediabetic within a week» [2]. What happens is that without getting enough sleep or rest, the central nervous system becomes more active.

This condition inhibits the pancreas, causing it to produce adequate insulin inefficiently.

Remember that before going to sleep, protein for diabetics such as casein can also nourish you so that you sleep and rest better.

Nutrition in high-performance sports

Many professional athletes and participants in various sports have diabetes, which means the details must be taken into account. Currently, there are no specific dietary guidelines for applying this in sports, although recommendations do exist. Athletes with diabetes should adjust their diet according to the guidelines suggested for the general population, possibly paying attention to their daily nutritional composition and food quantities, in order to preserve their health and ensure adequate performance and strength. A critical aspect of diabetes management is preventing complications caused by persistent hyperglycemia. In addition, people with diabetes may experience various changes in connective tissue, including the bones, tendons, and cartilage [3]. In any case, not only is protein for diabetics necessary, but comprehensive support is also required, ranging from balanced nutrients in the diet to key supplementation for both the musculoskeletal system and the organs. Some musculoskeletal disorders are more common in people with diabetes, including osteoarthritis, tendinitis, fractures, intervertebral disc degeneration, and decreased bone mineral density, which may occur especially when training or competing at a high-performance level. As mentioned above, pharmacological treatment of Type 1 diabetes requires insulin supplementation. In this context, athletes affected by type 1 diabetes should pay attention to:

• The relationship between the pre-meal insulin dose and,
• The amount of carbohydrates consumed with food.

In clinical practice, the quantity and quality of carbohydrates should be considered the main factor in determining insulin requirements.

Supplementation for diabetics

Certain bodybuilding supplements help increase insulin efficiency and glucose elimination. Alongside protein for diabetics, a successful training program requires:

• Maintaining insulin sensitivity and,
• Optimal nutrient utilization.

For this reason, bodybuilders use supplements that optimize insulin metabolism, including alpha-lipoic acid: impressive for increasing insulin sensitivity.

• You can add about 300–400 mg to your post-workout carbohydrate/protein shake.

Chromium picolinate: increases insulin sensitivity to keep blood sugar stable, while also supporting the pancreas.

• You can add 200 mg to the same shake or at breakfast on rest days.

Gymnema sylvestre leaf extract also works because it helps balance blood sugar.

• A dose of 400 mg three times a day is recommended.

An alternative is vanadium sulfate: this supplement was very popular among old-school bodybuilders in the early 1990s because of its pro-insulin properties and its ability to improve glucose utilization. It fell out of favor sometime in the mid-1990s, but it has proven its effectiveness time and again.

• You can add 7–7.5 mg with each meal containing carbohydrates.

Strange as it may seem, vitamin C together with vitamin E helps reduce blood glucose levels and also protects the kidneys.

• You can add 1000 mg three times a day for the effects mentioned above and also because of its ability to reduce cortisol.

Conclusions

You should bear in mind that a blood sugar level that is too high or too low before training may warrant waiting until it returns to normal; it should be between 100 and 120 mg/dl. In all cases, if you are diabetic, you should bear in mind:

• Stay hydrated by drinking plenty of water before, during, and after physical activity to prevent your body temperature from rising too much, which in turn helps avoid major fluctuations in blood sugar.
• Keep some protein snacks for diabetics on hand, along with glucose tablets for when hypoglycemia occurs.
• Have a post–workout shake to replenish glycogen stores, with a low-sugar protein and complex carbohydrates, or alternatively, some BCAA with glutamine, even before finishing your workouts.
• Keep protein intake under control by following a diet consisting of 45–50% carbohydrates, 25–30% protein, and 20% fat.
• Recover completely by occasionally taking casein before bed or some amino acids as a nighttime snack.

We hope that if you are not a bodybuilder and suffer from diabetes, after reading this article you will decide to adopt this new lifestyle. If you are already an athlete, make sure to tell anyone with this condition that bodybuilding can be a powerful ally for you. Finally, remember that insulin is the metabolic key for every athlete, whether amateur or professional.