Effect of Protein Meals on Plasma Insulin in Mildly Diabetic Patients

We have reported that in mildly diabetic patients increases in plasma insulin are subnormal in response to infused amino acids while others have reported excessive increases in response to ingested protein. Increases in plasma insulin exhibited by nonobese, mildly diabetic patients in response to the ingest ion of protein meals and to the intravenous administration of a mixture of ten essential amino acids were compared to those of healthy nonobese control subjects. The plasma insulin responses to protein meals were also determined in a group of mildly obese, mildly diabetic patients. The results of these studies indicate that: (1) the mean insulin response of nonobese mildly diabetic patients to protein meals is subnormal and not excessive, (2) mildly obese, mildly diabetic patients respond excessively to protein meals as compared to control subjects of normal weight, and (3) the excessiye insulin response to protein meals reported by others to occur in diabetics is probably the result of a greater degree of adiposity in their diabetics than in their control subjects, rather than of the presence of diabetes mellitus. Unless the degree of adiposity is similar in diabetic and healthy subjects, meaningful comparison of their insulin responses to protein meals or other stimuli cannot be made.