Protein is a vital nutrient that the body needs in order to function properly.

When most
people are asked about proteins, they tend to associate them with muscles. However, they are
extremely critical components of all tissues of the human body; including bones, blood, and
skin.1 Proteins belong to a group called macronutrients of which there are three different types:
proteins, lipids and carbohydrates. Macronutrients are utilized by the body for energy. In
addition to consuming proteins, lipids and carbohydrates the both is able to synthesize them.
Unlike carbohydrates and lipids, proteins are synthesized according to instructions provided by
our DNA. Another key difference between proteins and the other macronutrients has to do with
their chemical makeup. In addition to the carbon, hydrogen, and oxygen atoms also found in the
carbohydrates and lipids, proteins contain a special form of nitrogen that the body can readily
use. Our bodies are able to break down the proteins in foods and utilize the nitrogen for many
important processes.1 (p218)
The proteins that are found in our body are made up of various combinations amino
acids, the building blocks of protein. Amino acids are molecules composed of a chiral carbon
atom connected to four other groups: an amine group, and acid group, a hydrogen atom, and a
side chain. While the amine and acid groups and hydrogen atoms do not differ from one amino
acid to another, it is the side chains that give each amino acid its individual characteristics. There
are approximately twenty amino acids found in the body, but only nine of them are categorized
as essential. An essential amino acid is one that cannot be made in the body and therefore must
be obtained from food. Without the proper amount of essential amino acids in our bodies, we
lose our ability to make proteins and other nitrogen-containing compounds. Nonessential amino
acids are just as important as essential amino acids, but our body makes enough of them so we
do not need to ingest them. 1 (p218-219)

Protein is found in all types of meat, for example, beef, poultry (including eggs), and fish.
Also, milk, cheese and other dairy products are great sources of protein. Lastly, beans, nuts, and
legumes all provide us with protein.2 While there are many sources of protein, The American
Academy of Dietetics and Nutrition recommends protein derived from lean meats, fat free dairy
products, and/or low-fat plant protein foods as the first option in your diet. The leanest cuts of
fish or poultry are excellent alternatives.5
The digestion of protein entails breaking the complex molecule first into peptides, each
having a number of amino acids, and second into individual amino acids. The pepsins are
enzymes secreted by the stomach in the presence of acid that breaks down proteins (proteolysis).
The pepsins account for about ten to fifteen percent of protein digestion. They are most active in
the first hour of digestion, and their ability to break down protein is restricted by the necessity for
an acidic environment with a pH between 1.8 and 3.5. The trypsins (proteolytic enzymes
secreted by the pancreas) are much more powerful than pepsins, so the greater part of protein
digestion occurs in the duodenum and upper jejunum.3 The trypsins break down the smaller
peptide fragments into single amino acids, which are then transported to the liver for distribution
to our cells.1
Proteins have a plethora of different functions. For example, when our body has depleted
its carbohydrate and fat energy stores, protein provides us with the much needed energy we seek.
In addition to providing the body with energy, proteins also enable growth, repair and
maintenance of body tissues; act as enzymes and hormones; maintain fluid and electrolyte
balance; maintain acid-base balance; makes antibodies, which strengthen the immune system;
transport and store nutrients, and produce compounds such as neurotransmitters, fibrin, and
collagen. Proteins function best when adequate amounts of carbohydrates and fats are eaten.1

Diabetes Mellitus, also known as Type 1 diabetes, is a disease in which the body
cannot produce enough insulin. Insulin, a hormone that is made from amino acids, acts on
membranes to facilitate the transport of glucose into the cells. When someone with Diabetes
Mellitus eats a meal and their blood glucose rises, the pancreas is unable to secrete insulin in
response. Glucose cannot move into the body cells and remains in the blood stream. The kidneys
try to expel the excess blood glucose by excreting it in the urine.4
So how does protein play a role in diabetes mellitus? A high-protein diet can increase the
risk of kidney disease, particularly those who have been diagnosed with Diabetes Mellitus
because of the fact that people with this condition are predisposed to kidney failure. If that is the
case, it could be said that those affected by the disease would greatly benefit from a lowerprotein diet; however, according to The American Diabetes Association, people with diabetes
have a higher protein requirement than people without diabetes, but a protein intake of fifteen to
twenty percent of total energy is adequate to meet these increased needs.5 However, The
American Diabetes Association also reports that the current evidence indicates people with
Diabetes Mellitus have similar protein requirements to those of the general population-about
0.86g/kg per day.6 Changing your diet to a high protein one may seem like it should make a
difference in glucose regulation, but the protein probably doesn't help much at all, at least in the
long term. According to a review completed by The Academy of Nutrition and Dietetics,
increasing protein intake doesn't appear to have any significant impact on how your sugar is
digested or absorbed and it doesn't have any long-term effects on your glucose or insulin
requirements. So if a diabetic switches to a high-protein diet, any therapeutic benefit is probably
due to the concurrent reduction and closer regulation of carbohydrate consumption.7 And yet to
confuse things further, The Institute of Medicine conducted a similar review and the report

concluded that there was insufficient scientific evidence for recommendations of an upper limit
of protein intake, but suggested an acceptable macronutrient distribution range of ten to thirty
five percent of total energy for protein intake.8
The American Diabetes Association provides contradictory advice concerning the
recommended protein intake of sufferers of Diabetes Mellitus. While it is stated that victims of
this disease perhaps have higher protein requirements than healthy individuals, it also advises
that diabetic patients should consume similar amounts of protein to the latter. Coupled with the
advice from Academy of Nutrition and Dietetics, that increased protein has no effect on the
digestion and absorption of glucose, it should be advised that diabetics should avoid high-protein
diets and continue to closely regulate their carbohydrate consumption, especially because of the
fact that although, protein plays a role in stimulating insulin secretion, excessive intake should be
avoided, as it may contribute to the pathogenesis of diabetic nephropathy.6

References

1. Thompson, J. L., M. M. Manore, L.A. Vaughan. Science of Nutrition. 3rd ed. Glenview,
IL: Pearson Education, Inc; 2014: 218-220
2. McWilliams Margaret. Food Fundamentals. 10th ed. Upper Saddle River, NJ: Pearson
Education, Inc; 2013: 219-316
3. Dworken H.N., N.W. Hightower, W. Keeton. Human Digestive System. Encyclopedia
Brittanica. http://www.britannica.com.dax.lib.unf.edu/EBchecked/topic/1081754/humandigestive-system/242936/Digestion-and-absorption-of-specific-nutrients. Accessed October
11, 2013.
4. American Diabetes Association. 2010. Genetics of Diabetes. www.diabetes.org/diabetesbasics/genetics-of-diabetes.html
5. Martin, W.F., L.E. Armstrong, N.R. Rodriguez. 2005. Dietary protein intake and renal
function. Nutrition Metabolism: 2-25. www.nutritionandmetabolism.com/content/2/1/25
6. American Diabetes Association. Diabetic nephropathy. Diabetes Care 2000;23 (suppl):S69
72.
7. Academy of Nutrition and Dietetics, Evidence Analysis Library. "Recommendations
Summary: Diabetes Mellitus (DM): Protein and Diabetes." Accessed October 13, 2013.
http://andevidencelibrary.com.
8. Food and Nutrition Board, Institute of Medicine: Macronutrient and Healthful Diets for
Diabetic Patients. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty
Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, D.C., The
National Academies Press; 2002::609-696.