RESUMO
Using indirect colorimetry, the authors demonstrated disordered energy metabolism at rest in patients with insulin-dependent diabetes mellitus (IDDM) with a moderate decompensation of metabolism: carbohydrate oxidation was reduced and fat and protein oxidation increased, this being aimed at maintenance of the basic metabolism within the normal range under conditions of insulin insufficiency. Improvement of common parameters of compensation during optimization of insulin therapy and therapeutic diets was associated with approximation of substrate oxidation structure and energetic structure of a diet, as well as with increased production of useful energy coupled with reduced oxygen consumption. Moreover, a positive correlation between insulin level and carbohydrate oxidation rate was revealed. Analysis of the effects of qualitative composition of protein showed a more rapid improvement of metabolism during metabolic diet, whereas during therapy with diets including soybean protein increase of metabolism efficacy is more manifest. Bioenergetic parameters may be used as criteria of the efficacy of IDDM treatment. Changes in these parameters not always correlate with the time course of routine criteria of compensation and provide supplementary information on a patient's metabolic status.
