Pioneering technique promises type 1 diabetes breakthrough

14 November 2016

New University of Sydney research is taking a completely novel approach to insulin dosage, with the potential to make it easier for people with type 1 diabetes to adjust their insulin levels after a fatty meal.

Led by Dr Kirstine Bell from the University's Charles Perkins Centre, the cutting-edge project will use an innovative bioengineering approach developed in conjunction with Harvard Medical School. Dr Bell's team have successfully modelled blood glucose responses to meals of varying fat content and can accurately predict how much insulin is required to keep glucose levels within a tight optimal range.

The findings hold the promise of empowering people with type 1 diabetes with more accurate information on how to moderate insulin doses and reduce the risk of dangerous high and low blood glucose levels.

"Currently, mealtime insulin doses are calculated based solely on the amount of carbohydrate in the meal, despite recent studies showing dietary fat can increase insulin requirements by more than 40 percent," said Dr Kirstine Bell, who is also a dietitian and credentialed diabetes educator.

"Traditionally whenever someone reports high blood glucose levels after a meal, it was assumed this was because they did something wrong: they didn’t calculate their carbs right or estimate their portion size correctly.

"Now we're learning that we didn’t have all the information and we need to go back to the drawing board to learn more about what's really happening in the body to create better solutions."

Currently more than 118,000 Australians live with type 1 diabetes. High blood glucose levels increase the risk of life-threatening complications such as blindness, kidney disease and amputations.

The findings from this study will be able to give people with type 1 diabetes the answers they need to improve their blood glucose levels and get on with enjoying their lives.
Dr Kirstine Bell

"Once we have these results, we will be able to work with clinicians and people with type 1 diabetes to find the best way to integrate this evidence into practical solutions, such as apps or as part of insulin pumps to deliver the most effective insulin dose in the most convenient way."

To mark World Diabetes Day on 14 November, the study was announced as winner of a competitive $60,000 grant from the ADEA Diabetes Research Foundation, which aims to advance critical research in diabetes education and care.

The research team is comprised of world-leading diabetes experts including Professor Jennie Brand-Miller from the University of Sydney's Charles Perkins Centre and Faculty of ScienceProfessor Stephen Twigg from Sydney Medical School and the Charles Perkins Centre; and Associate Professor Garry Steil from Boston Children's Hospital and Harvard Medical School.

"This research promises a novel, more accurate way to manage blood glucose related to meals," said Professor Stephen Twigg.

"We want to address how people with diabetes can better match their insulin to their diet, thus minimising blood glucose excursions after meals and reducing the risk of diabetes complications."

Dr Bell was also recently awarded an Early Career Fellowship in the latest round of National Health and Medical Research Council grants.

The project will be conducted over the next 12 months, with results expected in late 2017.

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