Food Insulin Index (FII) versus Traditional Carbohydrate Counting for Glycemic Control in Adults with Type 1 Diabetes.

In this 3 month, parallel randomised controlled study in individuals with type 1 diabetes, we will compare two methods of adjusting the dose of insulin to match the nutrients in a meal. The intervention group will use a novel algorithm based on the food’s normal insulin response in healthy subjects (the Food Insulin Index or FII). Participants randomised to the FII intervention group will received 1x 2hr group education workshop, including presentation & discussion of relevant information, demonstration & practical activities on using FII counting and estimating food portion sizes; and 1x 30min individual appointment to reinforce the education and apply FII counting to individual food choices/preferences (note: diet not provided - subjects continue normal eating patterns). All education sessions will be delivered by an Accredited Practising Dietitian. Participants will be given a written education materials (pictorial reference book, pocket-sized reference book and session manual) and access to the study website and an iPhone app. Subjects are emailed weekly throughout the 3 month trial to see how they are going with the FII counting and offer assistance if needed. Glycosylated haemoglobin (HbA1c) and postprandial glycaemia and the occurrence of hypoglycaemia (recorded using a Continuous Glucose Monitoring System, CGMS) will be compared at baseline and after 3 months. We hypothesize that using the novel FII to adjust mealtime insulin dose will improve blood glucose control, compared with carbohydrate counting.