Is Hunger Training the answer to reducing the risk of Diabetes? A pilot study

For the first 4 weeks, participants are instructed to measure their capillary or interstitial glucose (depending on whether they are randomised to Group A or B) every time they want to eat (or drink a caloric beverage). Participants are then permitted to eat only if their glucose concentration is below their individualised cut-off. Individualised glucose cut-offs are calculated as the average fasting glucose concentrations over two mornings, using the first glucose readings that are measured by fingerprick (for Group A) or scanned with the reader (from Group B). If glucose is too high, they are instructed to choose an activity that distracts them from food, and wait at least 15 minutes before testing glucose again (if hungry). Participants can consume hypocaloric drinks (e.g. black coffee or diet soft drinks) at any time. Alongside the glucose monitoring, participants indicate how hungry they were prior to measuring their glucose (1 to 10 scale), glucose concentration (if measured), and whether food was eaten (yes/no). Participants complete this hunger training ‘diary’ daily for the first month, and for one week per month thereafter (a total of 63 days). Both hunger training arms receive the same guidance and support throughout the trial, but the mechanism for measuring glucose will differ. In Group A, participants will measure their capillary glucose from a finger prick sample by portable glucometer (Abbott Freestyle Optium Glucose Meter, Australia). In Group B, participants will use the Freestyle Libre Flash Glucose Monitoring system (Abbott Diabetes Care, Australia) to measure interstitial glucose.