Intensive insulin therapy (IIT) has been shown to improve long-term outcomes for adults and children with T1DM  and may take the form of multiple daily injections (MDI) or insulin pump therapy (continuous subcutaneous insulin infusion [CSII]). Current IIT requires the patient to monitor their blood glucose levels (BGLs) and adjust the insulin dose to match the pre-prandial BGL and carbohydrate content of the meal. There has recently been an increased focus on the impact of other macronutrients, such as fat and protein, on postprandial BGLs. Our group, in collaboration with the Paediatric Diabetes service at the Princess Margaret Hospital in Perth, have recently completed a study that showed that meal protein and fat content significantly alter postprandial BGLs [data awaiting publication].
Algorithms have been developed that recommend additional insulin depending on the fat and protein content of the meal . However, studies using these algorithms have shown a hypoglycaemia rate of up to 35% post-meal . To date there has been limited research into how fat and protein influence the postprandial BGL. Therefore at present there is insufficient data to advocate how to give insulin to prevent postprandial hyperglycaemia in meals of varying fat and protein content.The proposed study will determine the postprandial blood glucose dose-response curves to varying fat and protein amounts. This will enable further research to calculate an accurate insulin dosing schedule to account for dietary fat and protein ingestion.