Can you describe the aim of your research in 10 words?

How fatty foods affect BGL and insulin requirements in diabetes

What have you discovered so far?

Traditionally insulin doses in type 1 diabetes have been calculated based on the amount of carbohydrate in the meal, since this is the macronutrient that directly raises blood glucose levels.  However, in the absence of sufficient exogenous mealtime insulin, high fat meals can also raise cause substantial late postprandial hyperglycaemia (>3hrs following a meal).

Our previous work has shown that insulin doses may need to be increased by 40% or more for high fat meals.  It isn’t as simple as just increasing the insulin dose though.  Dietary fat delays gastric emptying and so there is also an increased risk of early hypoglycaemia if the insulin is dosed too early.

What part of your findings excites you the most?

In conjunction with Harvard Medical School, we have successfully used an innovative bioengineering approach to model 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.

This completely changes how we approach the problem and is really exciting!  Researchers from around the world, including ourselves, have been working on this research question for a few years now.

We kept trying to figure out the formula for calculating the insulin dose and then trialling this in practice to see what improvements in the blood glucose response we could yield. However this new approach uses the mathematical model to run through every possible dosing scenario and determine the best solution.  Sometimes the results have been really surprising.  Many of the current insulin dosing methods for fat suggest insulin should be given through dual-waves run over long periods of time, with the majority of insulin coming in later.  However our model (and then our patients) showed us it’s actually much better to run the insulin dose over a much shorter period of time (2-3hrs), with more insulin given upfront before the dietary fats make the body too insulin resistant and really big increases in insulin doses are needed.

How far is your work from impacting patient care?

We are really close but also have a long way to go.  By the end of 2017 we will have a much better understanding of the relationship between dietary fat and blood glucose levels and how insulin doses need to be adjusted, which can be directly integrated into clinical practice.  The real trick though, will be finding ways to make using these results easier for people with type 1 diabetes day-to-day.  Counting carbohydrates and calculating insulin doses is a tough job, let alone add complexity with adjustments for fat.  There are possibilities for integrating it into smartphone apps, bolus calculators and insulin pumps – we’ll be talking to lots of people with diabetes and healthcare professionals to figure out what they want and what will be most helpful.

If you could discover one thing in your research, what would it be? (e.g. what’s your holy grail?)

I’d love to find a way to make mealtime insulin dosing easy but accurate for people with type 1 diabetes. I also want to be able to equip health professionals with the tools they need to be able to provide great clinical care in this area.

What’s the last book you read?

The just finished reading ‘Small Great Things’ by Jodi Piccoult.  She’s my favourite author and I think I’ve read everything she’s ever written. Jodi draws you into really difficult, ethical dilemmas using characters from every perspective on the problem.  She writes so well that I can’t help but relate to each character and feel conflicted over the issues. I always come away having learnt something about myself and the world.

What does your perfect weekend look like?

Breakfast with my fiancé at our favourite local café, something active and outdoors like a bushwalk with the dog, quality time with my girlfriends, a night out watching a musical (either a professional production or a local theatre featuring one of my insanely talented friends) and then some down-time on Sunday afternoon ready for the week ahead.

Want to take part in the Holy Grail? email us at [email protected]