title: Clinical Application of the Food Insulin Index for Mealtime Insulin Dosing in Adults with Type 1 Diabetes: A Randomized Controlled Trial.
abstract: BACKGROUND
  The Food Insulin Index (FII) is a novel algorithm for ranking foods based on their insulin demand relative to an isoenergetic reference food. We compared the effect of carbohydrate counting (CC) versus the FII algorithm for estimating insulin dosage on glycemic control in type 1 diabetes.
  
  
  METHODS
  In a randomized, controlled trial, adults (n = 26) using insulin pump therapy were assigned to using either traditional CC or the novel Food Insulin Demand (FID) counting for 12 weeks. Subjects participated in group education and individual sessions. At baseline and on completion of the trial, glycated hemoglobin A1c (HbA1c), day-long glycemia (6-day continuous glucose monitoring), fasting lipids, and C-reactive protein were determined.
  
  
  RESULTS
  Changes in HbA1c from baseline to 12 weeks were small and not significant in both groups (mean ± SEM; FII vs. CC, -0.1 ± 0.1% vs. -0.3 ± 0.2%; P = 0.855). The incremental area under the curve following breakfast declined significantly among the FID counters with no change in the CC group (FID vs. CC, -93 ± 41 mmol/L/min [P = 0.043] vs. 4 ± 50 mmol/L/min [P = 0.938]; between groups, P = 0.143). The mean amplitude of the glycemic excursion (MAGE) was significantly reduced among the FID counters (FID vs. CC, -6.1 ± 1.0 vs. -1.3 ± 1.0 mmol/L; P = 0.003), and only the FID counters experienced a trend (-44% vs. +11%; P = 0.057) to reduced hypoglycemia.
  
  
  CONCLUSIONS
  In a 12-week pilot study, MAGE and postprandial glycemia following breakfast were significantly improved with FII counting versus CC, despite no significant differences in HbA1c.
authors: 1 Charles Perkins Centre, The University of Sydney , Sydney, New South Wales, Australia .|2 School of Molecular Bioscience, The University of Sydney , Sydney, New South Wales, Australia .
authors: Kirstine J
authors: KJ
authors: Bell
authors: 3 Sydney Insulin Pump Clinic , Sydney, New South Wales, Australia .
authors: Robyn
authors: R
authors: Gray
authors: 3 Sydney Insulin Pump Clinic , Sydney, New South Wales, Australia .
authors: Diane
authors: D
authors: Munns
authors: 4 Department of Statistics, Macquarie University , Sydney, New South Wales, Australia .
authors: Peter
authors: P
authors: Petocz
authors: 5 Harvard Medical School , Boston, Massachusetts.|6 Children's Hospital , Boston, Massachusetts.
authors: Garry
authors: G
authors: Steil
authors: 3 Sydney Insulin Pump Clinic , Sydney, New South Wales, Australia .
authors: Gabrielle
authors: G
authors: Howard
authors: 1 Charles Perkins Centre, The University of Sydney , Sydney, New South Wales, Australia .|2 School of Molecular Bioscience, The University of Sydney , Sydney, New South Wales, Australia .
authors: Stephen
authors: S
authors: Colagiuri
authors: 1 Charles Perkins Centre, The University of Sydney , Sydney, New South Wales, Australia .|2 School of Molecular Bioscience, The University of Sydney , Sydney, New South Wales, Australia .
authors: Jennie C
authors: JC
authors: Brand-Miller
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003131:Combined Modality Therapy / Q000009:adverse effects; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy* / Q000188:drug therapy; D003927:Diet, Diabetic / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005502:Food / Q000145:classification*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D062407:Meals; D008875:Middle Aged; D010353:Patient Education as Topic; D010865:Pilot Projects; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human