Hypoglycaemia (blood glucose <4.0 mmol/l) is a potentially serious event for people with Type 1 diabetes on insulin therapy. Treatment usually entails consuming glucose immediately followed by foods high in carbohydrate content with lower fat and protein to normalize blood glucose. However, many patients who experience hypoglycaemia struggle to make appropriate food choices, which can have severe medical consequences. Dietary decisions during hypoglycaemia can be explored by studying children who are placed in a state of hypoglycaemia as part of routine growth hormone assessment for poor linear growth. A food preference task has been developed, which will run on a tablet. Participants complete 153 binary-choice comparisons that incorporate 18 commonly consumed foods that vary systematically in macronutrient content, taste (sweet/savoury), and energy-density. In each trial, participants are asked to select the food they would ‘most like to eat right now’ by touching the corresponding image on the screen. Participants will complete the task at baseline and 3 times after the administration of insulin. Prior to each assessment point, participants will also rate their hunger and their ideal choice of food. Separately, parents/guardians will complete a food familiarity questionnaire. We hypothesize that as blood glucose concentrations fall, preference for foods high in carbohydrate (versus high in fat/protein) will increase. Findings from this study could shed further light on the role of glucoprivation in triggering appetite, and might provide evidence for a ‘carbohydrate hunger’. Together, these observations can also inform strategies for the effective management of hypoglycaemia in diabetes.
