[ Diabetes Type 1 ]

Effectiveness of dose adjustment for normal eating (DAFNE) – PubMed Health – National Library of

The directorate supports a full range of specialist and general clinical services, for a stable local population of 600,000, and a local diabetes population of 42,000 people with known and unknown diabetes (2011). Written informed consent was obtained from all trial participants, after they had had sufficient time to consider the Patient Information Sheet and had any questions pertaining to the trial answered. This inpatient program focused on intensive insulin therapy and the self-management of type 1 diabetes (references 1 – 3). DAFNE: Dose Adjustment For Normal Eating is a way of managing Type 1 diabetes and provides people with the skills necessary to estimate the carbohydrate in each meal and to inject the right dose of insulin. Results  With DAFNE structured education, the mean (± sd) HbA1c fell from 71 ± 12 mmol/mol (8.6 ± 1.1%) at baseline to 65 ± 12 mmol/mol (8.1 ± 1.1%) at year 1, with a subsequent rise to 67 ± 13 mmol/mol (8.3 ± 1.2%) at year 7 (P = 0.0048 vs. While patients highlighted benefits to attending group-based follow-ups, principally to receive empathy and emotional support from peers, they described needing tailored, professional inputs post-course to optimise and sustain glycaemic control, and trouble-shoot issues of concern. Severe hypoglycemia rate fell from 1.7 ± 8.5 to 0.6 ± 3.7 episodes per person per year (1.1 [0.7-1.4]) and hypoglycemia recognition improved in 43% of those reporting unawareness.

Delivering education through a structured education format is thought to result in a paradigm shift from the traditional medical model of care to a more empowering model that fosters self-management [2]. The indication of commencement of CSII therapy was to improve overall glycemic control in 45% patients, impaired awareness of hypoglycaemia in 26% and patient preference, felt it would suit their lifestyle, in 23%. Structured education in flexible insulin therapy (e.g., the U.K.’s Dose Adjustment for Normal Eating [DAFNE]) and/or use of insulin pump therapy reduces severe hypoglycemia (SH) (1), but some continue to experience impaired awareness of hypoglycemia (IAH) with high rates of SH, their problematic hypoglycemia resistant to intervention. Quality of life was reported in three studies: two reported improved quality of life after programme participation and one demonstrated significant reductions in the negative impact of diabetes after DAFNE. This approach has now been widely adapted and developed across Europe. (They’re not interested in increasing their patient numbers but just in developing the course). Beneficial foods that contain useful substances like natural statins and Omega 3.

They stated that follow-up sessions may be needed to maintain the effects of DAFNE. Results collected from this trial will be analysed in late 2012 and 2013. Participants provided follow-up data at an average of 44 months after their DAFNE course. 1. And among those who had reported severe hypoglycemic episodes before taking the course, 62 percent had not experienced another severe low-blood-sugar episode in the year following their DAFNE participation.

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