Diabetes Forum UK

For those who haven't heard of a DAFNE course it stands for 'Dose Adjustment For Normal Eating' and is available in the UK.

It's a 5 day course either done in 1 week or over a month at various centers around the country. You can read further, and check where your nearest centre is here:http://www.dafne.uk.com/scripts/type...afnetoday.html

Course qualifications:

• Minimum 1 year since diagnosis
• Over 18
• Type 1

The best way to get on a course is to locate your nearest center, ring them up, and ask for an application form. The waiting lists can be up to a year so the quicker you get your name down the better.

You’ll be required to attend a pre-course appointment a week or two before it commences. Here they take an HbA1c, urine sample, and ask a few questions about your current control.

The all in 1 week course is the better choice as you’re working from results from the previous day.

Some companies will allow time off work if you show them the letter from Dafne although this may differ from job to job. The benefits you’ll receive outweigh the money you may lose by taking time off.

The days are structured as follows:

Day 1

• Introduction + Goal setting (1)
• What is Diabetes
• Nutrition
• Metabolic self monitoring
• Blood glucose
• Keytones
• Definition of individual goals

Day 2

• Discuss individual blood sugar levels
• Nutrition
• Insulin injection techniques
• Insulin types, actions, timings

Day 3

• Discuss individual blood sugar levels
• Introduction to insulin dose adjustment
• Nutrition & exercise
• Exercise discussion
• 45mins of moderate intensity activity (walking)
• Eating out & Alcohol

Day 4

• Discuss individual blood sugar levels
• Goal setting (2)
• Annual review & screening for complications
• General discussion with Doctor
• Hypoglycemia (2)
• Sick day rules (illness)
• Ketoacidosis (DKA)

Day 5

• Discuss individual blood sugar levels
• Healthy eating
• Quiz answers
• Contraception & Pregnancy
• Evaluation

At lunchtimes the group all eat together. You can bring sandwiches or buy from the canteen depending on the facilities at your center. You will be encouraged to count the carbs in what you eat and inject accordingly.

On my course we went to a pub for lunch on the 4th day, but this may vary across the country.

Dafne provide a folder containing some very useful info including a diary for logging results, and a pocket sized carb list which although being small contains enough info to be able to work out the carb content of most meals.

Dafne work in what they call CPs (carbohydrate portions) 10g of carbohydrate = 1 CP.

They start everyone off on a ratio of 1:1 (1 unit of insulin for 1 CP (10 carbs))

If you’ve been counting carbs for many years the CP idea may seem odd but is extremely simple to go along with even if it’s only for the duration of the course. For newer people the CP idea works fine.

Dafne concentrates on blood testing before each meal and before bed. This is where they set their targets.

Dafne target Range:

• Before breakfast 5.5 – 7.5 (99) - (135)
• Before other meals 4.5 – 7.5 (81) - (135)
• Before bed 6.5 – 8.0 (117) - (144)
• HbA1c 6.0 – 7.0%

These targets are debatable for the more experienced D as are the times of testing, but for anyone wanting to get a tighter control, and understanding of their own diabetes they are perfectly acceptable. By achieving the Dafne targets one should see an improvement in HbA1c results and be able to fall within the 6.0 – 7.0% range.

If you current HbA1c is already within or below this range you may still benefit from the course as I did.

No matter how long you’ve had D I’d highly recommend this course for anyone.