DAFNE did anyone feel like it didn't really help them?

[Engineer88]

Yeah I confused everyone with using lactose free products and gluten free.

Let's not start on the g vs cp thing.

We were given the carbs and Cals book and I gave it back as there was virtually nothing I could eat in it. I then showed I was proficient at reading numbers off a pack and they left it at that!

 

[ElyDave]

They tried to tell me that lentils and beans don't have any carbs in them

 

[AlexMBrennan]

If you go on DAFNE and 19 things just irritate you but you learn one thing that improves your diabetic management, surely that's a win?

If I have to overdose on insulin (presumably in order to learn how to work out that you are taking too much insulin) by going back to the default 1:10 ratio in order to attend then the information better be **** important.

 

[Spiker]

If I have to overdose on insulin (presumably in order to learn how to work out that you are taking too much insulin) by going back to the default 1:10 ratio in order to attend then the information better be **** important.

Somehow I would not put you at the top of the list to blindly follow stupid instructions Alex. All of us are capable of ignoring dumb or harmful advice, you more than most. And this was not core DAFNE anyway, this was an error. They are supposed to use your existing ratio if you have one, and work from there.

 

[novorapidboi26]

They tried to tell me that lentils and beans don't have any carbs in them

Did you educate the nurse as to what she was actually meaning with regards to lentils and beans ..........

 

[novorapidboi26]

make you change a ratio without evidence

they actually done this on your course..........?

the whole point was to get you in the habit of collecting evidence to back up your adjustments......

were you changing ratios on one days readings?

 

[Engineer88]

they actually done this on your course..........?

the whole point was to get you in the habit of collecting evidence to back up your adjustments......

were you changing ratios on one days readings?

Yes but when you had already worked out your own carbs ratio they would try and put you back to a standard starting point to do the course. I was lucky my ratio was 1:1 anyway. and yes i switch between g and portions and CP and just about every other measure. but i know what i mean!!!

 

[Spiker]

Yes but when you had already worked out your own carbs ratio they would try and put you back to a standard starting point to do the course. I was lucky my ratio was 1:1 anyway. and yes i switch between g and portions and CP and just about every other measure. but i know what i mean!!!

They really should never do this. That's insane. For someone who doesn't know their ratio, fine, start 1:1CP. Otherwise it is dangerous. They didn't do this on my course. Nor do I believe anyone who knew their ratio would go along with changing it. We all used our existing ratios (about half of us already did some form of basal bolus) and then adjusted them in an evidence-based way. That was the whole point.

I can't and don't believe the DAFNE curriculum says to put everyone on 1u:1CP regardless of any existing ratio. Of course as the DAFNE curriculum is a legally protected secret we can't know for sure. But it would be dangerous, unethical and pointless. The point of DAFNE isn't to set your ratios for you, it's to teach you how to set your own ratios based on evidence and a rigorous method.

 

[Spiker]

Did you educate the nurse as to what she was actually meaning with regards to lentils and beans ..........

Again this is not fair. They don't claim these foods have no carbs. They just say you can ignore them. And as long as you are not low carbing, you are fine. If the proportion of DAFNE "free" foods in your diet is overall constant, then your DAFNE ratios are slightly higher to compensate for the minor extra carbs.

I think we need to clearly separate general gripes about DAFNE from low carbers' specific gripes about DAFNE. DAFNE is not a low carb programme and it's not compatible with low carbing. End of. Evaluate it on its merits, not as something it was never intended to be.

 

[noblehead]

Did you educate the nurse as to what she was actually meaning with regards to lentils and beans ..........

This came up on our course, because most pulses are low-gi the insulin can kick-in well before the food hits, but the way round that is to bolus later rather than not bolus at all, otherwise bg will inevitably rise.

 

[Spiker]

Yes but when you had already worked out your own carbs ratio they would try and put you back to a standard starting point to do the course. I was lucky my ratio was 1:1 anyway. and yes i switch between g and portions and CP and just about every other measure. but i know what i mean!!!

They really made you change your bolus ratio? Not just round it to the nearest CP multiple? And you went along with that?

I guess if your ratio was already 1:1 you don't know that they would have tried to make you change it. Are you saying they did that to other course members, not you? If so, that should be reported. I know one of the DSNs that brought DAFNE in from Germany, I will tell her. What hospital was it Eng?

 

[noblehead]

I think we need to clearly separate general gripes about DAFNE from low carbers' specific gripes about DAFNE. DAFNE is not a low carb programme and it's not compatible with low carbing. End of. Evaluate it on its merits, not as something it was never intended to be.

No it's not compatible with low-carbing in the respect that some members aim for on the forum, however you could say that anyone that eats below the RDA does indeed lower carb if they are eating a third or half of what is suggested.

I know when I did my course there was myself and another person who were eating around the same amount of carbs a day ( then 120g a day) and the course was just as useful for us as it were for those who weren't as restrictive with their carbs.

 

[novorapidboi26]

This came up on our course, because most pulses are low-gi the insulin can kick-in well before the food hits, but the way round that is to bolus later rather than not bolus at all, otherwise bg will inevitably rise.

That's exactly what I was referring to with regards these foods........

I only started taking insulin for beans when pumping......when I injected I never.......

the way you described it there was as if the carbs in the pulses would kick in later, hence the need for insulin, but my understanding was that the whole carb load was absorbed evenly, just really slow.......so I wouldn't expect a rise later from them, as the background insulin would have sufficient activity to mop up the slow carbs...

 

[novorapidboi26]

Yes but when you had already worked out your own carbs ratio they would try and put you back to a standard starting point to do the course. I was lucky my ratio was 1:1 anyway. and yes i switch between g and portions and CP and just about every other measure. but i know what i mean!!!

I understand your experience, but did @Spiker s' team change the ratios without evidence after less than 2 days........?

 

[Spiker]

I understand your experience, but did @Spiker s' team change the ratios without evidence after less than 2 days........?

No they didn't. You quoted my reply to someone else [], I wasn't talking about my own DAFNE experience. I was asking in incredulous shock about someone else's. [ it was @ElyDave ]

 

[Engineer88]

they stuck everyone on the same 1:1 ratio to start with and it was northampton. I used more in the mornings(had no evidence just added a unit or two) but they had me do 1:1 for 2 days until i proved I was right.

 

[smidge]

The one I attended tried to put everyone on the 1:1CP starting point. My ratio was 1:8g and they insisted I rounded to 1:10g and call it 1:1CP. After a day of it I just ignored them and went back to what I know works for me.

We were definitely told not to jab for beans, vegetables or for any carb up to 10g. No jabbing for protein. On that basis alone, it's unsuitable for low-carbers - obviously, I ignored their insistence that I shouldn't jab for protein.

I found the whole experience depressing.

Smidge

 

[Spiker]

Well those experiences are depressing, I agree.

The problem with the CP system is that it's way to crude. All because of the assumption that people are too stupid to divide, even by whole numbers, and even too stupid to multiply except at intervals of 0.5. Depressing.

Yes on my course they did round my existing ratio (which was 1u:12gCH at the time) to the nearest DAFNE CP equivalent, 1u:1CP.

I argued vociferously on the course that the CP system was stupid and I don't think any participant walked out of there using CPs. I also put a big pitch in for low carb so I raised the awareness of the 10 or so participants.

Overall it was still a great experience. The DAFNE carb counting and dosing system (which is BS) is only a small part of it.

 

[ElyDave]

in general replies to the above

1) yes, the DSN called me ahead of the course adn told me to change my ratio from 20:1 to 10:1 with no evidence or discussion. I flat refused. During the course, based on evidence I reduced my basal and now use a 15:1 ratio. At that point 10:1 woudl have left me with serious daily hypos.

2) they specifically told me to ignore carbs in lentils. Even when I told them that dinner that night was a bowl of lentil chilli. Nothing else, just lentils, kidney beans, tomatoes and veg. You don't need to bolus was the repeat mantra despite me telling them several times that my wife was Indian and that lentils are a major part of the diet. They were also nonplussed at my suggestion that I needed to adjust bolus for the fibre content, although we did discuss bolus timing related to GI.

3) I did not have any discussions about low carb with them.

 

[Spiker]

they stuck everyone on the same 1:1 ratio to start with and it was northampton. I used more in the mornings(had no evidence just added a unit or two) but they had me do 1:1 for 2 days until i proved I was right.

That's appalling. They need to retrain the trainers. It's supposed to empower you to make evidence-based personal decisions about dosing, not impose one size fits all. :-(