BDEC online course

[noblehead]

So if you are not breaking any oath of secrecy, and answering me won't get you marched between two rows of DSN's flogging you with Novopens , what does a DAFNE course comprise of, that it takes five days ? I'm genuinely curious !

I fear the worst

Seriously though it's teaches you the principles behind carb counting and matching your insulin to suit, as mentioned a good day of it is looking at basal insulins and how to get that right, if you don't get the basal dose correct then you'll never get good bg control no matter what you do, in other words you'll be just chasing your tail.

The start of the day is looking at the previous days results, each person has to go through their previous days bg diary and give their thoughts on it, once that happens everyone can add something to the discussion before the course leader intervenes. It's quite nerve racking at first and we used Acetates so that everyone could see the results on a over-head projector.

The rest of the week is taken up at carb counting, working out ratio's and correction doses, sick-day rules, how exercise effects bg and what to do about it, a Q & A session with the Consultant, DSN and Dietitian, then an afternoon spent where family members and friends can come in and join in and learn what to do when a person is ill and unable to look after themselves.

The final day is a refresher of all what's been said then everyone goes out for lunch at a local restaurant to put their skills to the test and a farewell chat, there's a 6 week follow-up to the course whereby a date is agreed on before everyone leaves the course.

I already knew a some but still learnt a great deal from the course, very worthwhile for anyone that is struggling with their control.

 

[Spiker]

So if you are not breaking any oath of secrecy, and answering me won't get you marched between two rows of DSN's flogging you with Novopens , what does a DAFNE course comprise of, that it takes five days ? I'm genuinely curious !

Signy

The secret of DAFNE is that it's much more than just a dose adjustment course and much more than just carb counting. That could probably be taught in a day (as you have realised!). It is a complete refresher course of diabetes management skills, and it's a peer education and group support session - diabetics educating and supporting each other, from their own experience.

 

[phoenix]

The original course on which DAFNE is based was on an in patient basis. The courses I have done are also on that basis; spending several days in company with other T1s is an education in itself.

 

[jack412]

Heh! Most of my adjustments have been self calculated from the get go of being on basal/bolus. It was a case of being handed pens and penfils and "Go forth and be thou diabetic "

It's only these last few weeks after several years that it's finally dawned on them that Lantus really, truly didn't suit me and the insulins are being changed with DSN input.

Signy

That's pretty slack that they didn't suggest a course. trial and error isn't a good way. Though I think it is still happening by the number of late night posts asking help for hypo or they are feeling sick from high BG with all that that indicates

 

[Heathenlass]

That is really interesting, I've never used NPH as was put onto lantus at diagnosis even though the hospital had little experience of it at the time ( one doctor said one thing about pre bed levels and the consultant contradicted her saying that this new insulin was flat).
They really stress twice daily basal and that makes sense. I've noted elsewhere that there seems to be a move in the NHS (and in Germany) back to NPH as a basal; similar results lower costs.

Isn't it ?
I went straight on to Lantus/ Novorapid from Novomix, the start of years of hypo hell. I stuck with it though because apart from the hypos it is a better system with more flexibility regarding as and when I eat, and that is important in my lifestyle. My hypos were night time, and initially the Lantus dose was at night, so I switched it to morning. Then split dosed it. Then reduced the night time dose to 2 units . I still had hypos on the vastly reduced night time dose, but not as severe or frequent as they were . It also had other side effects that I was assured were not connected to Lantus.

Now I'm on NPH as a basal, and haven't looked back. No night hypos at all, brain fog has gone, I have more energy quite apart from the fact I now sleep through the night, it's difficult to describe exactly what I mean by that. Plus an irritating rash thats hung around since the Lantus started has gone

I've never understood why, when it's been known for a long time now that Lantus doesn't last 24 hours, it's still prescribed as a once daily dose ? If, say, it lasts for 18 hours, that leaves 6 hours not covered by a basal. It's not rocket science that people have struggled to keep their BG's in check

Signy

 

[Heathenlass]

Thank you all for the insight in to the DAFNE course, and I hope you don't suffer too much as a result !

@ jack412, The problem is that there isn't enough areas doing courses, and where they are being offered, the places are limited. I suspect you are right in saying it's the lack of education on diagnosis and follow up that shows in the difficulties people are experiencing. There is also a problem with consistency of training with HCP's, a GP practise may have a "diabetic nurse ", i.e a nurse that deals with the diabetics, but this is not necessarily her speciality . The one at my surgery for example, admits she knows very little about Type 1. Not everyone has access to a specialised diabetic clinic at a hospital either.

We should all, according to NICE (I think? ) guidelines have access to education, but the reality is that it's not happening.That's true for Type 2's also.

Signy

 

[Beverley2531]

Thankyou for posting this online course. I think it's going to help me a lot.

 

[phil55494]

Another issue with DAFNE is that there needs to be 3 people from a clinic trained to give the course - DSN, dietician and a doctor.
I was able to get on a course about 7 years ago but back then the online stuff wasn't there so when it did come online I wasn't able to access it (not that I'm all that bothered).

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[jack412]

I found this worth reading and even made sense to me, in my quest to learn more
It does dosage and corrections

http://www.diabetesinscotland.org.uk/Publications/9224 Overview of Carbohydrate Counting.pdf

http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf

http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

http://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf

http://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf

 

[noblehead]

Another issue with DAFNE is that there needs to be 3 people from a clinic trained to give the course - DSN, dietician and a doctor.
I was able to get on a course about 7 years ago but back then the online stuff wasn't there so when it did come online I wasn't able to access it (not that I'm all that bothered).

Your quite right Phil, as you are aware there's a Q & A session during the course with the HCP's where you can put forward any questions that the group want to ask, we started making a list on the Monday so come Thursday there was a list as long as your arm.........

 

[mrman]

Only had dsn and dietician on my course, no doc ?

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[noblehead]

Only had dsn and dietician on my course, no doc ?

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That's a shame Brett, we had all three luckily enough.

 

[mrman]

That's a shame Brett, we had all three luckily enough.

Never mind

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[noblehead]

Never mind

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Well its not done you any harm, you seem to have good control over your diabetes Brett

 

[mrman]

Well its not done you any harm, you seem to have good control over your diabetes Brett

thanks noblehead, was a rollercoaster at the beginning as I'm sure it was for everyone at the start. Having good support from home, and here has been a massive help.

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