DAFNE confusion

[RuthW]

This all raises interesting questions though. I was brought up on Exchanges, countdown, etc. That was all about carb counting. I know DAFNE shows evidence of sustained improvement after 6 and 12 months, but there is no evidence after 24. I've carb counted all my life, and in spite of not having DAFNE, when moved to MDI was given basics in ratios (and we are talking somewhere around 1991). This is what I've done all my life.

What I don't really see is what is different about DAFNE-like courses? CPs are equivalent to exchanges, and fundamentally it's all about carb counting. The NDA figures would suggest that there hasn't been significant change in the way most people manage their diabetes.

Is a 10% improvement on a 72 going to make any difference to complications?

In a word, yes.
As the following article says, a 10% reduction in hbA1c gives a 43% reduction in the likelihood of retinopathy.

http://m.diabetes.diabetesjournals.org/content/44/8/968.short

And Rome wasn't built in a day. People whose blood sugars are way out of control have to start somewhere. Stepping them down 10% at a time is more likely to result in long term success and (I hate this term but I have to use it) compliance, than a demand for rapid change which just hurls them onto the diabetic 'rollercoaster.' From there, they are likely to retire injured and go back to running high for the sake of their mental security.

 

[michelle lilly]

Hi I live in France and have never been on any course, when I got my pump had five days in hospital told I had to count carbs and adjust bolus, that was that, didn't even show me how to utilize the pump that was five hears ago and have had to learn as I go really, there no wonder my diabetes is brittle with many many complications hope to keep learning new thing here, so far learned I don't know enough!