DAFNE Carbohydrate System

[LittleSue]

I would think the number who do the DAFNE (or similar) course and "don't continue it" must be small. You might choose to continue eating similar amounts of carbs at similar times - but that's the whole point - it's your choice. I probably eat around the same carbs on average than pre-DAFNE on most days (having cut out regular daytime snacks and usually having smaller evening meals, but eating more once/twice per week when I eat out or have a bigger snack). It takes more time and thinking than non-DAFNE, but it doesn't take long to realise it's worth it.

Go back to not having the knowledge, choice and better control that goes with it? No way!!

 

[Debloubed]

Local to me (Bucks) the course is called 'Insight' and it's life changing! I'm now a avid label fan and love the simplicity of it all, but best of all love the control it gives me! Like others have said, I was a bit miffed that I didn't know about this gem until earlier this year and only then because it was mentioned to me in passing by one of the Registrars at my 6 monthly clinic - in my area you need it before you can have the pump so kids have to do it? Defo the same as DAFNE though, even down to projecting your results onto the wall :lol:

 

[goji]

Is there any criteria for getting on DAFNE? Like do you have to have bad control to get sent on it (in the same way that only badly-controlled people get to have pumps).

 

[neededthat]

i've been a type 1 for nearly a year and was told about the dafne coarse prity much straight away i've not been on it yet but was given the offer to go on it within a couple of monthes(althought i think they do say you have to wait for a year after diagnosis). from the beginning my nurse trained and advise me on how to work out the carbs and the ratio to give insulin accoring to what i eat(which i understand thats how the dafne coarse works.) i am now booked to have the dafne coarse as i feel now i'm ready for it. the care i have received from my hospital has been brilliant so far.

 

[hanadr]

Wouldn't it be NICE if all PCTs offered Dafne courses?
Hana

 

[jopar]

Goji

Why do you assume that you’ve got to be a badly controlled diabetic to be able to have an insulin pump?

Insulin pump is a delivery method it wasn’t designed just for bad controlled diabetes it was designed as a choice of delivery for all diabetics… Yes sadly for many in the UK who are unable to self fund insulin pumping, there isn’t the choice there should be…

Funding for insulin pumps are not just funded for those with ‘bad control’ but to those that have diabetes that is difficult to control for many reasons

Some diabetics do have good control of there diabetes, but have other chronic conditions that makes maintaining this problematic or makes using a insulin pen difficult to operate..

Then you get the diabetic who has good control, but have issues and problems with injections sites, the pump is very useful in these circumstances…

There are those that can maintain good control, but to do so interferes with there quality of life and the pump returns this to them…

If I take myself as an example of why I use an insulin pump…

One of the bases of good control is having a flat basal profile to work your quick acting insulin off, which a fair few people can achieve with one or perhaps two injections of background insulin per day…

This is something I was unable to do, as I suffer DP alongside quite a fluctuating out put of glucose from my liver during the day and night… So it was impossible to flatten out my basal profile with two jabs a day. Add to this I only need a very small amount of quick acting insulin to counteract what I ate… The smallest amount that is deliverable with an insulin pen or syringe is 0.5units, this small amount can cause an hypo or hyper in my case…

So for me to maintain good control of my diabetes was very hard time consuming work, requiring up to 9 or so injections a day, as you can see this has a very big impact on ones day to day quality of life…

The insulin pump allows me to adjust my basal/background insulin hour by hour in 0.01 units giving me a flat basal profile which to work from, I have different bolus that I am able to use so that over-all my ability to maintain my good control is yes a lot easier and less time consuming than the life I lead on MDI….

So for me it’s not badly controlled diabetes that I have an insulin pump, but to make life a lot easier for me to live a near to normal life with diabetes…

Hanna

All PCT's offer some form of carb counting course to T1 diabetics

 

[Debloubed]

So for me it’s not badly controlled diabetes that I have an insulin pump, but to make life a lot easier for me to live a near to normal life with diabetes…

sign me up!!

 

[LittleSue]

Is there any criteria for getting on DAFNE? Like do you have to have bad control to get sent on it (in the same way that only badly-controlled people get to have pumps).

You don't have to have bad control, but they have to be confident you're motivated to put the effort in. Its not a magic wand where you miraculously get everying sorted. The course is the start, then its up to you to keep on recording what you do, observing the results, interpreting and acting on them. For example if you constantly moaned about poor control but refused to test or try anything different to improve things, don't expect them to put you down for DAFNE.

 

[Gazhay]

When I was researching pumps, the literature from the NHS stated quite clearly you needed :

a) to have trouble getting HbA1c down below 8% whilst on MDIs
b) to have frequent and disabling hypos

as my HbA1c is 7% and I haven't had a serious hypo, I wouldn't qualify.

Add to the mix I live in Northern Ireland where even diabetes specialists nurses have only 'heard' of one or two patients with pumps and I think you'll agree, if I ain't funding it, i'm not getting a pump.

 

[lexilox]

I did DAFNE last year, after 20yrs with type 1. It was brilliant, but I only found out about it and got on it after a chance encounter with a diabetes nurse I had as a child when I was newly diagnosed. I think all who are prescribed insulin should be offered the course - it is literally a life saver and I'm sure the NHS would be saved a fortune if more like me we're to do these courses!

 

[Hilary52]

They do not offer DAFNE in Fife where I live. Don't know if they offer it anywhere else in Scotland.


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[noblehead]

They do not offer DAFNE in Fife where I live. Don't know if they offer it anywhere else in Scotland.

Hopefully you'll find the following useful:

http://www.dafne.uk.com/scotland-courses-1.html

 

[Hilary52]

Cheers. Will look into it [SMILING FACE WITH OPEN MOUTH AND SMILING EYES]


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[dafneandjim]

Hi I went on a DAFNE course it was the best thing that happened to me health wise :grin: I learnt more in those 5 days than in the previous 32years of having diabetes it was good fun too while learning .We all learn from each other sharing which you wouldn't get from doing a course on line .it made a big difference to my life and I'm glad I did it

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[glenmoray]

I've been over dosing my insulin by 90 units every day for nearly 16 years until I went on the November DAFNE course in Birmingham. It was my so called GP diabetic doctor who put me on the doses and in 16 years put on 10 stone. Since the DAFNE course my diabetes control has greatly improved and I have lost over 2 stones.I only found out about the DAFNE course when I was refered to diabetic foot clinic with a bad infection in my foot. The consultant has now refered me to his diabetic clinic and everything has improved 100%. My opinion of GP diabetic clinics now is bad as my GP had no idea how to run the clinic and I think he was only doing the clinic to get extra money.

 

[Hypehypehype]

How do I get on to one o these courses ? Thanks


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[noblehead]

How do I get on to one o these courses ? Thanks

Ask your diabetes care team if they run the DAFNE course in your area, if they do then ask to be enrolled on the next available course. The course runs for 5 days (mon-fri) so you will need to take time off work in order to complete the course.

Just be aware, such is the popularity of the Dafne course waiting times can be quite long in some places.

 

[taffy_63]

I did my carb counting course in Plymouth about 31/2 years ago over 6 weeks, 1 morning a week and for some of us it led to a pump. As a preparation for the course we did 1 morning a week for 3 weeks where we completed food diaries and worked out our ratios and correction doses so that we hit the ground running when we started carb counting. What the first 3 weeks achieved was the chance to get our basal rate right before we started carb counting and this made such a difference. I didn't know what a correction dose was (and I've had diabetes for nearly 40 years!) I was injecting levemir morning and evening as my control was very hit and miss and after doing 3 am bloods initially my levemir increased. However after using a CGM it transpired that my sugars swing low after midnight and then the 'dawn phenomenon' kicks in and combined with dangerously low hypos and the 'seesaw effect' my sugars were through the roof in the mornings. If I hadn't done the carb counting course I would still be increasing my evening levemir and swinging even higher in the morning. I've been pumping for 18 months now and my control is excellent and I would never be without my pump, BUT the biggest difference was the carb counting. I no longer feed my insulin - I eat what I like and I may be a label fanatic, but I control my diabetes - it no longer controls me. Carb counting was life changing and liberating for me and although keeping food diaries for a total of 9 weeks was a bit of a pain, it was well worth it and I would recommend it to every diabetic. There may be a waiting list - I waited 8 months but it's made such a difference!!

 

[tim2000s]

DAFNE and the Bournemouth system are both similar to the carb counting i was put on when diagnosed 25 years ago. the main difference being that i started on a twice a day insulin regime which didn't easily allow for the balance achievable with the extra insulin as is possible with the current basal/bolus regimes.

What i find astonishing is that it has taken 20 odd years for this to come back up as a good technique, in a clinical way, as it was what I've spent most of my life doing.

Still, it seems all industries have a Not Invented Here after all, including medicine.

 

[hagster69]

I attended the 1st DAFNE course in the North East in 2005 and, although it did make me understand food and insulin and the relationship between them much better, I struggled to keep to the regime. My main problem is finding out how much carb is in the food. Jacket potato carb depends on the weight and it's difficult to ask the vendor of a jacket with cheese to weigh the potato before serving it. I kept judging the carb content wrong and either going hypo or hyper. Although my HbA1c has improved slightly since taking the course and due to the course in my opinion, it is quite difficult to get things right a lot of the time with DAFNE