DAFNE vs obesity

Counting carbs is important for good control, but even if we manage to cover the carbs correctly with insulin we do still need to watch what we eat.

Do you think it's just the novelty of DAFNE that has encouraged your wife to eat more? Or is she having to eat more than she wants to cover hypos?

What type of diabetes does she have? How was her weight before she took the course?

spacedust55 said:

hi,
since my wife started the Daphne system for insulin she has put weight++ on. seems this is now common with daphne (obviously not everybody) but as this system allows people to eat more then we will be adding obesity to the equation. can this be good, maybe stopping daphne needs to be looked at.

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DAFNE does not cause weight gain, it's what goes in the mouth that does.

@spacedust55 Dose Adjustment For Normal Eating. The first thing pointed out on my Dafne course was that it wasn't a weight management course but a course to educate on marrying insulin requirements to food consumed. The last two words of the acronym Dafne are very important. How we define normal rating is open to debate. Personally I felt the course does open the door to more varied diet and as long as you adjust your insulin accordingly your hba1c should remain stable, irrespective of weight gain. It can become easy to eat extra knowing that you can keep your sugars in range with insulin adjustment. Maybe this new found freedom is behind the weight gain. Your wife could always go back to her old regime if Dafne isn't working for her. They do say that it doesn't work for everyone.

therower said:

Maybe this new found freedom is behind the weight gain. Your wife could always go back to her old regime if Dafne isn't working for her. They do say that it doesn't work for everyone.

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This is the issue in the naming convention. Normal eating to many means eating a lot of rubbish and too much of it!

therower said:

Dose Adjustment For Normal Eating. The first thing pointed out on my Dafne course was that it wasn't a weight management course but a course to educate on marrying insulin requirements to food consumed.

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In-part that is exactly what it is.

Although it's a good few years since I did the course it does say in the Handbook that the course isn't their to advise on diet and it leaves it up to the individual to decide.

@tim2000s . Dafne did offer some good advice but I have to admit I found some aspects of the course unusual. Diabetes control does require diet control, I'm not talking lchf specifically but just plain common sense. If only we knew what was normal life would be so easy. But yes the last two words of the acronym are misleading and maybe even wrong.

@therower, I think it's so misleading that I wrote a blog post about it in November last year.... http://crick-tech-munch.blogspot.co.uk/2015/11/dafne-and-other-structured-courses-dose.html

spacedust55 said:

hi,
since my wife started the Daphne system for insulin she has put weight++ on. seems this is now common with daphne (obviously not everybody) but as this system allows people to eat more then we will be adding obesity to the equation. can this be good, maybe stopping daphne needs to be looked at.

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What would it be replaced with, as I am sure we can all agree....for folk who have had no education on dose adjustment, DAFNE is a god send...

tim2000s said:

@therower, I think it's so misleading that I wrote a blog post about it in November last year.... http://crick-tech-munch.blogspot.co.uk/2015/11/dafne-and-other-structured-courses-dose.html

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@tim2000s great bit of information regarding facts and figures. For me the biggest issue is the name as you point out. It needs changing.

I've seen a wide range of reports on DAFNE over the years and a few too many where people are told they can eat what they want and just adjust the insulin to suit; wrong. When on insulin you still need to keep the carbs down to avoid weight gain from those carbs. Luckily I avoided DAFNE as I came up via the mis-diagnosed T2 route. I still believe for many the course is unnecessary but not all would agree (tin hat on). For many carb-counting can be explained in the surgery during a 1/2 hour diabetes review appointment.

Daibell said:

For many carb-counting can be explained in the surgery during a 1/2 hour diabetes review appointment.

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@Daibell, the course covers much more than carb counting such getting the I:C ratio right, basal testing/adjustment, Sick Day Rules and how to adjust your insulin doses when exercising to name a few.

Daibell said:

I've seen a wide range of reports on DAFNE over the years and a few too many where people are told they can eat what they want and just adjust the insulin to suit; wrong

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I always understood the statement to mean you can eat any type of food, with no mention of the quantity involved. Obviously if people interpret this as stuff yourself silly then that's down to the person doing the stuffing.

My DAFNE course didn't teach me to eat more carbs but it did teach me lots of good stuff. We all know that when your blood sugar is running high that you lose weight - perhaps the OP's wife has now lowered BGL and no longer has this problem. I was also told to expect a few lb's weight gain when going onto the pump because of the improvement in BGL.

Also the DSN and dieticians that run the courses have to get on with ALL of the people that are on the course. Not all of them are clued up, or even want to be, They are not there to be judgemental but rather to help you with the things that you find difficult. On my course there was a guy who didn't eat during the day, but smoked, had two spoons of sugar in every cup of teas and full sugar coke in his vodka at night. They tried to help him within his limitations and with gentle persuasion got him to give up sugar. Also I know they continued to see him and try and help him for many weeks after the course.