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DAFNE vs pump DAFNE

sleepster

Well-Known Member
Messages
750
Location
Northumberland
Type of diabetes
Type 1
Treatment type
Pump
Hello!
So I've been using a pump since 2012, diagnosed 1997. I've never done a DAFNE course, despite wanting to and I'm struggling with bolusing for meals*. I changed hospitals last year and at the old hospital the person who did the pump DAFNE had retired and they didn't want me to do the normal DAFNE as it would be "confusing to a pump user". I'm on the waiting list at the new hospital for the pump DAFNE but obviously the pandemic is stopping such things for the time being. Normal DAFNE is being done online, but pump DAFNE is not. I asked if it would be beneficial to do the normal one or would it be better to wait and was told I could do both.
I guess I'm just looking for opinions, did other people do normal DAFNE or pump DAFNE? Is it worth doing both? I'd like to hear your experiences with DAFNE and pumps please and thank you.

*basic carb counting is fine, it's things like pizza, pasta, higher fat, higher fibre....most of it really! I've done BERTIE and have carbs and cals but I'm still struggling.
 
I had to do the normal local variant of the DAFNE course before I was even allowed on the pump, my local area has its own course though called CHOICE, don't even know whether there is one for pumps or not.
Not sure what would be that different anyways unless it also involves some pump training.
 
Thanks @Rokaab, all that happened before I was allowed my pump was I had to sit down with the dietitian (the one and only time I saw her) and there was a pile of plastic food and empty containers and I had to sort them into piles; contains carbs or doesn't contain carbs. When I got my pump and had the training for that, everyone else had done the DAFNE but I was never given the option
 
Hi @sleepster, I was told in November I had to do pump Dafne before they would put me on the waiting list for a new pump. I think you already know I’ve now got the Medtronic 780G. My consultant accepted the online BERTIE course as a way of getting a pump. Like you I’ve carb counted for years so that was fine but again like you pasta pizza complex carbs etc & just the way they react to your body I wasn’t sure about. I completed it in a couple hours and you get a certificate at the end to send your DSN. I’ll admit I did skip sections on things I knew about or things I was confident with but there is certainly some interesting reads.
 
BERTIE and Dafne are very similar courses, all about carb counting and diet balance. On a pump with higher fat / fibre meals you need to adjust the bolus timings and likely also pre-bolus too. I bolus up to 30 mins before meals and spread the rest over an hour up to 2 hours, using the extended bolus feature. So set % insulin up front, set time for rest of bolus remaining %, then decide based on food, exercise, BG how far in front of meal to activate bolus.
 
Hello,

I think you’ll have to ask about it. However when I was doing DAFNE in november 2019, there was another person with a pump doing it with us. But when it came to adjusting our carb ratios, his ratios and the advice given to him were more specifically for him and his pump.

With higher fat, you’ll need to do an extended bolus or square bolus or split bolus to cover the delayed carb action, percentage is up to you - whether you want 50/50 or 60/40 or 70/30, it’s up to you.
 
MeiChanski said:
With higher fat, you’ll need to do an extended bolus or square bolus or split bolus to cover the delayed carb action, percentage is up to you - whether you want 50/50 or 60/40 or 70/30, it’s up to you.
Click to expand...


Think this is pump dependant now, the newer pumps with automode features don't use the square or split bonus unless in manual mode. Or at least the Medtronic 780G doesnt, the automode feature takes care of any spikes from higher fats.
 
Maco said:
Think this is pump dependant now, the newer pumps with automode features don't use the square or split bonus unless in manual mode. Or at least the Medtronic 780G doesnt, the automode feature takes care of any spikes from higher fats.
Click to expand...

Though that does depend on the person
I'm on the slightly older 670g auto-mode and I miss the dual wave, cos I now have to take about 1/2-3/3rds ate the beginning and remember the rest about an hour later, if I take it all at once, then hypo-territory here we come and if I don't take the second lot later (normally because I've lost track of time) it takes the auto-mode an awful awful long time to do anything about it
 


I used to struggle form this especially with takeaways with the fat content but the 780 seems to of taken it away, I used to always go hypo after the meal then absolutely rocket through the night. Not sure if it’s now down to having tighter control and better carb ratios but the hypos seem to of stopped. I used to wake up in the 17/18s after a cheat meal on a Saturday but now I’m waking up around 6/7 with a peak of 13/14. Automode usually takes care of it within a couple hours
 
Maco said:
Think this is pump dependant now, the newer pumps with automode features don't use the square or split bonus unless in manual mode. Or at least the Medtronic 780G doesnt, the automode feature takes care of any spikes from higher fats.
Click to expand...

The t:slim has extended bolus with adjustments.
 
Maco said:
Think this is pump dependant now, the newer pumps with automode features don't use the square or split bonus unless in manual mode. Or at least the Medtronic 780G doesnt, the automode feature takes care of any spikes from higher fats.
Click to expand...

I’m aware of auto mode because I’m in auto mode. There are very very few of us on CGMs/closed loop systems so pumps without that do offer a split/square/dual wave bolus for higher fat meals.
 
MeiChanski said:
I’m aware of auto mode because I’m in auto mode. There are very very few of us on CGMs/closed loop systems so pumps without that do offer a split/square/dual wave bolus for higher fat meals.
Click to expand...

This is not 100%, the t:slim has about as much capability as the 780G plus with the CGM too and has this capability today with CIQ sw loaded.
 
MeiChanski said:
I’m aware of auto mode because I’m in auto mode. There are very very few of us on CGMs/closed loop systems so pumps without that do offer a split/square/dual wave bolus for higher fat meals.
Click to expand...

That’s exactly why I said it’s pump dependant
 
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