Dafne

Didn't you find the sick day rules mind blowing too? I would have never ever considered taking that much insulin if I was ill throughout my time as a diabetic but amazingly it does work! You can potentially stop yourself from needing to go to hospital as a result! Bonus!

For those wondering why I'm not putting down specifics about the sick day rules: I don't recommend just any diabetic just going ahead and doing the DAFNE sick day rules with only tid bits of information about it - can be potentially very dangerous to anyone not DAFNE trained and any DAFNE educator will agree. Even my DAFNE team couldn't believe it worked!

Actually, I believe that learning to cope with sickness is too important to leave to as and when someone gets to go on a DAFNE course. There are large numbers of people living in areas where there is either no course, or the waiting list is very long.
I've read so many times of people who are sick and haven't the foggiest what to do. Many have never been told to check for ketones and if they do so don't know what to do if they are present. Its not surprising so many end up in hospital with DKA.
The DAFNE sickday 'rules' can be found easily on the net . They don't appear to be essentially different to many other such protocols available on the net, or indeed those I was given here in France.

Dafne seems to be a good course, almost everyone I read of has found it useful, (though I recently read of someone who had a very good HbA1c and already dose adjusted who didn't learn much) However, they don't teach an exclusive method and certainly people report having to modify some of the things they are taught. ( not surprising we all differ a bit ) Other courses in the UK use a similar outline. The Dafne course was based on the curriculum taught in Dusseldorf, so too was the BERTIE and its variously named offspring including the BDEC online carbcounting/dose adjustment course .

One aspect which, from reading, I think that Dafne lacks is a practical physical element, talking about the effects of exercise/insulin and actually doing it are very different. Both courses I have done here (pump and intial MDI) have included at least one long , hilly walk and a fitness 'class' with a phsyio, there were also a couple of exercise bikes for people to use in the evenings. ( courses were taken as in patients so very focused !)
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DAFNE was good to have in your box of tools to help you try and get the best control that you can. I found that my Insulin Doses did not change at all after doing the DAFNE...I was "instinctively" giving myself the correct dose of insulin to carbs ,just by doing it for years really and lots of self testing to work out what foods did what to my BG levels. So I cant say it taught me much practical dose adjustment to be honest...I'm sure it did some people though.
I found it interesting and enlightening to meet other long term Type 1's and hear about their experiences with this disease, that was a great help.

I was a little disappointed that protein meal coverage was not touched on at all, as there were a few of us this did effect , the ones who had had Diabetes for a lot of years..The newly diagnosed people seemed to be fine with a Basal coverage. I'm sure I would have been fine with a basal coverage for protein meals in my early years with it, never looked at it back then though in any detail....and my memory is getting a bit foggy, too many Hypos over the years :crazy: And I take on board that they advocate carbs with every meal...but it is still a reality that protein effects blood Glucose, with me as much as carbs. So I felt it was VERY much carb based and not food based. But we take from things what are applicable to us and discard the rest at the end of the day...thats life

Agree with Pheonix, that the exercise bit on my course was soooo short, a 10 minute talk. Even though half of us did it on a daily basis. Where as, the alcohol consumption concerning BG had a massive section done on it ,it went on and on, with follow up tests for every alcohol scenario you could think off...I found that a bit sad really, and maybe a bit indicative of our times. Yes, it needs covering ,but boy was it covered....though not much on certain foods and exercise.

Overall ,worth all Type 1's going on it...but you still need to be prepared to adjust away from DAFNE with an ever changing disease, but a good base to build on for the newly diagnosed.

thankyou for all your replies i am still waiting to hear back from my sons team so was waiting to see the response fromthe dietian but it has been a week so will log on to the online course and let you know how we get on thankyou

Hi, Ive never heard of DAFNE before reading this post! haha :crazy:
Can i ask.. "Dose Adjustment For Normal Eating" - does this course teach you how much insulin to take based on the carbohydrate you are about to eat?
I've been doing it the exact opposite way for years.. when my BG level goes a bit high i inject extra insulin to lower it (1 unit of Novorapid insulin for every 1 mmol it needs to come down by is a perfect dose for my needs)
If yes i might get in to this as it must be better to keep your BG down rather than lets it go up so you bring it down an hour later! haha (If that makes any sense at all)

phoenix said:

Actually, I believe that learning to cope with sickness is too important to leave to as and when someone gets to go on a DAFNE course. .

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you are so right!

phoenix said:

The DAFNE sickday 'rules' can be found easily on the net . They don't appear to be essentially different to many other such protocols available on the net, or indeed those I was given here in France.

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That's quite a claim. Care to give some actual evidence of this?

Most diabetes fail to keep tabs on their ketones properly or cannot see the real meaning of them apart from "I'm seriously unwell now". Ketones are a natural key part of any sickday rules, this is a given. You may not agree but considering how obviously dangerous the DAFNE sickday rules are to someone who didn't have a full understanding, they're certainly not something that should be thrown around willy-nilly.

One things for sure, I'd rather listen to someone from my healthcare team than some twit on the internet who's more likely to not know what they're talking about really (or just quoting some site that happens to agree with their point).

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That's quite a claim. Care to give some actual evidence of this?

Most diabetes fail to keep tabs on their ketones properly or cannot see the real meaning of them apart from "I'm seriously unwell now". Ketones are a natural key part of any sickday rules, this is a given. You may not agree but considering how obviously dangerous the DAFNE sickday rules are to someone who didn't have a full understanding, they're certainly not something that should be thrown around willy-nilly.[One things for sure, I'd rather listen to someone from my healthcare team than some twit on the internet who's more likely to not know what they're talking about really (or just quoting some site that happens to agree with their point).

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If you want to find them just google Dafne sick day rules . I won't link as it's on another forum.
But actually you are agreeing with me about what many diabetes do. Unfortunately they frequently end up in hospital with DKA. This is not only potentially life threatening for the person but can be extremely costly for the NHS.
That's why it is so shocking that fairly normal procedures for dealing with sickness and ketones, are not taught from the outset and left to a course which many people never hear of, let alone get to go on. (how long had you had T1 before you went on your course?)
Very early on someone with T1 should have an agreed personalised sickday management protocol.

This 'What to do leaflet' from the Australian Diabetes Asscociation is a good example of what could be used. It contains both a place for personalised calculations and a quick guide as to the percentage of tdd to take at different BG/ketone levels
,http://www.adea.com.au/asset/view_document/979316045

(and as a 'twit' on the internet, I can think of more than one occassion when I've helped a person who has been sent home by their GP with ketones, no advice and a come back next Tues. Usually by doing the only thing you can do by the time they blood glucose levels in the stratosphere and large ketones, telling them not to wait until Tuesday but go to A&E now. Learning how to deal with it , before the emergency would help prevent this type of incident)

I'm somewhat laughing at the moment...

Oh dear some really shine out as I know all about DAFNE but I never been on a course :lol: :lol: :lol:

When has information found in DAFNE course been classed as a Trade secret and specialist information only the only part of DAFNE that is confidential information is personal names and personal information given by those who attended the course with you... DAFNE doesn't publish it's books purely because they wouldn't really make sense unless you attended a DAFNE course, as they aren't thick in depth manuals but a glossary of the main/basic information you've been taught to be used as a reminder!

I was actually already doing carb counting and adjusting my insulin dose, and my consultant did ponder whether it was worth sending me, but even at my level of understanding my own diabetes DAFNE helped me to explore other areas of control.. Such a DP's and it was nice to refresh on things such as sick days rules...

I was lucky with the group I was with, as well we all were a bright and knowledgeable lot so able to cover more ground, and probably did a bit more around exercise as we did have a marathon runner in our group

Jopar,
(because I'm not certain whether you are criticising what I've said or not, I hate the internet sometimes)
To put my point of view and think I made it clear at the start, I have not been on a Dafne course. I have read the curriculum which is very much the same as other courses based on the original in Germany. Everything I read, including others opinions, makes me think it is well worth doing, which is why I always suggest it.
I mentioned the lack of practical exercise. (clear from the written curriculum) because I think that actually doing some exercise as a group helps both emphasises it's importance and also being able to discuss it together gives some additional input on dealing with any problems.
I also feel quite strongly that best practice on dealing with sickness isn't reserved information and should be part of intitial education, something that many people don't seem to get very much of.

Sorry Phoenix no you weren't included in my criticism... I should have worded my reply better me thinks..