DAFNE

Hi,
Sorry I can't help you with details of Dafne courses, perhaps Diabetes UK might know? Also, I wondered if your diabetes nurse or consultant has explained about carb counting and helped you work out a starting insulin:carb ratio? You really need this as a starting point and can then it's a bit if a trial and error thing, doing lots of BM's, to try and get your ratios as accurate as possible. You could also invest in a carb counter book, there are lots available to choose from.

Sorry if you already know all this and I am stating the obvious, but these were just my thoughts on reading your post.
Good luck.
Sue

Hi there

This is a problem that many people face - their own area doesn't do the course. It is generally NOT possible to go elsewhere to get the course because each PCT (primary care trust) pays for it out of their own budget, so wouldn't take someone else's patients. I believe it's a travesty, but there you go.

BUT there is hope. There is an online version of DAFNE (link below) which is good. Be careful as you work your way through it, though - it is easy to miss sections and get confused. It certainly introduces you to the basics.

It might be worth giving this a go, though: the basic position is that you need to work out how much insulin your body needs to deal with a certain amount of carbohydrate. A good place to start is to aim to have 1u of your rapid acting insulin for every 10g of carbs you eat. This sounds a hassle, and you will need to get scales, but it WILL work. Food packets all have nutritional info these days anyway. So, if each slice of bread has 15g carbs, and you have two slices, have 3u of insulin. Start off on this ratio, test before and after each meal and figure out if you need to tweak it.

There are also a LOT of books out there about using insulin wisely: have a look on Amazon and buy a couple (it's likely that some are better than others). This will give you something to go on.

Also, seriously consider at least cutting down on the amount of carbs you eat. Although in theory you can shoot for what you eat, this is difficult. Cutting out some carbs from your diet will probably help.

Anyway, the link is below and good luck!

http://www.bdec-e-learning.com/

I don't think there is anything on the DAFNE course that you can't learn yourself, it is basically an intensive learning program over a couple of days, I did it the hard way and learnt it all by myself over a long time period.

To start I agree with the above, 1u fast acting for every 10g carbohydrate should get you started, measure your BG before meals and 2 hours after.

You should also be taking roughly half of your insulin in basal bolus and half your insulin in fast acting, for example, I take 26u of Lantus and between 20-26 u of humalog per day aver three meals.

The basal bolus is the hardest to get right, you should test your BG as soon as you wake up and if it is any more than about 6, you may need to take more. However, this will take a few days to kick in, so increase by increments of 1 or 2 every 3 days if you need to.

Keep a diary of everything you eat and what dose of insulin you are taking, plus make notes about your level of activity and mood - you should see a pattern emerging after a few weeks

You minimum number of blood tests should be:
Wake up
Before breakfast (if this is a significant time after wake up)
2 hours after breakfast
Pre-lunch
2 hours post lunch
before tea
2 hours after tea
before bed

I actually do more that this on an average day and it gets a little tedious, but each to their own

keep your diary and take it to the DN/consultant when you go so they can see what you have been doing

Armed with these details they have no excuse not to help you!

Just been on a DAFNE course in birmingham east trust so it is available there. I work through heartlands hospital in bordesely green and go to yardley green medical practice, so might be an idear to check there.

Tom