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Discussion in 'Type 1 Diabetes' started by ariaxo, Dec 11, 2020.
What does it entail? I’ve been told if I want to go on the insulin pump, I have to do this course.
I chink @MeiChanski and @ert have done it fairly recently, they might be able to tell you some more
Thank you @Antje77
Hello there, DAFNE is Dose adjustment for normal eating, so you’ll learn about how to help yourself in scenarios when you are unwell, how exercise affects your BG, how certain carbs with different GI affect your BG, also to learn how to count carbs so you can adjust your insulin for all those scenarios. Adjusting your insulin gives you flexibility over different things, like you may need less insulin on this particular day etc.
In terms of a insulin pump, you need to know what to do when your pump decides to pack up or when it’s not doing enough for when you are unwell - some people have to revert back to MDI. Also on a pump, you need to effectively count your carbs to be as accurate as possible. (There’s less wiggle room on a pump vs MDI)
I think @MeiChanski has covered what it entails fairly well @ariaxo but I found the input very superficial and largely unhelpful and not particularly informative. The "text book" given at the beginning of the course had all the information and if this had been distributed prior to the start of the course and it had been a flip learning course it might, just might have been more beneficial. I learned more from talking to participants on their experience than on the course. I did it in the hope that I might, again just might get a CGM. My Ffaniny modryb in Wales (you'll need to put that in Google translate)and she wouldn't have gained much from the course. I was very disappointed
Some areas do their own variants of the course though, my area has its own and I found it very useful, it was one day a week over 4 weeks - I found it very useful, we had to keep a food and blood test diary for 4 weeks (starting the week before the course) and each week at some point through the day they went through said dairy with use individually and could help with sorting out basal rates and carb ratios for different times of the day, they also helped one person and got his basal changed because it was causing him extreme tiredness but he hadn't know it was the basal doing it.
I knew how to carb counting anyways, I'd already had diabetes about 40 years, and going in I thought it'd be a waste of time, but I was proved wrong, it also meant I'd done it so this meant they'd approve me a for a pump when I finally got the consultants agreement it would help
I thought it would be a waste of time, but it was the only way I could get a pump. I was pleasantly surprised, and learnt a lot both from the team leading it, and from the other participants. Our team didn't follow the book exactly, and there was daily reporting back of what had gone wrong and right in the last 24 hours from each person on the course if they wanted to. No pressure, but everyone found it helpful to get input from the team and other type 1's, and agreed they had benefitted from it. Our course was 5 days in a row, plus the following Monday.
I definetly think I am going to go in this, I think it is all beneficial and there will always be something new to learn or some good advice we can take onboard! Anything to make our lives easier if possible!
I couldn't believe the course was for a week before I started. I thought I was well researched beforehand, completing the Bertieonline course, but I really didn't realise how much there was to know. It did cover pumps in detail. For me, I met other type 1 diabetics for the first time, learnt about all of the different insulins, injections, dosing, ketones, technology, physiology, injection sites, IR, different CHO ratios for different times of the day, sick day rules, hypos, travel, Frio bags, normal eating, recording and testing analysing the data and giving and receiving dosing advice across a group as practice, antibodies, pregnancy, research, and exercise and specific sports training, I felt really confident and competent by the end of the course and as a result managed to move my BS's into the normal range, with my fuller understanding of type 1.
Sounds brilliant, definetly one to book then, glad you managed to get within a good range, hopefully that will be me next! ❤️
And you can always build from what you've learned and discard the parts that don't fit you personally
I feel the only downside to the course was, they covered hormonal changes etc for the younger people but they didn’t give enough information on those who are going out the other end (menopause etc). But it’s a really nice one week course (or once a week course) to meet other people, you’ll get information about technology as well. If you are really struggling your hospital can lend you a CGM for a week to find out what’s happening. I know nowadays doing DAFNE might get you a libre. When I did that, it wasn’t available. But now it’s common to have a libre while doing DAFNE so you can understand your trends and BG a bit better.
Also to note that some people doing a carb counting course doesn’t want a pump. They just want to manage their BG better.
on my dafnee course I knew most of it before but needed it for access to pump and chatting to 8 other diabetic's was helpful the course tends to be 5 days long
Don’t let your diabetic team fob you off with ‘You can only have a pump if you do Dafne’ because it’s not the case at all. I work for my self, so In November when I enquired about going back onto a pump I point blank refused to do the course. Before COVID it was a 5 day course and there’s no chance I was taking 5 days off work. My clinic have been trying to get me on Dafne for months so it was already on my file that I wouldn’t do it when I enquired about the pump. Diabetic nurse then went on to explain that Dafne was now done virtually with 1 session per week and was told it could take upto 6 month to complete it. I honestly just laughed at them & told them I wanted the pump ASAP not do 1 session a week for 6 month then go onto a waiting list. What I did was the online BERTIE course, takes a few hours at the most to complete and you get a certificate at the end to send to your consultant/nurse. Still goes into depth about different carbs and carb counting etc but I’ve carb counted since I was 13 so I didn’t have any issues with it.
Long story short, I did the Bertie course sent them my certificate and I get my pump on the 7th of January. Fully funded 780G with the CGM to go with it. Instead of what would of been around a year wait I’ve managed to secure it within 2 months. My advice would be push push & push some more, ring them daily weekly or even email. It’s what I did, yes I seemed like a right nagging pest but it’s the only way to get them to listen. If not your put to the back on the queue and most likely forgot about.
I did all the above in terms of contacting my team, but was refused the pump until I did the DAFNE course, so while it obviously worked for you in your area, it didn't for me and others in my area. Each area is different and what works in some area won't in others.
Once I'd done the course I had no problems getting my pump.
I’d put money on it working in just about every area if you pushed it enough, I was refused a pump at least 4 times in the last 3 year because of Dafne being part of the criteria. All of a sudden when I push them hard enough & then find out about the Bertie course I’m suddenly fine to have the pump? It’s bull.. Same with the Libre, didn’t meet any criteria last year but because of a good relationship with my consultant I was granted it. Still have the email on my phone where He told me he needed me to show significant improvement because he went against all criteria to let me have it.
I’d say a big part of it comes down to the relationship you have with your team.
I'm sorry you didn't get to do the DAFNE course.. I've also completed the Bertie online but found the DAFNE life-changing in terms of insulin management and safety. Which is why it's a pre requirement.
Dont need to be sorry, like I say it was my choice not to do it due to work commitments. To be honest I don’t learn well in a class room anyway so for me 5 days in a room learning from books etc wouldn’t really benefit me. I’m more a hands on learner if that makes sense..
What really annoys me is why the requirements differ so much from area to area, obviously it’s benefited me but it’s got to seriously annoy people. No Dafne for me but I get a pump, don’t meet Libre criteria but I get a Libre. When I was on a pump as a child I didn’t have to do Dafne then either.
Out of interest what was you Hba1c before the pump or Libre? Did it make a difference?
When I was giving the funding for Libre it was in the low 60’s, I came off Libre for a while and it went up to 83. When I challenged my team in November about a pump my Hba1c was still 83 but they where still determined I had to do Dafne (which I didnt). Maybe the raise in hba1c give them the kick up the backside to let me have the pump
Your Hba1c remaining high despite trying to manage your diabetes would have met the criteria for the funding.