At T1 diagnosis in 1994 the advice I was given was well-meaning but terrible. Basal/bolus had just come in but they threw the baby out with the bathwater. They were overjoyed to tell me I would not need to count exchanges. I was to follow a normal "healthy diet" (TM) and deny myself almost nothing, just cut back a little on the sweets - you know, just a healthy diet. They told me nothing about carbs and I was totally on my own as to how to calculate bolus doses - "trial and error". Maybe I fell between two stools into the worst possible world between carb exchanges and bolus carb counting?
I ended up devising my own systems, first counting total calories, then after chronic failure of that, finding out myself about carb counting.
DAFNE in my opinion is superb, but the DAFNE method should be taught at diagnosis. OK the NHS don't have a time machine, they couldn't travel back to 1994. It has taken about 5 years to get on DAFNE, maybe because I'm a contract worker and I can't take a week off easily. Frankly I didn't learn much about carb counting that I hadn't already figured out. DAFNE is an OK dose regime but it's not pure genius. What is pure genius about DAFNE is putting 8 diabetics with a hundred years of experience in one room to learn from each other for a week. The clinical staff just stand back and watch the magic, it's incredible. So I think diabetics should get the basic dose mechanics taught at diagnosis, then a follow up peer group session every 5-10 years. Currently DAFNE is fulfilling both of those functions, but it could be split.
I agree with the person who said that basal/bolus frequently degenerates into "eat whatever the hell you want, just dose for it". Whose interests are served by getting us to use less insulin? Notice that most of the treatment technology, historically nearly all of it, was developed by firms whose profit centre is insulin sales. All the delivery delivery systems are loss leaders for selling insulin, always have been. Why can I no longer get a pen calibrated in half units?
Advice to newly diagnosed diabetics should be simple: "You have a disease, diabetes, which makes you carbohydrate-intolerant. That's its definition. Carbohydrates are toxic to you, and quickly or slowly, carbohydrates will kill you. We have a drug, synthetic insulin, that can be used to mitigate the harmful effects, but it is imprecise at best, harmful at worse."
I wish I had been given that harsh but realistic advice at diagnosis, instead of HCPs going out of their way to reassure me everything would continue as normal and I wouldn't need to change anything. Less management of my "state of mind" and a few more facts, please!
So, er, that's a Yes then.