- Messages
- 8,934
- Type of diabetes
- Type 1
- Treatment type
- Other
I've found it interesting to read all the criticisms about DAFNE telling people to eat what they want and inject accordingly. To me, this is a reassuring positive. I haven't been on the course yet and I was only diagnosed with T1 a month ago, but I have to admit that probably the ONLY thing that has kept me going through this stressful period of my life is the reassurance that I can eat as normal and not change my diet. Not everyone wants to move on to an ultra low-carb diet to manage their diabetes and my understanding is that, with reasonable exercise, I should not have to change what I eat and should carry on as normal - if I feel like a cookie or ice cream, I should have it and learn how to deal with the insulin dose accordingly. In my opinion it's hard enough living with T1 without having to restrict what you eat and having to take away some of life's food pleasures!
I think this is where the messages being purveyed become very confused. With MDI treatment and DAFNE, you can eat what you want, when you want. In order to maintain a good level of control, you maybe shouldn't always eat what you want, when you want.
Having the ability to understand how much insulin is required to stop your glucose levels spiking post-prandially based on the content of the food is very important. Understanding the timing of delivery of that insulin is also very important. Both of these affect the height of the spikes and when done properly, reduce the Hba1C, reducing the risk of complications.
The issue at hand is that for many diabetics, eating normally means eating badly, and that's where the controversy arises. As mentioned in the other thread that @smidge created after her DAFNE course, should the DAFNE simply describe how to manage your diabetes in relation to what you eat, or should it really promote ways of eating that will enable you to find it easier to control your diabetes and blood sugar?
As an example, when I was diagnosed in 1988, (in the days before proper food labelling and the internet) we were advised to buy a book called "Countdown" which listed the majority of foods and provided carbs (in exchanges of 10g) per serving/portion/weight. It included fresh and non-fresh food. This book was split into Green, Amber and Red sections. Foods in the Amber and Red were advised to be eaten infrequently because they were not that great in terms of Diabetic control. This is where I learned to carb count. I distinctly remember that my meals were composed of 7 exchanges (70g of carbs) per meal as I had a lot of weight to recover having been running high blood glucose for a long time. Transposing this onto MDI was fairly simple (and in the first instance was an insulin to carb ratio of about 1u:6g). It was very clear in these circumstances what was considered good and bad, and I was encouraged to eat "good" carbs (starchy, low GI).
This is the question that a lot of people are asking. Should DAFNE encourage what should be "Normal eating for Diabetics" or simply "Normal eating for the population at large who won't get complications"?