I’ve been adjusting my own insulin for years, so why should I do DAFNE?
Many people who have been on a DAFNE course say this before they complete their DAFNE programme. Some people with Type 1 diabetes have learnt over many years of private trial and error how to adjust insulin to food in a very sophisticated way. However DAFNE teaches people the skills that take the guess work out of insulin adjustment and people are much more likely to keep the blood sugar in the target range and reduce the risk of a severe hypo. DAFNE builds confidence quickly to make the very large changes in insulin needed on a meal-by-meal basis, in a truly free diet.
The added benefit is that it is an opportunity to learn about new ideas in diabetes care, and is also a refresher of basic information.
Why can’t I do DAFNE myself, do I really need to attend a course?
DAFNE is a package that includes not only the patient course but includes support from experienced healthcare professionals; plus the entire DAFNE programme includes lots of measures to ensure and maintain the quality of the course.
It is this entire DAFNE package that has proved to be successful in trials conducted both in Europe and here in the UK. This is not to say that other ways of delivering the DAFNE course may not be as successful as the 5-day course, however any alternative methods of delivery must be scientifically assessed before they are recommended. People need to be offered a ‘tested product’.
By having the course over a week, people are able to discuss every day how they are progressing, and get all of the information in a concentrated way. It also means people can learn from each other and be more experimental with new ways, knowing it can be discussed within 24 hours.
Can I really eat what I want?
Yes, except for having sugary drinks you can adjust your insulin to cover anything you choose to have. DAFNE allows people to eat what they want when they want; this includes not eating if you do not feel like it.
How is DAFNE different from what I already do?
It is different because it enables you to be much more precise with your insulin doses, and allows for much more flexibility then other current insulin regimes.
I thought carbohydrate counting was an old approach?
Yes it was, but in the past it was used in order to control and regulate the amount of carbohydrate in people’s diet. People were told how much carbohydrate to eat during the day to match fixed doses of insulin. Varying the amount of carbohydrate eaten from day-to-day was not recommended. However carbohydrate counting in DAFNE enables dietary freedom, people can choose to eat as much or as little carbohydrate as they want, enabling people to have a truly free diet.
What happens if I can't get time off work to attend the course?
Some employers allow people to have paid time off work to attend and a letter is available to explain the benefit to employers. Some have chosen to arrange holiday for the week.
Managing diabetes already cuts a huge amount of hours out of people’s working lives. Long term DAFNE may help to reduce this, as DAFNE graduates can manage their diabetes better requiring less input from healthcare professionals. Also by improving blood glucose control the risk of long term complications (and the lost working hours encountered because of this) may also be reduced.
For example, one DAFNE graduate had terrible problems with hypo unawareness for at least a couple of years prior to their DAFNE course. Despite being a very fit and athletic individual, they were in and out of A&E repeatedly with bad hypos. As a result they also missed a huge amount of time from work related to this problem.
In the 12 months following the completion of the DAFNE course this individual has not missed a single day at work.
My blood glucose control is already quite good; do I need to do DAFNE?
Improving blood glucose control is only one of the benefits of DAFNE.
DAFNE has been proven to improve the negative impact that diabetes may have on quality of life. DAFNE may be able to give you more freedom to eat as you like, for example miss meals if you want to.
DAFNE can also reduce the risk of severe hypos in addition to providing new ideas for managing hypos and exercise.
Is it dangerous to mess about with my insulin?
No. The DAFNE course is delivered over a 5-day period. During this time participants practice dose adjustment at lunch times with the group. During the evenings participants are encouraged to experiment by eating out, exercising and cooking meals. Their choices/experiences are discussed with the group the following morning. In total participants have about 12 opportunities to practice personal insulin dose adjustment, plus all the experiences they gain discussing the choices made by the other course participants. So during the week there is ample time for practice.
In general a lot of people have needed smaller insulin doses than they did before DAFNE. It may be that the type of insulin won't change but DAFNE enables you to fine tune your insulin needs.
If I improve my blood glucose control won't I have more hypos?
The experience from DAFNE and from the original courses in Germany show that severe hypos are less frequent. Mild hypos will not be unusual and glucose treatment is aimed to be much more efficient than before.
My diabetes centre does not offer DAFNE, how can I get onto a DAFNE course?
We believe that anyone who wants to do DAFNE gets the opportunity. However some diabetes units are unable to offer DAFNE for a range of reasons. Getting Involved explains this in a little more detail.
I have Type 2 diabetes, would DAFNE be suitable for me?
DAFNE was developed for people with Type 1 diabetes. There are major differences between Type 1 and Type 2 diabetes - lifestyle issues are much more important in Type 2 diabetes. People with Type 2 diabetes who require insulin may benefit from the DAFNE principles around insulin adjustment, but the DAFNE course would need to be restructured in a very major way in order to be made suitable for people with Type 2 diabetes.
However, there is a programme being developed for people with Type 2 diabetes at the moment. A Collaborative representing 13 diabetes services around the UK and including people with Type 2 diabetes, is currently piloting a new structured education programme for people with Type 2 diabetes. This programme is called Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND). More information about DESMOND can be obtained from the DESMOND website.
Is DAFNE suitable for children with Type 1 diabetes?
DAFNE was developed for adults with Type 1 diabetes and as such is not suitable for children with Type 1 diabetes. However it is clear that the DAFNE principles may be applied to children, but there would need to be significant changes to the curriculum to make it suitable for children.
A group of doctors in Sheffield are currently developing a DAFNE type programme for 11-16 year olds. This research is in the early stages and will be piloted in units in Derby, Manchester and Sheffield. For further information and updates please refer to the Further DAFNE research of this website.
What if DAFNE is not for me?
It is important that everyone has a choice. The majority of people would find the DAFNE regime suitable, but some may prefer not to take the option.
A few people who have attended a DAFNE course did choose not to carry on with DAFNE at the end. However, they found the week very useful and the skills learned still help to manage their diabetes day-to-day. Whatever you decide you will still be offered the same level of support and treatment from your diabetes clinic.
Will I put on weight?
Overall some people will loose weight and some will gain weight. The freedom of food choices will allow you to eat like anyone without diabetes. It can help with weight management because you can choose what you have.
I am planning a pregnancy can DAFNE help?
It is important to have good diabetes control before conception; the DAFNE regime can help to achieve this because of the flexibility.
What are the benefits of the DAFNE approach?
DAFNE has been proven to:
| • | Improve blood glucose control without an increased risk of severe hypoglycaemia. | |
| • | Reduce the negative impact of diabetes on quality of life. | |
| • | Improve treatment satisfaction. |
Why not read the personal accounts of the difference DAFNE can make in the What are the benefits of DAFNE? pages of this website.