Last Friday evening, Noel from Dublin who has lived with type 1 diabetes for nineteen years shared a post in our closed diabetes support group about his recent experience of completing a structured education course called DAFNE, stating that his diabetes management was the best it has ever been since completing the course over a week ago. He also included a graph of his stable blood glucose levels for the previous 24 hours.

“Since I finished last Friday and began putting the DAFNE teachings into practice, I have seen more improvements in my glucose control. Taking the last 24 hours as an example this has become a regular day now. No severe lows and no crazy highs.”

This type 1 diabetes course is only available in only 7 diabetes centres in Ireland meaning that only a fraction of the adult diabetes community in Ireland have access and this experience has prompted Noel to advocate for every person with type 1 diabetes to have access to DAFNE. DAFNE stands for Dose Adjustment For Normal Eating and is a way of managing Type 1 diabetes that provides people with the skills necessary to estimate the carbohydrate in each meal and to inject the right dose of insulin. People applying DAFNE principles learn to stabilise their blood glucose which reduces the risk of complications, improves quality of life for them and their families.

Noel joined the diabetes online community group a year ago and says that the support and information he has received there prompted him to move to the intensive insulin or basal/bolus regimen and gain access to a continuous glucose monitor which really improved his management and his quality of life with diabetes.  

SELF TAUGHT CARB COUNTING NOT SUFFICIENT

He also mentioned that he taught himself how to count carbohydrates so he could reduce the number of high and low blood glucose levels he was experiencing, this made him skeptical of what more he could learn doing DAFNE. But he says he is a convert now and believes that every person with type 1 diabetes SHOULD have access to this education. 

He continued in his post to list all the things he learned:

“For me the list below are what I took from last week:

• I now properly understand Basal Insulin

• I now know I was carb counting incorrectly

• I was taking too much bolus insulin

• I am more comfortable on nights out

• I'm less anxious about training and exercising

• I no longer over correct hypos resulting in rebounding high glucose levels

• I understand sensitivity better and bolus ratios”

ACCESS TO STRUCTURED DIABETES EDUCATED LIMITED

There are currently 19 hospital diabetes centres out of the 33 providing diabetes care who provide type 1 diabetes education programmes such as DAFNE and BERGER, however some of those have currently suspended this programme due to staffing shortages.

 BENEFITS OF DAFNE

More about the benefits of DAFNE, which has been embedded into the NHS in the UK, can be found here including the “reliability, credibility, impact and effectiveness of DAFNE can be demonstrated through over 25 years of peer-reviewed published research in both the UK and Europe. DAFNE has been shown to improve blood glucose control, to improve quality of life and to reduce the risk of severe hypoglycaemia. These improvements are associated with immediate savings in the cost of care and long term savings through reduction in

Complications. In the short term, DAFNE is associated with immediate savings from lower insulin doses and reduced hospital attendance due to ketoacidosis and hypoglycaemia.