DAFNE - a question for Brits

[Ella1]

Hello!

I know that in the US it's not known. I'll just explain what it means. DAFNE stands for - Dose Adjustment for Normal Eating. It's a fairly new programme in the UK which educates people with diabetes how to adjust their insulin doses for food. It's something what you call carb count in the US. The method has been practiced in Germany for over 30 years now and it has proven to be successful.

I just wanted to hear from anyone who was on this programme in the UK. My boyfriend has been signed up for it by King's College Hospital in London, so he will join it in June.

The thing is he is already on the intensive insulin therapy, i.e. he doesn't stick to any fixed regimen and injects as many times as it's necessary depending on what he eats when he eats and how many times he eats. To do this he uses the program Diabet2000, and doing it very successfully. I wanted to find out whether DAFNE is using the same concept as is in this program, and whether we will learn anything new for us.

Thank you in advance for sharing:)

[DeusXM]

DAFNE is less to do with 'intensive' insulin therapy and more to do with carb counting. Whilst he might be injecting every time he eats, and probably has a rough idea of how much to jab, DAFNE helps formalise that and helps you work out exactly how much you need depending on time of day, what you're eating etc.

The majority of people are on intensive insulin therapy with isophane and then something like Humalog, but most of us haven't been on DAFNE yet. There's talk about making it an essential part of diabetes treatment on the NHS now.

[Ella1]

Thank you, DeusXM

Do you know whether they only count carbs? I understood that it is very useful when you eat out and haven't got scales with you all the time, you kind of learn to measure by eye. Is it true?

I think they definitely should move to DAFNE practice. Though, when we mentioned it to the specialist which we saw privately, he said: DAFNE - is an expensive way to teach common sense to people. Such a nonsense! I think some doctors sometimes forget that what is a common sense to them could be a totally new revelation to others.

Whenever my boyfriend sees a dietitian as a usual twice a year routine check-up, all they tell him is this food pyramid and healthy eating habits... If I didn't start getting into all these low-carb diets 2 years ago, he would have never learned the carb : BG : insulin relationship. Such neglegence annoys me a bit.

So I think DAFNE is definitely a step in the right direction

[DeusXM]

From what I've heard of DAFNE, the majority of people who think they're very competant with predicting their insulin intake still find the programme incredibly useful. I haven't been on a course yet, but I'd imagine there is a bit more than just carb counting, though I'd imagine it's a fairly important part.

The problem with dieticians is that they're supposed to be a jack-of-all-trades and so usually can't give specific advice. Also, the medical establishment here has suffered probably irrepairable damage from Diabetes UK (Formerly the BDA), who for years have said that people with diabetes should eat vast quantities of high-carb starchy food. Now that people are starting to realise that in fact we should be eating the complete opposite, D-UK is now refusing to admit it may have made a mistake and has done very little to help re-educate healthcare professionals. I'm lucky in that my diabetes nurse is very clued up. Most people aren't so lucky though.

[Teresa]

ive never heard of it, so thats a no from me! I just guess at what i need to take and when! ive never had any dieticain advice, except to be told im overweight and i need to lose some weight! But ive moved house now, hopin my new hospital will be better!!

i have tried carb countin tho - ive not been sucessful as yet, but im gonna keep tryin

[Ella1]

Yes, it's so important to get a good specialist who is enthusiastic about his/her job and is always up-to-date.

That's why we had to go to see a doctor privately... And to be honest, not much difference.. well apart from the 200 quid bill.

Only recently figured that we can move to King's College. And it's absolutely brilliant, though I heard that they are running low on the money front now. Such a shame :( I think it's only a couple of hospitals in the UK who practice DAFNE.

Teresa, my boyfriend was doing exactly the same when he was on his honeymoon period for the first 2 years, but when it was over, the guessing technique just stopped working for him. The BS were swinging like mad. Until we understood what was happening and tried to analyse evry single case when BS were too high or too low, we just couldn't deal with it. We figured that elimination method worked, when you rule out all possible causes that you know about. I had to read a lot of medical literature to understand what was happening.. And now it's so much easier, once you can explain for yourself what you did wrong and adjust it. The best, of course is to ask questions :)

[Ella1]

Teresa, I just reread my message and realised that it's all word and words, and no practical advice... I guess it's getting catchy, since I heard all that myself all way long :p

Please feel free to send me a message and ask a question if you need a help with carb count. I know all this bulk of information could be daunting at times :)

[Teresa]

thanks, i know how to carb count in theory... its just a lazy thing... i dont enjoy having to work out the carb value of everything i eat... id rather just eat! i know i need to tho! Until bout 2 months ago i was only testing my blood sugar once a week at the very most! ive started testing daily now tho... i think the "im not looking after myself" thing kicked in... realised my blood pressure meds wouldnt work unless i took them, and stuff like that!

trying to be better now!

Thanks

[Ella1]

Yes, I know what you mean about a lazy thingy.
My boyfriend, James, had the same issue at first. But when he tried to apply this very simple mathematical method, it became so much easier. Besides, later you won't even need to use it, as you will have the doses in your head for such things like 100g of potatoes, bread, rice, pasta. And it won't be just a guess, it will be the right dose for you which you calculated some time ago and after having used it many times, you simply have memorised it, like we do with telephone numbers, which we dial a couple of times. :)

[kitty]

I was due to be on the DAFNE couse at King's next week, had I not had some kind of freaky reaction to lantus and been changed onto insulatard. I'm hoping I can go on the one that's running in I think May.

I think it would be good for me to go on the DAFNE course. I can remember when I was diagnosed, I was told to count exchanges, and I believe that is what led to a weight increase for me which I have finally started to fix. After the hospital doctors told me to no longer count in exchanges, I have completely lost the plot in counting carbs. I have a rough idea, but not a brilliant judgement, the dieticians that I have met did not really go through carb counting with me (in fact they made me feel a little bit dumb with the advice they gave). I don't think that DAFNE only teaches about carb counting, although that's probably a major aspect of the course.

I heard that DAFNE has a trial run in the UK, and that only certain centres are allowing their patients on it, so maybe that's why some ppl havint heard of it:confused: .