[domsko67]

Since developing diabetes I think I now know more acronyms than there are in the oxford english. Anyway the latest to cross my path is DAFNE. A long-term T1 suggested to me that this was the way to go diet-wise, you basically eat what you want with the exception of sugary drinks, and just cover it with insulin. That seems like madness to me because:

1) I recently bought Dr Richard Bernstein's book on how to manage blood sugars, and the central argument is that we T1 diabetics MUST limit the carbs in our diet to achieve better control, less swings, avoid spikes etc.

I must say that this approach has revolutionised my control. I am in the normal range nearly all the time now, when I stick to the low carb diet he recommends. I cheat every now and then but we're all human, right? I'm feeling much more energetic and I've been 200% more productive at work, the difference in me is tangible, even my family has noticed and said so.

2) Surely a diet where you just eat anything would lead to potentially hundreds of spikes, as even the fastest acting insulin would still struggle to cope with the food intake?

Which leads me to my next question - Glycomark testing. Anyone know anything about this and whether it is available on the NHS in the UK?

Apparently if you want to know whether your blood glucose is behaving itself after meals, the GlycoMark Blood Test is the way to go. It allegedly measures a unique sugar (called 1,5-AG, short for 1,5- anhydroglucitol) which enables doctors to separate patients whose higher A1cs stem predominately from post-meal spikes from those patients whose problem is basal glycemic control.The test is likely to be useful if your A1cs are moderately good, but not quite there. It could reveal post-meal spikes that you weren’t aware of, giving you and your doctor the ability to make necessary adjustments to your medication.

any advice on this appreciated folks

[Subby]

Hiya domsko, yes I would agree with you and Bernstein that reducing carbs right down is a great way to effectively improve control. I need to get around to getting his book because although I tend to go more towards low carb since reading his website and chatting around here, I'd like to find out what else he has to say about it all.

As for Dafne, I havn't done it and I must admit I didn't realise there was a thrust of "all you can eat" mentality. I assumed they were at least sensible with carbs. Tsk tsk. Carb counting and I:C ratio dosaging in itself is the way to go though, so in that sense it gets it right. Although, we have just had a members go through a Dafne course and have the educators insist a "one size fits all" I:C ratio. Which is complete and utter madness. So I'd tend to agree that Dafne seems very dubious indeed for a few reasons.

As for the Glycomark testing, never heard of it I'm afraid.

Another method of seperating basal issues from bolus issues is basal testing. Here's a great article written on Basal testing and MDI. Basal Testing for MDI - Diabetes Daily Forum
Ever considered or looked into a pump? I get the feeling it may be worth looking into for you. Many of us find they are wonderful things to improve control.

[SueM]

DAFNE is not stick all you can in your gob and eat it.
What it does is teach you how to adjust your insulin for normal eating.
Now if you sit and stuff your face all day long whether you are diabetic or not then that is not normal eating is it?
DAFNE does not preach any kind of diet. It just teaches you to use your insulin in the correct manner.
No matter what you eat needs portion control and that is the key to diabetes control.
I have not done DAFNE either, but I have spoken to many who have and they have been very positive with their comments and also the greater control it has given them over their diabetes and life.
So don't knock it until you have tried it.

[Subby]

Originally Posted by SueM

DAFNE is not stick all you can in your gob and eat it.
What it does is teach you how to adjust your insulin for normal eating.
Now if you sit and stuff your face all day long whether you are diabetic or not then that is not normal eating is it?
DAFNE does not preach any kind of diet. It just teaches you to use your insulin in the correct manner.
No matter what you eat needs portion control and that is the key to diabetes control.
I have not done DAFNE either, but I have spoken to many who have and they have been very positive with their comments and also the greater control it has given them over their diabetes and life.
So don't knock it until you have tried it.

Ok Sue, thanks for the info. I'm very happy indeed that people have been and are getting improvements from Dafne. Please forgive my "all you can eat" comment, it was a careless way of saying it sounds like it might encourage people to think the carbs equation is solved without perhaps considering a lower amount of carbs. For many people of course, it isn't an issue. For other people that couldn't be further from the truth. I don't like seeing people slip through the cracks of doctrine - if it happens. If not, and if Dafne really doesn't encourage people to completely expect a medium or high carb diet to be solved through ratio dosaging... then all is good!

Check ant hill's post in "diabetes" forum for someone who's come up against a big brick wall with it - he has followed the rules and control is way off unless he breaks with his Dafne instructors rules of a certain I:C ratio. And sure, he might be an exception (I would hope so!). There do seem some worrying elements in some implementations of Dafne. (Maybe it's just the local version being so blindly brittle - do you know if it is common to dictate a certain I:C without modification?). Hopefully they will improve these fundamental issues where they occur.

Nethertheless, chastisement received and understood!

[ant hill]

Originally Posted by domsko67

Since developing diabetes I think I now know more acronyms than there are in the oxford english.

LOL You should take up the CCNA (Cisco Certified Network Associate) course as it has a stack full of acronyms in it.

Anyway the latest to cross my path is DAFNE. A long-term T1 suggested to me that this was the way to go diet-wise, you basically eat what you want with the exception of sugary drinks, and just cover it with insulin. That seems like madness to me because:

1) I recently bought Dr Richard Bernstein's book on how to manage blood sugars, and the central argument is that we T1 diabetics MUST limit the carbs in our diet to achieve better control, less swings, avoid spikes etc.

I think that when you look what insulin that maches the food profile is not at all perfect for instance if you had an orange and see the BG shoots up in a amazing speed and you try to find insulin to follow that and the other way like pizza or pasta which has low GI value and we have to bridge bolus to cover it.

I must say that this approach has revolutionised my control. I am in the normal range nearly all the time now, when I stick to the low carb diet he recommends. I cheat every now and then but we're all human, right? I'm feeling much more energetic and I've been 200% more productive at work, the difference in me is tangible, even my family has noticed and said so.

MMmm..... I must get this book!!

2) Surely a diet where you just eat anything would lead to potentially hundreds of spikes, as even the fastest acting insulin would still struggle to cope with the food intake?

Exactly!

Which leads me to my next question - Glycomark testing. Anyone know anything about this and whether it is available on the NHS in the UK?

Or Australia.

Originally Posted by Subby

As for Dafne, I havn't done it and I must admit I didn't realise there was a thrust of "all you can eat" mentality. I assumed they were at least sensible with carbs. Tsk tsk. Carb counting and I:C ratio dosaging in itself is the way to go though, so in that sense it gets it right. Although, we have just had a members go through a Dafne course and have the educators insist a "one size fits all" I:C ratio. Which is complete and utter madness. So I'd tend to agree that Dafne seems very dubious indeed for a few reasons.

Hello Subby, The one size fit all approch is not entirely true as they look at the I:C ratio at 1:10 as a basic fundermental to make carb counting easyer and I just cannot wait till the 18th thursday of this month to show that I still have to show that I can lower my ratio. I also see that they use a CP value (Carb Portion) which is around 10 Carbs and they still call 1 CP if they see 13 carbs so if I count say 5 CP's then I would look at the total carbs and recalulate and then do the I:C rato.

Another method of seperating basal issues from bolus issues is basal testing. Here's a great article written on Basal testing and MDI. Basal Testing for MDI - Diabetes Daily Forum
Ever considered or looked into a pump? I get the feeling it may be worth looking into for you. Many of us find they are wonderful things to improve control.

Thanks for the URL Subby and I'll have a look.

Originally Posted by SueM

DAFNE is not stick all you can in your gob and eat it.
What it does is teach you how to adjust your insulin for normal eating.

That's right Sue, It's not entirely perfect as you will find that there are foods that don't work for you.

No matter what you eat needs portion control and that is the key to diabetes control.

YES!!

I have not done DAFNE either, but I have spoken to many who have and they have been very positive with their comments and also the greater control it has given them over their diabetes and life.
So don't knock it until you have tried it.

I fined DAFNE good as it wont just magicly happen O'night as there is a lot to take in and the practice is on going and you will soon learn that not all food that's not what you can have and when you look at bernstien's diet will make seance as that would make a near perfect control.

[domsko67]

Thanks guys, some interesting points. Sue, apologies if you thought I was panning DAFNE, it's just the way that it was explained to me sounded all wrong and bear in mind this came from a T1 of over 20 years, so I was listening intently.