Living With Type 1 Diabetes

1st April 2019

When Sukeshi attended a DAFNE course, dose adjustment for normal eating, it changed her life

Sukeshi Thakkar has been living with Type 1 diabetes for almost 30 years. Both her parents had Type 2 diabetes and her father, a doctor, diagnosed her diabetes when she was 26.

Sukeshi put her own health ‘on the back burner’ when she cared for her mother who had suffered a massive stroke, but when her parents had both passed away she felt it was time to take control of her condition and manage it properly, as it had already affected her feet and kidneys. She thought she was an expert; but when her Consultant invited her to attend a DAFNE course (DOSE ADJUSTMENT FOR NORMAL EATING) at her local hospital she learned things that changed her life.

DAFNE course provides crucial information

“DAFNE is a 5-day training course, with a follow-up 8 weeks later,” she explains. “It’s quite intensive, but I learned a lot. The aim of the course is to help you work towards your personal diabetes-related goals so that you can lead as normal a life as possible, while controlling your blood glucose and reducing the risk of long-term complications related to diabetes.”

“The DAFNE course teaches you the skills to administer the right amount of insulin for the amount of carbohydrate you choose to eat.” Sukeshi continues, “There’s a lot about carb counting and you learn the importance of testing regular, varying injection sites, changing needles each time.

To begin with they suggest trying a ratio of 1 unit insulin to 10g of carbs. Even for dose adjustment they suggest 1 unit insulin brings down BG (blood glucose) by 2 or 3 millimoles.”

Groups of 6-8 participants are given guidance by educators trained in DAFNE, allowing them to learn by experience and practice the key skills of estimating carbohydrate and adjusting insulin dose. Participants can share their experiences, but can also speak with the DAFNE Educators privately about their individual circumstances. One of the core goals of DAFNE is to allow people to fit diabetes within their current lifestyle, rather than making huge lifestyle adjustments for their diabetes.  The skills you are provided with are crucial - especially for people considering Libre (a patch that helps you monitor your blood sugar levels)...but it’s important to know that DAFNE is currently only offered by diabetes units that have DAFNE trained educators and doctors, and private DAFNE courses are not yet available.

DAFNE – the facts

Eligibility Criteria

A person must meet the following criteria in order to attend the DAFNE program:

• Have Type 1 diabetes
• Be 18 years or older
• Not be on a pump
• Take one or two injections of long acting insulin each day and quick acting insulin each time you eat
• Be willing to inject, check and record your blood glucose levels at least four or five times a day
• Be prepared to adjust your own insulin according to what you eat, your blood glucose levels, and other factors (for example, exercise)
• Be able to attend all five days of the program from 9 am to 5 pm
• Be able to speak, understand and read English.

What you will learn on a DAFNE course

• How to count carbohydrate and calculate quick-acting insulin doses according to your carbohydrate intake
• How to correct your blood glucose levels if you need to
• How to adjust your long-acting (background) insulin to approximate basal insulin requirements
• And how to evaluate your blood glucose patterns and adjust both quick-acting and background insulin (on separate occasions, not at the same time) to attain blood glucose levels in the target range.

The benefits

In both Australia and the United Kingdom people using DAFNE have experienced the following benefits:

• Improved HbA1c
• Reduced diabetes distress, depression and anxiety symptoms
• Increased dietary freedom
• No weight gain
• No increase in blood fats
• No increase in severe hypoglycaemia (Australian studies of DAFNE have found that severe hypoglycaemia has been reduced).

Sukeshi Thakkar would definitely recommend the DAFNE course to anyone who has Type 1 diabetes

“When I first attended the DAFNE course my blood sugar levels were at 119 – whereas the normal prescribing level is between 45 – 55 units. After the course I’m now down to 72 – but it’s my aim to get to 50.

At the end of Day one I went home thinking that the DAFNE course was so good that it should be compulsory for Type 1 diabetics; a bit like a driving test,” she comments.

“I suppose it won’t suit everyone but that’s how I felt; and I still feel that all Type 1 diabetics should be told about the DAFNE course and given the opportunity to attend one. It could help nearly all Type 1 diabetics significantly improve their blood sugar control.

There will always be a few people with special situations where the benefits don’t materialise but my results have made me a raving fan of DAFNE.”

Further information

For more information on DAFNE you can visit the DAFNE website and also read our Medical Matters blog article 'Blood Sugar Testing For Diabetes'.