Aileen Robertson and Razia Amin

1
Welcome to DAFNE

• Aileen Robertson and Razia Amin
• DAFNE Educators
• Diabetes Centre
• NHS Grampian
• Grampian Diabetes Professional Conference
• 24th May 2006

2
Case Study

• Mike 35 years old
• Poor glycaemic control
• Nocturnal hypoglycaemia
• Complications
• To switch to a basal bolus regimen

3
Background

• Dose Adjustment For Normal Eating
• 5 day structured education for type 1 diabetes
• Self management, confidence and competency
• Started in UK in 2000 (Scotland in 2005)
• BMJ 2002 325 746-751

4
Inclusion Criteria

• Type 1 diabetes - post honeymoon period
• Over age 17 years
• HbA1c lt 12
• Motivated to improve control
• Able to read and converse English
• Able to attend a full 5 day course
• Willing to test and inject at least 4 times a day
• 8 participants per group

5
Patient Costs

• Baseline clinic visit (individual appt)
• 5 day course
• Follow up 6 - 8 weeks post DAFNE
• Follow up 12 18 months post DAFNE

6
Evidence

• 0.5 reduction in HbA1c
• Improvements in QoL
• No increase in hypoglycaemia
• No weight gain
• BMJ 2002 325 746-751
• NICE Guideline 60, Diabetes UK report

7
DAFNE Timetable
8
DAFNE Targets
HbA1C 6.0 7.0
9

• This is a must for all diabetics.
• Fantastic it is like a light bulb being
  switched on after being in the dark for the past
  25 years.
• Fantastic. This week has gifted me with the
  tools I have been missing over the years.
• To be in control of me for the first time ..
• I understand more about diabetes now than I
  managed to pick up in twenty years.
• Looking forward to life now, not dreading it.

10

• This course is essential. The value of the
  course and its content cannot be
  underestimated.
• An amazing week, not only can I now eat what I
  want but I can live a normal life. Suddenly
  diabetes is no challenge.
• Instead of being ruled by my diabetes I will
  control it.
• This week has taught be how to live with
  diabetes rather than fighting it on a daily
  basis. Everyone with type 1 diabetes should have
  the opportunity to live a normal life.

11
Case Study

• Mike 35 years old
• Poor glycaemic control
• Nocturnal hypoglycaemia
• Complications
• To switch to a basal bolus regimen

12
Questions ??
13
www.dafne.uk.com

• Aileen Robertson
• Senior Dietitian
• Diabetic Clinic
• Woolmanhill
• Aberdeen
• Tel [phone]
• aileen.robertson_at_nhs.net

• Razia Amin
• DSN
• Diabetic Clinic
• Woolmanhill
• Aberdeen
• Tel [phone]
• razia.amin_at_nhs.net