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Welcome to DAFNE. Aileen Robertson and Razia Amin DAFNE Educators Diabetes Centre NHS Grampian Grampian Diabetes Professional Conference 24 th May 2006. Case Study. Mike – 35 years old Poor glycaemic control Nocturnal hypoglycaemia Complications To switch to a basal bolus regimen.
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Welcome to DAFNE Aileen Robertson and Razia Amin DAFNE Educators Diabetes Centre NHS Grampian Grampian Diabetes Professional Conference 24th May 2006
Case Study Mike – 35 years old Poor glycaemic control Nocturnal hypoglycaemia Complications To switch to a basal bolus regimen
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
Inclusion Criteria • Type 1 diabetes - post ‘honeymoon’ period • Over age 17 years • HbA1c < 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
Patient ‘Costs’ • Baseline clinic visit (individual appt) • 5 day course • Follow up 6 - 8 weeks post DAFNE • Follow up 12 – 18 months post DAFNE
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
DAFNE Targets HbA1C = 6.0 – 7.0%
“…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.”
“This course is essential. The value of the course and it’s 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.”
Case Study Mike – 35 years old Poor glycaemic control Nocturnal hypoglycaemia Complications To switch to a basal bolus regimen
Aileen Robertson Senior Dietitian Diabetic Clinic Woolmanhill Aberdeen Tel: (01224) 555221 aileen.robertson@nhs.net Razia Amin DSN Diabetic Clinic Woolmanhill Aberdeen Tel: (01224) 555471 razia.amin@nhs.net www.dafne.uk.com