At the end of January, I attended a week-long course to help with the management of my diabetes. It’s a course that I’ve been recommended to attend for around 2 years; but given the limited number of places available on each course, it’s taken a while to get to the top of the waiting list! But how useful was the DAFNE course to me?
DAFNE. It reminds me of the pretty one from Scooby Doo, or the lovely wee lady that used to be on Eggheads on BBC Two. It actually stands for ‘Dose Adjustment for Normal Eating’ and is aimed at helping type 1 diabetics gain the confidence to make amendments to their insulin regime in line with their own lifestyles.
A huge part of balancing type 1 diabetes lies with counting the carbohydrates in the food that is consumed. If you know how much food you’re eating, you can work out how much insulin your body needs.
Simple, right? Not exactly!
When the possibility of attending the DAFNE course was discussed with me some time ago, I remember thinking that it was all going to be about carb counting. It’s something that I’ve been doing for years now – not necessarily doing well, but giving it a good bash anyway. So I wasn’t really sure what DAFNE would teach me that I didn’t already know.
I was a bit wary about attending, to be honest – I don’t know many other diabetics at all (despite there being thousands and thousands of us in the UK, you don’t tend to come across many others without looking for them – or I don’t, anyway) and I was a little afraid of being judged. After all, I certainly don’t have the best control in the world – what if people thought I was careless or stupid?
The course takes place in groups of 8 people – and by the end of the week, there were only 6 of us. It was pretty intensive learning, to the extent that I was mentally exhausted by the weekend. Although having prior knowledge of carb counting gave me a bit of an advantage, I still struggled with some things – and I get really frustrated when I get things wrong!
I would be lying if I said that there wasn’t a lot of content which focused on counting the carbs. It’s the most integral part of the DAFNE model – if the number of carbs is wrong, then the insulin dose is wrong, so the sugar levels go haywire. It’s a bit of a chain reaction really. But there was so much more content in the course, which I didn’t realise would be covered until I had my pre-assessment the week before.
There are various aspects of life which can affect diabetes control. So, there was a session on exercise. One on travelling. One on alcohol (because this course reflects real life, and I definitely enjoy a drink or six on a night out!) There was also one on pregnancy, which I found incredibly useful and less scary than I thought (I’ll explain why in a separate post – but I’M NOT PREGNANT).
The course is led by a Diabetes Specialist Nurse, and a Dietitian. Both were incredibly understanding of everyone’s individual circumstances and lifestyles. They were also full of advice on how to improve diabetes control in line with the DAFNE principles. Everyone was asked to do regular blood checks, and we presented our results each morning, together with a food diary. Then the group would work together to see where things were going well – or not so well.
The group of people I attended with were absolutely brilliant. Every one of us had our own story, our own fights with GPs over prescriptions, our own ways of tackling things – and we were all sharing those experiences with each other. It was great to talk and laugh about something that we all had in common – and to empathise when things didn’t go so well.
One of the final sessions was particularly difficult for me to take in. I’m incredibly sensitive to the topic of complications; I find it very upsetting. I have a huge sense of guilt about my past careless behaviour, and I often worry about whether that lack of care will mean I’ll develop complications in the future. I won’t go into the various things that can happen here; if you’re interested, by all means look it up, but it’s not a cheery read.
The session lasted about 90 minutes, and although I thought I was going to have to leave the room at one point, I managed to sit through it. I’m trying so hard to improve my control, and research shows that attending the DAFNE course and applying its principles can reduce HbA1c figures by around 1% (doesn’t sound like much, but it’s actually a decent amount).
Since finishing the course, I’ve registered with the DAFNE website, so I can access all of their guides and workbooks online. I’ve been really trying to record my food intake – I’ve been more strict than I was previously – literally weighing food before I cook or eat it. I’ve been doing regular blood checks, and I’ve been making adjustments to my insulin regime where necessary.
DAFNE isn’t a one-stop fix for type 1 diabetes control. There’s always going to be instances of low and high blood sugar levels, no matter how closely you monitor things. Sometimes, it just happens. But now I have the confidence to look at my results and do what I need to do to get things back on an even keel.
During the course of the week, I changed the type of my background insulin, and I’ve added an extra dose. Not ideal stabbing myself in the leg an additional time per day, but if it’s going to help then I’ll do it. I’ll continue to make changes as situations arise, and I’ve got a follow-up appointment at the start of March to see how everyone is getting on.
Would I recommend DAFNE? Absolutely. As someone who has had type 1 diabetes for over 20 years, it scared me how many things I didn’t know, or how many things have changed since I was originally taught. It was pretty intense at times, staring your own chronic illness in the face for a full week instead of it being at the back of your mine, but it was definitely worth it.