Oh I do make myself chuckle sometimes! This was my first response when the word DAFNE was mentioned to me in passing by my consultant a couple of years ago. When I was growing up we had a lovely cleaner called Daphne and I still see her face whenever I hear the word. Anyway, that is by the by, let me get on to the actual subject at hand, the wonderful DAFNE education program.
DAFNE stands for Dose Adjustment for Normal Eating and essentially, it is all about carb counting and adjusting the amount of insulin you take for each meal according to how many carbohydrate portions it contains. The idea is that even with Type 1 Diabetes, we should be able to eat whatever we want and adjust the dose accordingly so as to keep our blood sugars in range. Now that is the most simple way of describing it in a nutshell but those of you ‘in the know’ will be very aware that this idealistic view is perhaps not always the most realistic.
As I have had Type 1 Diabetes for 24 years and have Dr’s for parents, I probably haven’t had the most conventional diabetes journey so far and that coupled with a fear of hospitals and reluctance to engage with any HCP’s has meant that I got somewhat forgotten by the NHS. This was apparent especially from the transition in to adult clinics, arguably the time where I probably needed the most support, up until the last few years where I have become a lot more inquisitive and engaged. When I was first diagnosed, I was on one injection per day of mixtard 30/70 (a combination of 30% fast acting and 70% slow acting insulin) and we were given a guideline per meal as to what I should be consuming in terms of carbs, fats, proteins etc. Mum spent A LOT of time with her kitchen scales ensuring that we kept within these guidelines and for the most part it all worked out well. A few hypos here and there and the odd spike but generally all was A-OK. The whole carb counting thing kind of passed us by and we were never told about this new approach to everything therefore I always just continued to ‘wing it’ and amazingly have never had a super serious hypo or DKA.
It was when I moved to London and registered with a new clinic that DAFNE was mentioned to me and I have to be honest, my first thought was ‘how can it take a whole week to work out how many carbs are in certain foods and therefore how much insulin to do?’. Despite this scepticism, I was on a mission to tighten up my control so with renewed vigour and motivation I requested to go on the course. A few months and a lot of phone calls later I was finally given a date for my course. It would be 5 full days from Monday to Friday and there would be 8 of us in the group. Getting the time off work wasn’t easy but in my mind, health is the most important thing therefore I put my foot down and managed to sort it.
We were told to keep a paper blood sugar diary in the run up to the course and had a pre-appointment with a DSN in order to set our expectations and have a look at our current regimes as well as obtain an up to date HBA1C. It was at this point that I moved on to split dose Levemir as my basal insulin rather than once a day Lantus. When I got to the course I discovered that most others had also switched their basal insulin in preparation. I was then all ready to go and really looking forward to finding out what there could actually be to learn that would take up a whole weeks worth of time!!
Stay tuned – I have split this post up in to smaller chunks as I seem to have A LOT to say therefore the next installment is imminent…
So if I do 47 million units I can eat this WHOLE cake right?! 🙂