I have literally been trying to get onto a DAFNE course for the past 6 months and they have all been full !! I called everyone and tried my best to no avail !! But today I went to see my healthcare team and an opening has come up !! Yaya after 10 years of having diabetes . Worst timing ever was meant to go to France on Monday but this is way more important !!

Never thought I'd be more excited to go on a diabetic course than go to France but hey life changes !! Excited to learn more and gain more control and actually meet other diabetics !

Ce'st la vie !

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I don't know what DAFNE is, but it sounds like some sort of Diabetic education course? Is it geared just to Type 1's? Sounds like a great plan and you can always go to France another time. Good for you for making your D care a priority! Enjoy!

Hi Zoe

Yup it stands for Dosage Adjustment for Normal Eating and is for type 1 diabetics. Ever since i heard about it i've been trying to get on one but they are government funded and places are limited. Its a week of hardcore diabetes education with like 15 type 1 diabetics everyday 9 - 5 . Im just gona book france for the following week ! Tnx for positive vibes :)

DAFNE is Dose Adjustment For Normal Eating (DAFNE). This is exactly what we call carb counting in the US. I think this is a great course, with the exception that I believe one should interpret "Normal Eating" as the level of carb restriction that enables you to reach your blood sugar control goals.

Do eleborate Mr B ???

Not to speak for Brian, but giving my own take on it: Lots of education programs in various places now say that Type 1's can "eat whatever they want and bolus for it" in reaction to the more restricted diets they used to propose. Some people on this board adhere to that principal but many of us have found it doesn't work too well for these reasons:

Something Dr Bernstein calls "the law of small numbers". That means the less carbs you eat the less insulin you need to use to cover it and the less severe your errors will be in going too high or too low. Many of us have found this to be true in that it is hard to accurately bolus for larger amounts of carbs. For me the threshold is around 50 per meal (though I no longer eat near that many). When I went over that number I found time and time again my I:C ratio didn't work accurately. I also found (like many of us) that certain foods would make me high even when I bolused for the correct number of carbs. For me those impossible foods are rice and cereal and pasta a bit less. (I already don't eat sugar).

Secondly if you eat lots of carbs and take lots of insulin to cover them you are at risk of two things I for one want to avoid at all cost: Gaining weight and developing Insulin Resistance.

Although we are often told that as diabetics, we can eat whatever we want and just dose insulin, I don't believe that. At least in my case, if I ate a high carb diet, I would have a very hard time not spiking high and risking highs and lows after meals no matter how precisely I dosed my insulin. Instead, I eat less carbs and much less variation and I almost never have to correct or treat after a meal.

The whole trick is to balance the # of carbs you eat with the amount of insulin. I've been shocked since I started pumping to discover how very small adjustments in rates or ratios (.25U/ hour or .1Carb/ Unit of insulin) will make a clear difference in post-food bg. I haven't really had any medical advice in "fine-tuning" things but I also suspect that Brian's point is that it's easier to determine how accurate your rates are if you take smaller "doses" of carbohydrates? If you think your ratio is 10-1 and you eat 80 carbs and it's really 8-1, you are pretty much guaranteed to run a bit high, as there won't be enough insulin. you get the same result if you eat 24G of carbs but the amount you're off may be less and it may be easier to figure as you don't have units of leftover insulin floating around, etc.

Have a great time at DAFNE and I hope that it helps you make progress!

I agree.
It's true that the less (insulin/carbs) you take, the less you mistake.
But it's true too that (for someone) it's possible to eat carbs and dose and find the right bolus type to cover even "big" carbs.
They say "your diabetes may vary": there's hope and space for everyone ;-)

I did a DAFNE course here in NZ a couple of years ago. It is well worth doing. As others have mentioned it is an intense carb counting course but it also includes a lot of information on how other factors can complicate your dosage requirements. eg illness, exercise, slow release foods such as Pizza, hormonal factors if you are a woman and the amount of insulin you have on board at any given time.

It is promoted as a " you can eat anything you want as long as you bolus for it " course but I would also agree that eating a low carb high fat will do a lot to keep your numbers under control.

Regards,
Bruce

I did the Dafne course 2 years ago. Here's what I liked about it:

It's well-organized and comprehensive. We had people in the course who'd had diabetes for 30 years and people who were diagnosed three months ago, and all of us learnt something new.

It isn't just about food. We also covered some of the many other things that can affect your blood sugar. So on one day we had a practical session testing out the impact of exercise. Another day there was a ladies-only session where conception/pregnancy issues were covered. I kept hinting we should also have an alcohol session but sadly that chapter was strictly theory only!

It was a safe, confidential, supportive environment. Before going on the course, I hadn't had contact with any other T1s. But the first day, sitting around the table for lunch, we all got out our testing kit and pens/vials and I felt so liberated.

I was the only one on my course who was low-carbing. The good thing is, Dafne doesn't preach. Having heard horror stories about dietitians pushing high-carb diets, I'd gone in prepared to defend my heretical low-carb ways. This turned out to be unnecessary as Dafne doesn't tell you what you should eat. It just gives you the tools to make choices.

I agree with the insulin taken related to the carbs eaten. I have gone to a very low carb diet. that is not to say that I do not eat carbs, but reduced significantly the amount of carbs that I must count each day. In doing so, I have lowered my A1-c, insulin use, and improved my site life, and generally feel a lot better. Anything that one can learn to improve the relationship with insulin and carbs is worth the effort.

Good luck and enjoy the class. I think you will learn from it, and put it to good use when you go to France. I have been to France twice, and the last time I was there was a few months before being diagnosed. That is probably why I slept every chance I had; I was on a carb overload, and didn't know it.

Enjoy!

Brian Wittman

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