By Richard Surridge
I will admit that this is not the most exciting title in the world to use for my first blog, but it's what's weighing on my mind at the moment. So here goes.
About a year ago (and I really can't believe it was that long ago!) I did the DAFNE course. For those of you who have not come across this yet, DAFNE is a course designed to help you adjust your insulin dosages to account for what you eat, theoretically meaning that you can eat whatever you want as long as you inject accordingly. Sounds fairly simple, and the basic rules are.
But, of course, it's all the subtle refinements which confuse me. Every single thing I ever do seems to have an affect on my dosages. If I do any sort of exercise, I have to half my dosages. This has to continue into the next day. After that I can return to normal. Apart from my evening meal, which remains halved. Sex has to be taken account of, although only for the next meal. But I need a quick snack after ("Excuse me darling, I just need to nip off for a cracker..."). My background dosages are a law unto themselves which I won't try and explain. Needless to say it's taken me a long time to come even close to understanding all of this. And, of course, it's all unique to me, so there's no point in asking for advise from the nurse.
All of this is currently weighing on my mind as I've just returned from holiday. I'm a teacher and have just spent 5 days relaxing in Brussels and enjoying the fantastic food. However, my sugar levels have been going through the roof. And I was sure I was calculating my meals correctly. Eventually I worked it out. I wasn't working. I was too relaxed. More insulin needed!
Now I need to remember to take something else into account - I am enjoying myself too much?!
Thats quite interesting about your relaxing increasing your insulin requirements, I find the opposite is true for me. Stress increases the amount I need to inject.
Posted by: Mathew Hipwood | February 24, 2008 at 09:17 AM
This is what I mean - how on earth can we keep track of all this?! It's worth noticing as well that I'm pretty sure my own rules have changed in the past too!
Posted by: Richard Surridge | February 24, 2008 at 02:54 PM
I have the same problems from weekdays to weekends. I generally sit in the office Monday to Friday and then have to inject less at the weekend due to gardening, playing with the kids, etc. I also have to adjust for exercise and this changes depending on the time of day (ratio of 1.5:1 Carbs/Insulin in the morning and 1:1 in the evening)
Posted by: Rob Leggatt | February 24, 2008 at 11:48 PM
Richard - you have just summed up my life!
I have no day that is even remotly the same at work, sometimes I'm on my feet running about all day, sometimes I am at a desk - the varying effort effect's my sugar levels every day. That is why I got involved in DAFNE in the first place, to help give me some rigour around a process I was doing myself with some uneducated guesswork.
It has taken me over 1 year since I first was involved in DAFNE to get even close to being able to work it all out (partly because I let my own standards around snacks slip because I could under DAFNE but that's another story!)
Posted by: Scott Gillan | February 26, 2008 at 09:26 AM
Hi I have had type 1 diabetes 36 years! At moment I am on the sliding scale with my insulin and i must say it is never the same, as some days I am running around and others I am a little slower! I think I may need to be on some other insulin as I have been on soluable and lantus for a while now. How do you get to go on this DAFNE thing? I have never heard of it but I am intriqued by it! Is it worth me enquiring or what????
Posted by: Trina Ironmonger | March 16, 2008 at 01:19 PM
DAFNE is a program whereby you adjust your short acting insulin doses according to what you are eating at the time. You look at the carbohydrate content of your meal and make judgments related to your own, personal rules, plus your activity, stress levels, and anything else that might be affecting you at the time. It stands for Dose Adjustment For Normal Eating.
It's something that your nurse should know about and be able to help you with. You have to go on a five day course to learn all of the ins and outs. The only problem you might have is whether or not your local authority has bought into the program. I'm in Barking, Havering and Redbridge and I was on the first course they did last February.
Ask your nurse, and then pester!
Posted by: Richard Surridge | March 30, 2008 at 12:22 PM
As one of the docs involved with the DAFNE project, I can tell you that despite the success of the project overall it has been quite difficult to get local primary care trusts to support the courses by providing hard cash. Currently around 65 hospitals in the UK are DAFNE centres. Others are providing courses which aren't DAFNE. I think many are quite good but few if any have a system of inspection to ensure that the quality of the course and the educators is guaranteed. Some diabetes specialists and nurses still don't realise how important a course is to teach the skills of adjusting insulin and carb counting. If you haven't got access to DAFNE or an equivalent course then you should start complaining to your diabetes teams!
Posted by: Simon Heller | March 31, 2008 at 08:18 PM
I'm NOT a Type 1, and I DON'T use insulin, but those I know who do are and keep good control mostly recommend
http://www.insulin-pumpers.org/ and
http://www.insulin-pumpers.org.uk/
and a book by John Walsh
though the information is obviously principally for pumpers the information on finding your various rates also applies to injectors, and there's a lot of info and links on the site which may be helpful
Posted by: Trinkwasser | April 17, 2008 at 01:45 PM
Diabetes is becoming a worldwide problem and epidemic. The world leaders should take more action to help educate citizens about diabetes prevention and the cause of type 2 diabetes.
Posted by: Diabetes Causes | October 05, 2011 at 11:37 PM