Have you heard about DAFNE?

Have you heard about DAFNE?

By Trish Shanahan, Clinical Specialist Dietitian in Diabetes

Figure 1: The DAFNE team, Diabetes Day Centre, Hospital 5

L-R Jane Leonard Senior Diabetes Dietitian, Trish Shanahan Diabetes Clinical Specialist Dietitian, Dr Lisa Owens Consultant Endocrinologist, Jean Doyle DNS. Sinead Walsh DNS, Tom Hyland DAFNE administrator, Deirdre Delaney DNS, Yan Fu DNS.

DAFNE (Dose Adjustment for Normal Eating) is a new quality initiative in SJH Diabetes Day Centre (DDC) which provides skills-based training to adults with Type 1 diabetes to empower them to manage their diabetes effectively. Delivered by diabetes nurse specialists and dietitians, this programme supports participants to lead as normal a life as possible, whilst also maintaining blood glucose levels within healthy targets, to reduce the risks of diabetes complications.

Living with Type 1 diabetes is challenging. There is no standard dose of insulin that meets each person’s unique needs and every insulin injection requires consideration and adjustment according to carbohydrate intake, activity levels, stress, alcohol intake and other lifestyle factors. In the day to day management of diabetes, it is estimated that an individual will make 180 diabetes related decisions. Unsurprisingly, the incidence of diabetes burnout is common and this can be a contributory factor to poor diabetes outcomes. The DAFNE curriculum covers the real life challenges of living life with diabetes and the facilitators allows participants to benefit from peer to peer support within the group.

Figure 2: Topics covered in a DAFNE course.

Becoming a DAFNE centre:

Introducing DAFNE to St. James’s Hospital was identified as a priority when the Irish National Clinical Guidelines for Type 1 diabetes were published in 2018. A key recommendation was that all adults should be offered a structured programme of proven benefit after 6 -12 months after diagnosis.

Despite some delays due to the pandemic, St James’s secured dedicated funding for additional nursing, dietetic and administrative staff to support becoming a DAFNE centre in 2023. We are now one of 22 DAFNE centres in Ireland.

Figure 3: DAFNE centres in Ireland

Course Format:

DAFNE can be delivered remotely or in the face to face format. Whilst the online option suits patients who are juggling work and home commitments, others prefer the more traditional classroom based approach. Both online and face to face groups run throughout the year and patients can select their preference according to their needs.

Figure 4: Benefits of attending DAFNE:

DAFNE is of proven benefit and is not just for those who are newly diagnosed with Type 1 diabetes. Patients who have been living with diabetes for many years are also offered the opportunity to attend. For many, it can be the first occasion where they have met someone else with type 1 diabetes and the peer support forms an important part of the group dynamic.

Figure 5: Patient feedback

 DAFNE is now established in the care pathway of St James’s patients living with Type 1 diabetes.

Empowering our patients to fit diabetes into their lifestyle, rather than changing their lifestyle to fit in with their diabetes, has been a positive experience not only for the participants but also for the DAFNE educators.