Dose adjustment for normal eating (DAFNE) - an audit of outcomes in Australia

McIntyre, H. David, Knight, Brigid A., Harvey, Dianne M., Noud, Marina N., Hagger, Virginia L. and Gilshenan, Kristen S. (2010) Dose adjustment for normal eating (DAFNE) - an audit of outcomes in Australia. Medical Journal of Australia, 192 11: 637-640.

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Name Description MIMEType Size Downloads
Author McIntyre, H. David
Knight, Brigid A.
Harvey, Dianne M.
Noud, Marina N.
Hagger, Virginia L.
Gilshenan, Kristen S.
Title Dose adjustment for normal eating (DAFNE) - an audit of outcomes in Australia
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2010-06-07
Sub-type Article (original research)
Volume 192
Issue 11
Start page 637
End page 640
Total pages 4
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing
Collection year 2011
Language eng
Subject C1
11 Medical and Health Sciences
Formatted abstract
Objective: To audit and describe the effects of participation in the Dose Adjustment for Normal Eating (DAFNE) course on clinical outcomes in people with type 1 diabetes mellitus (T1DM).

Design, setting and participants:
Audit of clinical outcomes before and 1 year after DAFNE training for 145 people with T1DM who participated in courses at seven Australian diabetes centres between February 2005 and March 2007. Participants had been diagnosed with T1DM at least 1 year before and were beyond the "honeymoon phase", with glycated haemoglobin (HbA1c) <12% and no severe diabetes complications. They were aged over 17 years and able to understand written and spoken English.

A 5-day structured education program covering T1DM management with an emphasis on unrestricted diet, precise carbohydrate estimation and prandial insulin dosing using insulin-to-carbohydrate ratios.

Main outcome measures:
Glycaemic control (HbA1c levels), weight, severe hypoglycaemia, and quality of life scores on general (Hospital Anxiety and Depression) and diabetes-specific (Problem Areas in Diabetes) scales.

Mean HbA1c fell from 8.2% to 7.8% (95% CI for change, -0.5% to -0.2%; P < 0.0001) and weight from 75.1 to 74.2 kg (95% CI for change, -1.6 to -0.2 kg; P = 0.012). Severe hypoglycaemia was less frequent after DAFNE training (P = 0.0001). Quality of life improved (P < 0.0001 for both scales).

One year after participation in the DAFNE program of structured education, people with T1DM showed improved glycaemic control, reduced incidence of severe hypoglycaemia, slightly reduced weight and improved quality of life. The DAFNE course offers one means of improving clinical outcomes in T1DM. 
Keyword Enable Dietary Freedom
Intensive insulin managment
Dependent Diabetes-mellitus
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Created: Sun, 04 Jul 2010, 00:02:17 EST