Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomized controlled trial

DAFNE, Study Group, Amiel, S, Beveridge , S, Bradley, Clare, Gianfrancesco , C, Heller , S, James, P, McKeown , N, Newton , D, Newton, L, Oliver, L, Reid, H, Roberts, S, Robson , S, Rollington , J, Scott, V, Speight, J, Taylor , C, Thompson, G, Turner, E and Wright, F

(2002)

DAFNE, Study Group, Amiel, S, Beveridge , S, Bradley, Clare, Gianfrancesco , C, Heller , S, James, P, McKeown , N, Newton , D, Newton, L, Oliver, L, Reid, H, Roberts, S, Robson , S, Rollington , J, Scott, V, Speight, J, Taylor , C, Thompson, G, Turner, E and Wright, F (2002) Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomized controlled trial. British Medical Journal, 325

Our Full Text Deposits

Full text access: Open

Full Text - 266.36 KB

Links to Copies of this Item Held Elsewhere



Abstract

Objectives: To evaluate whether a course teaching flexible intensive insulin adjustment can improve both glycaemic control and quality of life in type 1 diabetes.

Design: randomized design with participants either attending training immediately (immediate DAFNE) or acting as waiting list controls and attending "delayed DAFNE" training 6 months later.

Setting: Secondary care diabetes clinics in three English health districts.

Participants: 169 adults with type 1 diabetes and moderate or poor glycaemic control.

Main outcome measures: Glycated haemoglobin (HbA 1c), severe hypoglycaemia, impact of diabetes on quality of life (ADDQoL).

Results: At 6 months, HbA 1c was significantly better in immediate DAFNE patients (mean 8.4%) than in delayed DAFNE patients (9.4%) (t=6.1, P<0.0001). The impact of diabetes on dietry freedom was significantly improved in immediate DAFNE patients compared with delayed DAFNE patients (t= -5.4, P<0.0001), as was the impact of diabetes on overall quality of life (t = 2.9, P<0.01). General wellbeing and treatment satisfaction were also significantly improved, but severe hypoglycaemia, weight, and lipids remained unchanged. Improvements in "present quality of life" did not reach significance at 6 months but were significant by 1 year.

Conclusion: Skills training promoting dietary freedom improved quality of life and glycaemic control in people with type 1 diabetes without worsening severe hypoglycaemia or cardiovascular risk. This approach has the potential to enable more people to adopt intensive insulin treatment and is worthy of further investigation.

Information about this Version

This is a Submitted version
This version's date is: 2002
This item is not peer reviewed

Link to this Version

https://repository.royalholloway.ac.uk/items/b743cc26-5949-0a6e-274b-6af0d2ec4f61/4/

Item TypeJournal Article
TitleTraining in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomized controlled trial
AuthorsDAFNE, Study Group
Amiel, S
Beveridge , S
Bradley, Clare
Gianfrancesco , C
Heller , S
James, P
McKeown , N
Newton , D
Newton, L
Oliver, L
Reid, H
Roberts, S
Robson , S
Rollington , J
Scott, V
Speight, J
Taylor , C
Thompson, G
Turner, E
Wright, F
Uncontrolled KeywordsDiabetes, DAFNE training, Quality of life, Insulin Treatment, Diet, Glycaemic control
Departments

Identifiers

Deposited by Research Information System (atira) on 25-Jul-2012 in Royal Holloway Research Online.Last modified on 25-Jul-2012


Details