A DAFNE course is a real eye opener says Tom Dare
When I was first diagnosed with Type 1 at the age of 23 in 2015, I couldn’t even begin to imagine how complicated, stressful, and confusing the next few years of my life would be.
I’m not a worrier and very rarely find myself stressed out, but one thing I wondered about more than anything else was my food. All I heard from the nurses early on was that nothing in my life needed to change. That I could still eat what I wanted, when I wanted to eat it. Great, I thought. But how?
Carb counting was the answer but, foolishly, I didn’t get on a course at the first opportunity. Life took over, I had other things to do, and so I left it for a good two years before I got my act together and registered for a DAFNE course. Not that I didn’t need it sooner. I was just stubborn. But somewhere in between another late-night hypo and a night spent sat on the toilet after eating some ‘diabetic friendly’ chocolate (there was absolutely nothing friendly about it), I decided to cut out the guesswork and get some answers.
And thank God I did. I can honestly say it’s the best decision I’ve ever made in terms of my diabetes. Not only is it five days of intensive blood testing, eating, lectures and furious note-taking, but it also gives you the opportunity to meet up with other diabetics who are going through exactly the same thing as you. I had completely shut myself off from the diabetic community after my diagnosis, and so often found myself struggling through some of the issues alone. My friends and family were amazing, as were my nurses, but Type 1 diabetes isn’t something you can really understand until you’ve had to deal with it first-hand.
As for the course itself, it was truly eye-opening.
It turned out that I was actually the least experienced diabetic on the course, with one gentleman having been diagnosed nearly 30 years ago. And yet there was so much he, and indeed I, didn’t know about the disease before DAFNE.
Learning how to carb count properly is the biggest thing I took away from my week with the DAFNE nurses (who were fantastic, by the way). I already had some basic understanding of how it all works, but everyone is different. I’d always worked on a 1 to 1 ratio, for example (one unit of fast-acting insulin for every 10 grams of carbs), but not everyone is the same. Some people will be on 2 to 1 with breakfast, 1 to 1 with lunch and 1.5 to 1 with dinner. It all depends on how your diabetes affects you, and during your week on the course you’ll find out so much more about how your body works.
The nurses encourage you to keep a detailed diary of what you eat, when you’re eating it and how much insulin you’re taking, which you then go over with the rest of the group at the start of each day to help find patterns. If, for example, your blood sugar was in target and you had 50 grams of carbohydrate for breakfast with 5 units of Novorapid, only to find that by lunchtime your blood sugar was at 13.7, an adjustment to 1.5 to 1 might be needed. Alternatively, your background insulin might need adjusting, which is something you will discuss with the nurses. I started the course on a ratio of 1 to 1 and, luckily for me, this appeared to be about right, but not everyone was the same. One gentleman on the course went from a ratio of 1 to 1 at the start of the week to a 2 to 1 by the end of the week.
It’s not a case of changing how much insulin you inject based on one meal or reading, but more about identifying trends and working with your nurse to find out what works for you. Since finishing the course I’ve put everything I learnt into practice and it’s made my life run a whole lot smoother, especially when it comes to eating out. I’ve now got a much better understanding of how much carbohydrate is in each meal, and can estimate far more accurately now than I ever could before.
And that’s just the tip of the iceberg. The course covers what to do when you’re sick, how different types of food affect your blood sugar, nutrition, exercise, correction doses, doctor’s appointments, long-lasting insulin and so much more. When you’re first diagnosed it can be hard to both come to terms with diabetes and take all of this information on at the same time, and that’s where DAFNE comes in.
Spaced over five days, it covers everything you’ve ever wondered or might have needed to know, while simultaneously bringing your blood sugars under control and letting you meet other people in your position. It teaches you techniques to take with you into the real world, gives you resources that really do help on a day to day basis, and opens you up to a network of people you might never have known existed beforehand.
Short of curing me of my diabetes (where do I sign up for that course?), I really couldn’t have gotten any more from the carb counting course. For too long I ignored the help available to me and struggled on alone, but that really doesn’t need to be the case. Type 1 diabetes is hard. It’s lonely. It’s all-encompassing. So if you’re struggling, and even if you’re not, put your name down at your local GP surgery now, and make the whole thing a little easier on yourself.