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

Amiel, Stephanie, Beveridge, Sue, Bradley, Clare, Gianfrancesco, Carla, Heller, Simon, James, Peter, McKeown, Natalie, Newton, Douglas, Newton, Lynn, Oliver, Lindsay, Reid, Helen, Roberts, Sue, Robson, Susan, Rollingson, Jackie, Scott, Val, Speight, Jane, Taylor, Carolin, Thompson, Gillian, Turner, Eileen and Wright, Frances 2002, Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes : dose adjustment for normal eating (DAFNE) randomised controlled trial, BMJ : British medical journal, vol. 325, no. 366, pp. 746-749.

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Title Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes : dose adjustment for normal eating (DAFNE) randomised controlled trial
Author(s) Amiel, Stephanie
Beveridge, Sue
Bradley, Clare
Gianfrancesco, Carla
Heller, Simon
James, Peter
McKeown, Natalie
Newton, Douglas
Newton, Lynn
Oliver, Lindsay
Reid, Helen
Roberts, Sue
Robson, Susan
Rollingson, Jackie
Scott, Val
Speight, Jane
Taylor, Carolin
Thompson, Gillian
Turner, Eileen
Wright, Frances
Journal name BMJ : British medical journal
Volume number 325
Issue number 366
Start page 746
End page 749
Publisher BMJ Publishing Group
Place of publication London, England
Publication date 2002-10-05
ISSN 0959-535X
1468-5833
Summary Objectives: To evaluate whether a course teaching flexible intensive insulin treatment combining dietary freedom and insulin adjustment can improve both glycaemic control and quality of life in type 1 diabetes.

Design: Randomised 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 (HbA1c), severe hypoglycaemia, impact of diabetes on quality of life (ADDQoL).

Results: At 6 months, HbA1c 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 dietary 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.
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2002, BMJ Publishing Group
Persistent URL http://hdl.handle.net/10536/DRO/DU:30036461

Document type: Journal Article
Collection: School of Psychology
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