Where do I go to get information and education for type 1 diabetes?
The five-day DAFNE (Dose Adjustment for Normal Eating) group education course at Central Middlesex Hospital changed my life!
When I was diagnosed with type 1 diabetes in 1974, I joined the “British Diabetic Association” (now known as Diabetes UK), and I started to receive their “Balance” magazine. Of course, there weren’t any online forums or websites and there was no group education either.
I fumbled along for thirty years until 2004 when I decided to take the five-day DAFNE (Dose Adjustment for Normal Eating) group education course at Central Middlesex Hospital, with seven other people with type 1 diabetes and it changed my life!
Instead of diabetes being in control of me and being forced to eat fixed amounts of carbohydrate at fixed meal-times to match my fixed twice daily insulin doses, with the ever-present risk of low blood glucose if and when my meals were a little delayed, I was now in control of my diabetes!
My insulin was changed to a more flexible “basal/bolus” insulin regimen (or multiple daily injections) - this is usually once or twice daily long-acting (or background insulin) and injections of rapid-acting mealtime insulin with meals.
Over time I learnt how to count the amount of carbohydrate in my food and I became skilled at adjusting my fast-acting mealtime insulin to match the carbohydrate/food I was now choosing to eat.
I learnt that I could eat anything I wanted including sweet foods such as cakes and biscuits as long as I had assessed the carbohydrate content accurately.
After all, both sugars and starches are converted to glucose in the stomach and all I needed to do was to ensure that I injected the right amount of insulin and not lose sight of the fact that healthy eating guidelines apply to us all!
I found out that my insulin to carbohydrate ratio (the amount of insulin I needed for 10 grams of carbohydrate) would change at different times of the day. For example, I needed less mealtime insulin at lunchtime per 10 grams of carbohydrate than I did at other times.
During the DAFNE course, we tested our blood glucose before a half-hour stroll along the towpath of the canal. We tested ourselves when we got back and I learnt how quickly even light exercise could reduce my blood glucose levels.
Today there are lots of diabetes websites and information available but I wanted to continue the interaction with other people with diabetes because this had been such a valuable part of DAFNE, so I joined my local Diabetes UK Education & Support Group. During the COVID-19 lockdown, we have been holding virtual meetings on Zoom.
This year I felt it was time to brush up my dose adjustment and carbohydrate counting skills by taking a refresher course, so I have just completed the BERTIE online programme.
It is a brilliant online course with lots of opportunities to share your own stories, ideas and concerns and to learn and compare from the experiences of other people who are also taking the course.
Unlike DAFNE, this course is immediately accessible to all people with type 1 diabetes and you can dip in and out of it whenever you want.
The course is provided by the Bournemouth Diabetes Centre based on their own four-day group programme. There are three main modules with an online assessment at the end of each module and you can print off your own certificate.
There are also three optional modules: Datawise; Streetwise, for younger people’s common issues; and Lifewise for things like insulin pumps, pregnancy, or going into hospital.
Taking the course reminded me of the importance of getting my background insulin dose right to help keep blood glucose levels steady through the rest of the day away from meals. This would also help me to avoid over or under dosing with my mealtime insulin to compensate for under or overdosing with background insulin.
There are videos and simple case studies, which will help you to understand and interpret your blood glucose readings and take corrective action if necessary.
However long you have had diabetes, there is always more you can learn and explore to help and support you to self-manage your diabetes.
