Glycaemic control and weight 7 years after Dose Adjustment For Normal Eating (DAFNE) structured education in Type 1 diabetes

Diabet Med. 2012 Jun;29(6):807-12. doi: 10.1111/j.1464-5491.2011.03525.x.

Abstract

Aims: The provision of structured education is increasingly prevalent in the management of Type 1 diabetes. There are little long-term follow-up data from such programmes. We have assessed HbA(1c) and weight over a 7-year period following the Dose Adjustment For Normal Eating (DAFNE) structured education course.

Methods: We obtained annual HbA(1c) and weight data in 111 patients who attended the initial series of DAFNE courses in our centre from June 2002 to end 2003 and in a matched group of 111 patients with Type 1 diabetes of similar age and duration of diabetes seen over the same period who had not undergone structured education.

Results: With DAFNE structured education, the mean (± sd) HbA(1c) fell from 71 ± 12 mmol/mol (8.6 ± 1.1%) at baseline to 65 ± 12 mmol/mol (8.1 ± 1.1%) at year 1, with a subsequent rise to 67 ± 13 mmol/mol (8.3 ± 1.2%) at year 7 (P = 0.0048 vs. baseline). In the comparator group, the baseline HbA(1c) level was 70 ± 14 mmol/mol (8.5 ± 1.3%) and remained approximately constant during 7 years of follow-up. Weight increased by 2.4 ± 6.0 and 2.8 ± 6.6 kg in the DAFNE and comparator group, respectively, during follow-up (not significant).

Conclusions: DAFNE structured education is associated with an improvement in glycaemic control at 1 year, and there remains a persistent and clinically relevant reduction in HbA(1c) of 3 mmol/mol (0.3%) after 7 years. The improvement in glycaemic control after DAFNE is achieved without excess weight gain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / diet therapy
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Male
  • Patient Education as Topic
  • Weight Gain*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human