Research project: Dose for Adjustment for Normal Eating (DAFNE)

The aim of DAFNEplus is to develop and convert DAFNE into a lifelong package to help people better manage their blood glucose levels lifelong, as high levels can cause dangerous complications. Our recent research confirmed that after attending a DAFNE course, people have better quality of life, better glucose levels (in the short-term) and are admitted to hospital less often for diabetes emergencies.

Although participants find DAFNE training useful, some find it tough to keep up the skills needed to maintain glucose levels to prevent diabetic complications. Specific challenges include checking glucose before every meal, counting the amount of carbohydrate about to be eaten, and then calculating the right amount of insulin to inject. After the course, people also find it hard to get support from health professionals. They have asked us to improve the course to help others develop and keep their skills over the long term.

DAFNE graduates, diabetes teams and psychologists will work together to develop a more effective course. People from a range of backgrounds, including those of non-white ethnicity and from deprived areas, will inform both the development of the course and support packages. The training will be developed to include skills of managing diabetes as part of peoples’ everyday lives. We will also improve the support that health professionals provide after the course, helped by new technology. We will then run a trial to evaluate the new approach at 14 UK centres.

Over 1 year, we will compare the results of around 300 people trying the new DAFNEplus course with 300 people on the standard course. We will measure their glucose levels and quality of life. We will also determine the effectiveness of formal professional support and improved training for educators. Throughout our research, we will work with a patient advisory group which includes DAFNE graduates and members of the Sheffield Teaching Hospital Diabetes and Endocrinology Patient Panel, some of whom struggle to manage their Type 1 Diabetes.

We will use the results to inform training on effective self-care delivered by the UK DAFNE collaborative each year to 1500 adults with type 1 diabetes. Diabetes UK will help us communicate research findings to all diabetes centres across the country. This work will also help us develop better training for other groups (especially children and young people). The results may also be relevant to other long-term conditions, where people need to learn and apply complicated skills to manage their own condition as part of their everyday lives.