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RE: [IPk] NICE



Exclusion clause: I am very new on both Db (5 months) and MDI (6 weeks).

> Anyone been following this DAFNE program? Stands for Dosage 
> Adjustment For
> Normal Eating. UK med pros are now examining whether it is 
> practical to
> encourage and train people on injections to fiddle with their 
> insulin doses
> each day so they can eat what they want, and still keep good 
> control. Hey -
> this forms the basis of pump therapy, but we're talking 
> injections here
> since it's cheaper. I've got mixed feelings about this, since 
> I reckon that
> without the consistency of an accurately controlled basal 
> rate that you get
> with a pump, you cannot match insulin to food with any 
> precision. If anyone
> here managed to do that on injections, I'd love to know how 
> you did it...


It depends what you mean by accurate control and precision.

I have been quite happy to juggle doses by +/- 50-70% ever since the doc
worked out the initial doses by guestimating ("your current daily
requirements are about 80. Two thirds of that is 54, so your short acting
should be three doses of 18). I tend to go 12 + 12 + 24 depending on when
the big meal is and then do a test and possible level adjusting dose 2 hours
later (I know how much by bg will drop after about 2 hours).  

This is fairly approximate DAFNE already. I thought a pump pretty much gave
you a better version of that approach. I'm slightly baffled why the DAFNE
training courses are 5 days - unless they assume a starting point of
scratch.

At present I'm testing a lot while I'm learning and attempting to manage the
bgs via a sort of "Balanced Scorecard" approach.

I have an hour with our clinic's Diabetic Dietician next week to get more
detailed gen on carb counting, GI and stuff.

Julian
(> 
> Diabetes UK have an interesting article on DAFNE at
> 
> http://www.diabetes.org.uk/update/summer01/selfadjust.htm
> 
> John
> 
> --
> mailto:email @ redacted
> http://www.webshowcase.net/johnneale
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