This is an old post but still seems relevant.
The provision of the DAFNE (Dose Adjustment For Normal Eating) structured education course is increasingly suggested for the management of type 1 diabetes. An assessment of HbA1c over a 7 year period is summarised.
“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 HbA1c and weight over a 7-year period following the Dose Adjustment For Normal Eating (DAFNE) structured education course.
Methods We obtained annual HbA1c 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) HbA1c 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 HbA1c 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 HbA1c of 3 mmol/mol (0.3%) after 7 years. The improvement in glycaemic control after DAFNE is achieved without excess weight gain.” [My italics]
So with the best educational provision currently available over a 7 year period a reduction in HbA1c of 0.3% to an average of 8.3% was achieved and thought to be clinically relevant! The tragedy of accepting average HbA1c in the region of 8.3% is illustrated in the post:
I don't expect any long term studies of DAFNE + LOW-CARB will ever be considered, but we all know of Type 1s who low-carb and maintain HbA1c below 6.5% and some individuals below 5%.
John
1 comment:
As per usual phoenix was trying to put a positive spin on the dafne thread, of course to improve the results would mean reducing carbs which would lead to lower insulin use which is something phoenix is totally alien to. Add her comments on a statin thread were she was in denial about the side effects we can come to the conclusion that she must have vested interest in Big Pharma.
Graham
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