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       #Post#: 147--------------------------------------------------
       How to reduce risk of developing long term complication of diabe
       tes?
       By: admini5 Date: May 13, 2015, 5:24 am
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       Type 1 diabetes requires hour-by-hour self-management in order
       to maintain optimal glycaemic control and reduce the risk of
       developing long-term conditions that are associated with
       diabetes. Patients therefore require skills-based training in
       carbohydrate counting and insulin-dose adjustment, in a range of
       different situations, to enable effective self-management.
       ‘Dose adjustment for normal eating’ (DAFNE) is a
       5-day structured education programme for adults with type 1
       diabetes that provides the knowledge and skills required for
       insulin adjustment on a meal-by-meal basis, within a safe
       environment. DAFNE is delivered by specially trained educators
       (diabetes specialist nurses and diabetes specialist dietitians)
       to groups of 6–8 adults with type 1 diabetes over 5
       consecutive days on an outpatient basis in any setting
       (secondary care or community).
       The programme on each of the 5 days usually runs between 9 am
       and 5 pm, with a slightly earlier finish time on Friday.
       There are 21 curriculum sessions to be covered during the
       week-long course. Each day is broken into a number of sessions
       lasting between 15 and 90 minutes, depending on the session.
       There is a logical sequence to the sessions to help participants
       to build their knowledge throughout the course. Lunchtimes are
       also used as a learning opportunity.
       The total duration of structured education in a DAFNE course
       should be no less than 31 hours 25 minutes and no longer than 40
       hours over the 5 days.
       DAFNE involves:
       •
       deliver the DAFNE patient course and setting up a DAFNE service
       •
       embedding of DAFNE within the service
       •
       resources for patients completing the DAFNE course
       •
       implementation of the quality assurance programme to DAFNE
       services
       -
       opportunities for DAFNE services
       -
       patient outcome data for comparison and bench marking with other
       DAFNE services
       -
       DAFNE service against nationally agreed criteria.
       The DAFNE feasibility study was a randomised controlled trial
       (RCT) conducted in 3 secondary care specialist diabetes units in
       England, between 2000 and 2001; the outcomes from the RCT were
       published in the BMJ in 2002 (see Contacts and resources).
       A full economic evaluation of the DAFNE programme was published
       in Diabetic Medicine in 2004 (see Contacts and resources) and
       considered by NICE as part of the development of Guidance on the
       use of patient education models for diabetes (NICE technology
       appraisal guidance 60).
       For further information, please go to :
  HTML https://arms.evidence.nhs.uk/resources/qipp/899091/attachment
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