Dose Adjustment for Normal Eating (DAFNE) in routine clinical practice: Who benefits?

Diabetic Medicine

Volumn 29, Issue 5, 2012, Pages 670-676

  Keen, A J A ^a   Duncan, E ^b   McKillop Smith, A ^a   Evans, N D ^a   Gold, A E ^a  

^a NHS GRAMPIAN   (United Kingdom)

^b UNIVERSITY OF ABERDEEN   (United Kingdom)

Author keywords

Education; Patient education; Type1 diabetes

Indexed keywords

HEMOGLOBIN A1C; INSULIN DERIVATIVE; ISOPHANE INSULIN;

ADULT; ARTICLE; ATTITUDE TO HEALTH; CLINICAL EFFECTIVENESS; CLINICAL PRACTICE; DEPRESSION; DIABETIC KETOACIDOSIS; DIABETIC PATIENT; DISTRESS SYNDROME; DOSE ADJUSTMENT FOR NORMAL EATING; DOSE CALCULATION; FEMALE; FOLLOW UP; HEMOGLOBIN BLOOD LEVEL; HUMAN; HYPOGLYCEMIA; INSULIN DEPENDENT DIABETES MELLITUS; MAJOR CLINICAL STUDY; MALE; PATIENT EDUCATION; UNITED KINGDOM;

ADULT; ANXIETY; DEPRESSION; DIABETES MELLITUS, TYPE 1; DIABETIC KETOACIDOSIS; FEMALE; HEMOGLOBIN A, GLYCOSYLATED; HUMANS; HYPOGLYCEMIA; HYPOGLYCEMIC AGENTS; INSULIN; MALE; PATIENT EDUCATION AS TOPIC; QUALITY OF LIFE; SCOTLAND; TREATMENT OUTCOME;

EID: 84859811035     PISSN: 07423071     EISSN: 14645491     Source Type: Journal    
DOI: 10.1111/j.1464-5491.2011.03479.x     Document Type: Article

References (23)

1. World Health Organization. 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases. 2008. Available at Last accessed 11 May 2010.
2. Yach D, Hawkes C, Gould CL, Hofman KJ. The global burden of chronic diseases: overcoming impediments to prevention and control. J Am Med Assoc 2004; 291: 2616-2622.
3. Rijken M, Jones M, Heijmans M, Dixon A. Supporting self-management. In Nolte E, McKee M, eds. Caring for People with Chronic Conditions: A Health System Perspective. Maidenhead: Open University Press, 2008; 6: 116-142.
4. Newman S, Steed L, Mulligan K. Self-management interventions in chronic illness. Lancet 2004; 364: 1523-1537.
5. Department of Health. Supporting People with Long Term Conditions. 2005. Available at Last accessed 11 May 2010.
6. Department of Health. Generic Models for Long term Conditions. 2007. Available at Last accessed 11 May 2010.
7. Department of Health. Self Care - A Real Choice. 2005. Available at Last accessed 11 May 2010.
8. Redman BK. Accountability for patient self-management of chronic conditions; ethical analysis and a proposal. Chronic Illn 2007; 3: 88-95.
9. Warsi A, Wang PS, LaValley MP, Avorn, J, Solomon DH. Self-management programs in chronic disease: a systematic review and methodological critique of the literature. Arch Intern Med 2004; 164: 1641-1649.
10. DAFNE Study Group. Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: Dose Adjustment for Normal Eating (DAFNE) randomised controlled trial. Br Med J; 325: 746.
11. Oliver L, Thompson G. The DAFNE collaborative. Pract Diab Int 2009; 26: 371-377.
12. Heller SR. Structured education in type1 diabetes. Br J Diab Vasc Dis 2009; 9: 269-272.
13. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67: 361-370.
14. Bjelland I, Dahl AA, Haug TT, Neclemann D. The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res 2002; 52: 69-77.
15. Polonsky WH, Anderson BA, Lohrer PA, Welch GW, Jacobson AM. Assessment of diabetes-related emotional distress. Diabetes Care 1995; 18: 754-760.
16. EuroQual Group. EuroQuol - a new facility for the measurement of health-related quality of life. Health Policy 1990; 16: 199-208.
17. Glasgow RE, Emmons KM. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health 2007; 28: 413-433.
18. Collins MM, Corcorant P, Perry IJ. Anxiety and depression symptoms in patients with diabetes. Diabet Med 2009; 26: 153-161.
19. Barnard KD, Skinner TC, Peveler R. The prevalence of co-morbid depression in adults with Type1 diabetes: systematic literature review. Diabet Med 2006; 23: 445-448.
20. Hermanns N, Kulzer B, Krichbaum M, Kubiak T, Haak T. How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment. Diabetologia 2006; 49: 468-477.
21. Speight J, Amiel SA, Bradley C, Heller S, Oliver L, Roberts S et al. Long-tem biomedical and psychosocial outcomes following DAFNE (Dose Adjustment for Normal Eating) structured education to promote intensive insulin therapy in adults with sub-optimally controlled type1 diabetes. Diabetes Res Clin Pract 2010; 89: 22-29.
22. Bland JM, Altman DG. Regression toward the mean. Br Med J 1994; 308: 1499.
23. Jorde R, Sundsford J. Intra-individual variability and longitudinal changes in glycaemic control in patients with Type1 diabetes mellitus. Diabet Med 2000; 17: 451-456.