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
2002; BMJ; Volume: 325; Issue: 366 Linguagem: Inglês
ISSN
0959-8138
AutoresStephanie A. Amiel, S. Beveridge, Clare Bradley, Carla Gianfrancesco, Simon Heller, Peter James, N. McKeown, Douglas F. Newton, Lynn D. Newton, Lindsay Oliver, Helen Reid, Sue Roberts, Susan Robson, J. Rollingson, V. Scott, Jane Speight, Carolin Taylor, Gillian Thompson, Eileen Turner, Frances Wright,
Tópico(s)Diabetes and associated disorders
ResumoObjectives: To evaluate whether a course teaching flexible intensive insulin treatment combining dietary freedom and insulin adjustment can improve both glycaemic control and quality of life in type 1 diabetes. Design: Randomised design with participants either attending training immediately (immediate DAFNE) or acting as waiting list controls and attending “delayed DAFNE” training 6 months later. Setting: Secondary care diabetes clinics in three English health districts. Participants: 169 adults with type 1 diabetes and moderate or poor glycaemic control. Main outcome measures: Glycated haemoglobin (HbA1c), severe hypoglycaemia, impact of diabetes on quality of life (ADDQoL). Results: At 6 months, HbA1c was significantly better in immediate DAFNE patients (mean 8.4%) than in delayed DAFNE patients (9.4%) (t=6.1, P Conclusion: Skills training promoting dietary freedom improved quality of life and glycaemic control in people with type 1 diabetes without worsening severe hypoglycaemia or cardiovascular risk. This approach has the potential to enable more people to adopt intensive insulin treatment and is worthy of further investigation.
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