Glycaemic control and weight 7 years after Dose Adjustment For Normal Eating (DAFNE) structured education in Type 1 diabetes

Diabet. Med. 29, 807–812 (2012) 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 HbA 1c and weight over a 7‐year period following the Dose Adjustment For Normal Eating (DAFNE) structured education course. Methods We obtained annual HbA 1c 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 ) HbA 1c 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 HbA 1c 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 HbA 1c of 3 mmol/mol (0.3%) after 7 years. The improvement in glycaemic control after DAFNE is achieved without excess weight gain.