According to the results of this trial, skills training encouraging dietary freedom improved quality of life and glycaemic control in type 1 diabetics without causing deterioration in severe hypoglycaemia or cardiovascular risk. The trial involved 169 adults with type 1 diabetes mellitus and was set in secondary care diabetes clinics in 3 English health districts (Sheffield, Northumbria and London).
Volunteers were randomised into a waiting list controlled trial. They either attended a 5 day training course immediately (immediate DAFNE), delivered in groups of 6-8 participants in each centre or they continued to receive usual care for 6 months as controls and then they attended a course (delayed DAFNE).
The 5-day training course provided the skills necessary for patients to replace insulin by matching it to the desired carbohydrate intake on a meal-by-meal basis rather than adapting the timing and content of meals to more fixed doses of insulin. The main outcome measures were glycated haemoglobin (HbA1c), severe hypoglycaemia and impact of diabetes on quality of life (ADDQoL). The results found:
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