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

Aims To explore the effectiveness of Dose Adjustment for Normal Eating in routine clinical practice in the UK. Methods Participants were 124 adults with Type 1 diabetes who had completed a Dose Adjustment for Normal Eating course. Data were collected before the course and again 1 year later on a variety of biological, psychological and social measures. Results There were a range of significant benefits consistent with Dose Adjustment for Normal Eating aims, including: better control among those with baseline HbA1c= 81 mmol/mol (9.6%) (z = -2.8, P = 0.004); reduced number of participants reporting severe hypoglycaemia (chi(2) = 4.27, P = 0.039); total eradication of diabetic ketoacidosis (chi(2) = 4.17, P = 0.041) and lower diabetes-related distress (z = -4.5, P < 0.001). The most deprived of the clinic population were significantly under-represented (chi(2) = 17.8, P = 0.001) and the levels of clinical depression were unusually low. Conclusions These results indicate that Dose Adjustment for Normal Eating delivered in routine clinical practice is associated with a range of benefits and that certain clinical and psychosocial characteristics are associated with better outcomes.