title: Dose Adjustment for Normal Eating (DAFNE) in routine clinical practice: who benefits?
abstract: OBJECTIVE
  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 HbA(1c) ≥ 81 mmol/mol (9.6%) (z = -2.8, P = 0.004); reduced number of participants reporting severe hypoglycaemia (χ² = 4.27, P = 0.039); total eradication of diabetic ketoacidosis (χ² = 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 (χ² = 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.
authors: Diabetes Centre, NHS Grampian Health Services Research Unit, University of Aberdeen, Aberdeen, UK. a.keen@nhs.net
authors: A J A
authors: AJ
authors: Keen
authors: E
authors: E
authors: Duncan
authors: A
authors: A
authors: McKillop-Smith
authors: N D
authors: ND
authors: Evans
authors: A E
authors: AE
authors: Gold
mesh_terms: D000328:Adult; D001007:Anxiety / Q000178:diet therapy* / Q000453:epidemiology; D003863:Depression / Q000178:diet therapy* / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy* / Q000188:drug therapy; D016883:Diabetic Ketoacidosis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010353:Patient Education as Topic; D011788:Quality of Life; D012606:Scotland / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin