title: Glycaemic control and weight 7 years after Dose Adjustment For Normal Eating (DAFNE) structured education in Type 1 diabetes.
abstract: OBJECTIVE
  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.
authors: Department of Diabetes and Endocrinology, Nottingham University Hospitals             School of Biomedical Sciences, University of Nottingham, Nottingham, UK.
authors: D
authors: D
authors: Gunn
authors: P
authors: P
authors: Mansell
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000178:diet therapy / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D010353:Patient Education as Topic; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human