Key result
DAFNE education cuts severe hypoglycemia and DKA by ~80% in type 1 diabetes.
Why the study?
The DAFNE structured education program for type 1 diabetes has evolved over 25 years with ongoing RCTs and real-world evidence, requiring summary and future direction.
The DAFNE structured education program continues to evolve and expand its reach across the UK, adapting to digital learning and new diabetes technologies.
Supports ongoing DAFNE adoption across UK trusts; extends original RCT efficacy to real-world T1DM care.
The original Dose Adjustment For Normal Eating (DAFNE) randomised controlled trial (RCT) was conducted nearly 25 years ago.1 It has transformed structured education for type 1 diabetes (T1DM) across the UK and is still evolving through its evidence base of further RCTs,2-3 and routine collection of real-world evidence (RWE),4 thereby proving that what works in a research setting, also benefits people with T1DM in the large number (more than half) of the hospital Trusts that have adopted DAFNE countrywide. This review summarises the latest national audit data, and describes future work responding to the rapid changes in technology used in T1DM, how we are evolving to support people living with type 2 diabetes (T2DM), and adapting our learning materials in the digital age. Through the strength and depth of committed multidisciplinary healthcare professionals (HCPs) we have been able to expand our portfolio of learning materials available to DAFNE centres, who pay a nominal annual fee of ~£5,000. By partnering with the Open University we now offer free accredited online learning to a wide range of HCPs, thereby helping to upskill the diabetes workforce at no extra cost to the NHS. Finally, in a new and exciting collaboration with the Diabetes Technology Network (DTN) and industry colleagues, DAFNE offers free online training to all people living with T1DM to prepare them for closed-loop therapy.
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Elliott et al. (2024) conducted a review in Type 1 and Type 2 Diabetes (n=11,213). DAFNE structured education program vs. Baseline (pre-course) was evaluated on Change in HbA1c at 12 months for participants with baseline >58 mmol/mol (reduction of 5.1 mmol/mol). The DAFNE structured education program improved HbA1c by 5.1 mmol/mol in type 1 diabetes patients and reduced episodes of severe hypoglycemia and diabetic ketoacidosis by approximately 80% at one year compared to baseline.
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