What is DAFNE for Diabetes?

DAFNE stands for Dose Adjustment For Normal Eating. It is a structured education programme for adults with Type 1 Diabetes. It is used across the UK by the NHS to help people manage their condition effectively while living a full and flexible life.

The programme teaches people how to adjust their insulin doses to fit with what they choose to eat, rather than having to plan meals around fixed insulin injections. This approach gives greater control and flexibility. DAFNE has been developed from research and clinical practice, and it follows a national standard so it is consistent whichever NHS centre runs it.

The main idea behind DAFNE is that people learn skills to self-manage their diabetes. Instead of being dependent on rigid instructions for insulin and diet, they have the knowledge to adapt to everyday situations. This can improve blood glucose control, help prevent complications, and improve overall quality of life.

Who is DAFNE For?

DAFNE is for adults over the age of 17 who have Type 1 Diabetes. It is not appropriate for young children or people with Type 2 Diabetes, as the needs of these groups are different.

Participants may have been living with diabetes for many years or may be newly diagnosed. They may already be using multiple daily injections or an insulin pump. The aim is to give them the skills to match insulin to carbohydrate intake and activity.

The programme usually requires that participants can read and write English to a level where they can take part in group discussions and follow written materials. Some centres do adapt resources for different languages.

People who take part often feel more confident about choices related to food, exercise, work, travel, and social events.

Structure of the DAFNE Programme

DAFNE courses are typically delivered as either:

• A one-week course, attended for five consecutive days
• A course spread over several weeks, with shorter sessions once or twice a week

Each course is run by trained diabetes educators. This usually includes a diabetes specialist nurse and a dietitian. Sometimes a consultant diabetologist is also involved. Courses take place in small groups of around six to eight participants to allow discussion and shared experiences.

The programme is highly interactive, with plenty of opportunity to ask questions, practise calculations, and discuss real-life situations. Learning methods include presentations, group discussions, meal planning exercises, and practical insulin dose adjustment activities.

What DAFNE Teaches

The programme covers practical and detailed diabetes management skills. Topics include:

• Carbohydrate counting: learning to estimate the carbohydrate content of meals and snacks using food labels, booklets, and visual estimation
• Insulin dose adjustment: matching quick-acting (bolus) insulin doses to carbohydrate intake and correcting high or low blood glucose levels
• Background (basal) insulin adjustment: setting the correct dose of long-acting insulin to maintain stable blood glucose when fasting
• Blood glucose monitoring: testing methods, recommended times to check, and interpreting results
• Managing hypoglycaemia: recognising low blood glucose, treating it quickly and preventing recurrence
• Managing hyperglycaemia: recognising high readings, adjusting doses, and checking for ketones when needed
• Food and drink choices: discussions on healthy eating, alcohol, eating out, and special occasions
• Exercise: understanding the effect of different activities on blood glucose and how to adjust insulin or food intake accordingly
• Sick day rules: managing diabetes during illness, when blood glucose and ketones can change unpredictably

By the end of the programme, participants should be able to make confident dose adjustments independently.

The Principles Behind DAFNE

The DAFNE approach is based on the principle of self-management with support. People with Type 1 Diabetes make many decisions every day about food, injections, and activity. The course gives them the skills to make these decisions using a clear framework.

One of the foundations is the concept of insulin-to-carbohydrate ratios. This means understanding how much insulin is needed for a given amount of carbohydrate. Ratios vary between individuals and can change over time. Participants learn to work these out for themselves and adjust as needed.

Another principle is flexibility. Instead of fitting their life to fixed insulin doses, participants can adapt insulin to fit their plans. This can reduce feelings of restriction and improve overall wellbeing.

Benefits of DAFNE

People who attend DAFNE often see benefits in both physical and emotional health. These benefits include:

• Better blood glucose control, as measured by HbA1c levels
• Fewer episodes of severe hypoglycaemia
• Greater ability to prevent extreme high or low blood glucose levels
• Improved confidence in adjusting insulin for holidays, unusual meal times, or varying work patterns
• Reduced diabetes-related stress

Research and NHS feedback show that these benefits can last for years after completing the programme if the person continues to use the skills they have learned.

Social benefits are also common, as the group format gives people a chance to learn from others with similar experiences.

Follow-Up Support

After the course ends, participants usually receive ongoing support. This may include annual review sessions, refresher workshops, or one-to-one appointments with the educators. Some centres offer access to online resources or a phone helpline.

Follow-up is important so that people can continue refining their skills, especially as life circumstances and health change.

Role in Health and Social Care

Within the wider health and social care system in the UK, DAFNE is part of the structured education offer for diabetes care recommended by the National Institute for Health and Care Excellence (NICE). GPs, diabetes clinics, and hospital diabetes teams often refer eligible patients to a local DAFNE centre.

DAFNE supports the aims of person-centred NHS care. It helps individuals take control of daily health decisions, which in turn can reduce unplanned hospital visits for diabetes emergencies. This links closely with public health priorities to reduce long-term complications such as heart disease, kidney disease, nerve damage, and vision problems.

In social care contexts, knowing that a person has completed DAFNE can help carers or support workers understand their level of knowledge and independence with insulin management. This can inform care planning, especially for people living in supported housing or with a care package at home.

Challenges and Considerations

Applying DAFNE skills in everyday life can have challenges. People may need to juggle the demands of work, family, and social life while managing their diabetes. Some may find carbohydrate counting difficult at first or may need extra support to fine-tune insulin ratios.

Cultural and dietary differences can affect how learning is applied. For example, traditional foods from certain cultures may not have nutrition labels, which requires alternative ways to estimate carbohydrate content.

Healthcare teams may need to offer additional resources, such as portion guides, mobile apps, or translated materials. Ongoing motivation and confidence are important for people to keep using DAFNE skills over time.

How DAFNE Differs from Other Diabetes Education Programmes

DAFNE is unique to Type 1 Diabetes and focuses strongly on matching insulin to carbohydrate intake. Programmes for Type 2 Diabetes have different goals and strategies, often focusing more on lifestyle changes and oral medications.

Compared with shorter education sessions, DAFNE is more intensive and interactive. The depth of learning is greater, as participants practise skills repeatedly over several days. The small group setting allows more time for personal questions and detailed discussion.

Unlike basic education, DAFNE graduates are expected to be able to change their own doses without needing daily or weekly instruction from clinicians.

Accessing DAFNE

In most areas of the UK, people are referred to DAFNE by their diabetes specialist team. Waiting times can vary, as classes need to reach a safe number of participants and require trained educators to run them.

Some NHS Trusts now offer an alternative called “Virtual DAFNE”, which uses video conferencing for the group sessions. This can be helpful for people who live far from the course venue or who have work or family commitments.

The programme is provided free on the NHS for eligible patients. This makes it accessible regardless of income, supporting equality in care provision.

Final Thoughts

DAFNE is a practical, proven, and highly regarded education programme that supports people with Type 1 Diabetes to live more freely while keeping good control of their blood glucose. Its strength lies in giving people the knowledge and confidence to make daily decisions about insulin and food, fitting diabetes into life rather than the other way around.

By covering everything from carbohydrate counting to managing illness, and by combining medical guidance with real-life discussion, DAFNE bridges the gap between theory and practice. It also contributes to wider NHS and social care aims of reducing complications, improving health outcomes, and supporting independence.

For those eligible, attending DAFNE can mean a lasting improvement in diabetic self-care and quality of life. It remains one of the key education offerings in UK diabetes care for adults with Type 1 Diabetes.