Basal/bolus insulin proportions

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Jos2 8 posts

Hi,

How do DAFNE advise basal insulin levels are set? I'm interested because of a quote in this article, http://www.diabetes.co.uk/news/2017/jun/study-provides-new-insight-into-insulin-dosing-for-adults-with-type-1-diabetes-92312051.html. It states:

"The findings support the view of the DAFNE course, which also states that many people take too high levels of basal insulin. DAFNE advises that most people with type 1 diabetes will benefit from 24 units of TBD per day."

Most people? Are people that similar? My daughter is average height and weight but only needs about 14 units of basal insulin (about 30% of her TDD). Hopefully they have been misquoted. Or maybe my daughter's unusual?

Jos

marke Site Administrator
South East Kent PCT
625 posts

Your daughter is not unusual , none of us are usual. Also DAFNE advises nothing of the kind. What it teaches us is to adjust our Basal levels to what is right for US. It is probably true that often people take too much Basal before DAFNE, as part of the course is to teach you how to work out the correct level of basal for you and also to realise this is not something that will remain the same for ever more. It's hard to explain the DAFNE approach without doing the course as its a collection of things and doing parts in isolation may cause more harm than good.

alturn DAFNE Graduate
NHS Grampian
66 posts

I ignore all these surveys as they are usually of a very small numbers involved, and a new one will be along next week.

If her HBA1C is ok and DSNs' are ok with treatment, then I would say all is Ok.

For interest, my basal is currently 24 units (but has varied between 22 and 2Cool which is about 65% of my TDD.

Regds,
J

Jos2 8 posts

Hi Marke,

Glad to hear that DAFNE were misquoted in the article (may be worth a comment from someone who's done the course), but I've not heard of anything taught in DAFNE that my daughter isn't already doing. She tests basal rates periodically by fasting and sets carb and BG correction ratios through the day in a similar way and matches her insulin to carbs, taking BG, exercise, insulin on board, timing of insulin/food, and insulin resistance into account as necessary.

I can see that DAFNE is valuable for someone who stuck with what we were originally taught (mixed insulin with set meal sizes, snacks and times), and also if someone is burnt out and needs a boost through meeting others in a similar situation (been there and benefited from a clinic course), but we've not heard anything yet that convinces my daughter of the need to take a DAFNE course. Thanks though for all the feedback to our previous question Smile

kind regards,
Jos