Does Dafne work?

Not sure why you think there are legal implications on questioning the background of BERTIE and David Cavan, where you not the people talking about secrecy and open-ness. I was merely stating that anyones opinion even a repsected consultant is just an opinion. I have looked
at the BERTIE online site and indeed it does look interesting. It does contain a big discliamer though as I would expect and says if you are unsure consult your Diabetes care team. Which is basically my issue with online courses, you still need the support of your Diabetes team and this is the biggest issue.
Its good to see an PCT website with so much information and one willing to provide an 'online' course. However I would ask why PCT's can't co-ordinate to make this kind of thing available nationally rather than just from an individual PCT's website. I'm sure 99% of Diabetics would never find this site on their own and thus make use of the information on it. I think this is also true of DAFNE as well by the way.
I think I will bring to a close my comments on this subject now and let others have the opportunity to comment on the issues raised if they so desire.

Just a final point from me before I leave the conversation. I think you will find that Dr Cavan is a little more than "a consultant". From 2000-2004 he was Chair of the Education and Psychosocial Care Section of Diabetes UK, and in 2003 with Joan Everett he founded the Type 1 Education Network of which he is now national spokesman.

Goodness!

The BDEC course, BERTIE, is one of the only 2 (as far as I know!) 5-star 100% ticks all the correct boxes/meets all the required Guidelines etc 'Approved education courses for Type 1 Diabetics' in the UK. The other one is of course, DAFNE.

The other Health Authorities do not deliver BERTIE but 'Local Versions' for the simple reason that they aren't allowed to call it BERTIE despite having undergone intensive training by the staff at BDEC and having had to have all their course material approved by them beforehand, then having their actual training checked out and given the OK by BDEC staff. In other words, almost exactly like DAFNE.

The reason why some Authorities choose to opt for the BDEC version is purely down to ££££££ and they usually have to rope in any number of pharmaceutical co's, pump and meter mfrs etc to sponsor them, in order to deliver the course in the first place. Also I think they don't have to take quite as much time away from the office to get the training, or perhaps it is more spaced out, having been sepcifically designed to help those partic Authorities as much as poss. This doesn't actually impact on the training given, it only enables it TO be given in the first place. However, there did seem to be refreshingly easy access to quite a fair number of different pens, needles, meters etc for those of us wanting to try different gadgets. LOL

My course was delivered for one day a week over 4 weeks - this is usually a lot more palatable to employers so can in fact make it a lot easier for anyone who hasn't got any or much spare holiday should they decide it ain't their problem and refuse to give you the time off. Despite a nice official letter saying how much it would potentially help them - there is absolutely nothing anywhere that says an employer has to give you the time off for this type of training - so some of em just refuse point blank.

Plus it gave you a chance to try what you'd learned for several days. This is good because if you happen to be taking Lantus, any changes usually takes a few days to kick in. On our course we were on a wide variety of different insulins, including one lady using animal insulin (she's resistant to 'synthetic' ones) and nobody had to change anything if it wasn't mutually wanted/necessary. We then each brought a detailed Food, activity, mood, BG reading, Insulin diary for 3 of those 6 intervening days to the next session - so we did all the things we would reasonably expect to do over a 4 week period, including kids birthday parties, nights out with mates, dancing, running, decorating, gardening, being lazy - whatever.

Each of these was reviewed round the table. Most of us could spot what someone else got a bit wrong quicker than we could spot and understand our own. The last week after the first 3 or 4 I collapsed in hysterical laughter and eventually managed to tell em the diaries were all looking almost exactly like the ones I used to be so good at forging before my hospital appointments in my younger days. Turns out we'd all - except the newly diagnosed - done it in the past.

The good news in two ways was; I had an HbA1c taken during those 4 weeks and the results appeared on the hospital computer on the morning of the last day, and the result was a 15% reduction in that taken 3-4 months previously! I'd been trying to carb count with the assistance of quite a number of people on a certain internet Forum for several months, and honed it all during those 4 weeks. Otherwise I think I'd have shot myself, finding how ill-educated I was about diabetes which I'd already had for 35+ years, begging for DAFNE-type training every time I visited a doctor - they lob you the insulin but then don't explain how to use it optimally. So you bumble along and muddle through. How am I even alive?

I learned so much about my body.

And yes - the on-line course is really good esp if they told you you were T2 originally then decided after (which was totally obvious had they bothered to spend the money on the proper tests in the first place but soon became apparent when nothing they prescribed worked at all, whereas as soon as you started on insulin your BG suddenly started to behave, but DAFNE in some areas is ONLY available to those whose records say Type 1 from the outset!!!) - this isn't me by the way, but the person I'm talking about is a member of this forum! BUT

Not as good as a real course round the table with professionals and fellow diabetics.

I think both courses are probably equally good. End of story - even the medics don't tell you you HAVE to do anything - you can as always, please yourself!

Incidentally, I do know that people are referred to Bournemouth by GP's and Consultants all over England. So on the face of it, I do feel that this gives me a little clue that BDEC is considered by other Doctors to be a centre of excellence.

And lastly, who exactly are my Diabetes team? A GP who doesn't seem to know anything much? a Consultant who I saw once? any of the innumerable, different sidekicks I've seen when I visit the hospital? who? (Since my CARBS 4 1 course, I do have a Diabetes Specialist Nurse who I've hung onto and do see on an ad hoc basis, but I have to make a Motorway trip from the City I live in to a nearby town to see her!) The friend I described cannot get a referral to a hospital clinic, so despite asking, has no access to a DSN either. (Your Notes say T2 so can't refer you, see the surgery nurse) (change em then? - No need!)

I think that DAFNE is more valuable than an online course. With an online course, there is no supervision. What happens if you try and follow it and give too much or not enough insulin and have serious consequences? One lady collapsed from a severe hypo on my DAFNE course, if learning alone at home this would have been very dangerous. Many others had mild hypos through the week, and my sugars were very high for several days. Not something in my opinion that you want to be going through alone. Also, before DAFNE I would not have had the confidence to muck around with my insulin. I had had no education in this whatsoever before DAFNE in 15 years of diabetes. It was a huge hurdle to get over and without face to face support for a week I couldn't have done it.

I would also agree that the face to face aspect is key. With an online course you only get one doctor's idea of what you should be doing. Doctors are valuable but in terms of living day to day, they don't really know about that and you wouldn't expect them to. So I think online courses need to include a forum for feedback on day to day issues and support from other diabetics. It is one thing saying 'you should do this' but real life doesn't work like that. It is important to get an idea of what to do if you can't manage the textbook way of doing things, or forget or something. An online course can't tell you that.

Have you done the online course then?

Personally when my BS was swinging from the 30's down to 1.8 and blow on a daily basis, I'd have been more than glad of anything that might help me!

Of course a face to face round the table course is always going to be better, but when you can't get anything where you happen to live and on;ine course has to be better than nothing at all!

Anyway, if a person doesn't read and take in the course content, before using whatever they do happen to notice willy nilly - they'll come unstuck anyway, no matter how it is delivered. That is why it is written in such a way that it takes quite a long time to go through it all and literally does lead you gradually on to the next bit. (I skipped stuff myself at times as I thought it was a bit slow, esp on the parts I already thought I knew - then found I had to go back to a previous Module and do a recap in order to even grasp, let alone participate in the next bit and you have to answer the questions correctly before it lets you continue LOL) They know who you are (from registering) and how much of the course you've grasped or not from the answers you give - I dropped out in the end but only cos I got onto a real course!

I haven't done the online course. But my point is I wouldn't do it instead of DAFNE. It is just my opinion as I hope I made clear. But I would not have the confidence to make big changes on my own. And if someone 'uses DAFNE willy nilly' then the next day they will have to show and explain their BGs and the others on the course as well as the nurses can help them improve. With the online course I don't know if you would be able to share your blood sugars with anyone.

I don't think anything is better than nothing. I think it depends on the individual. Some people like me need a lot of support and help. I would use the online course as a refresher after a face to face course but would not feel happy using it instead. Like I said, just my opinion though.

Well Lizzie no-one (health professional nor anyone else) can actually make you do what you don't want to do - short of placing a real loaded pistol to your head or similar - even if they ARE convinced you need to make that change. So to make that choice, and make any change, you need to be persuaded by the arguments they put forward, in the first place don't you.

Then if you are like me, you want to find out whether other bodies actually agree with that stance, or whether someone else you also respect say something entirely different.

At the end of this process you either go with what you are being told or ignore it and do something else entirely. It may even goad you into changing your doctor. But we can all do that thing at least. It is after all Free Choice.

I chose to strongly disbelieve the OH Doc that assured me that running a HbA1c even as high as the low teens would never cause me any present or later danger. But he convinced my employers that it was true and I was worrying about high 9's absolutely unduly. I have wished diabetes upon him many many times since that appointment. I asked him how he could even say that, bearing in mind what the NICE Guidelines said at that time. He pooh poohed NICE and their Guidelines. I even told him to his face at the time if he was my GP telling me that, I'd never rest for a single moment thereafter until I'd got him at least sacked if not completely struck off. So my employer gets told I'm agressive. Well that much WAS certainly true, anyway!

And I don't do what he told me to do and never ever will, despite knowing that his report would infer strongly to my employer that I was just using my diabetes as a convenient excuse to more or less skive off work.

Sounds like an incompetent doctor, JennyS. But why was he talking to your work? My doctor would have no right talking to my work. His only communication would be writing a sick note if I was ill long enough to need one, and that doesn't include making comments about my character (only giving info on my symptoms and how long I am likely to be ill), so I think your doctor was very wrong to say that to your work.

Because Lizzie he was an Occupational Health Dr that Jenny had been sent to by her work. Her employers were paying for his "professional advice" go figure to whom it was slanted??? If you have never been there you cannot comment, I have and it is an uncomfortable place to be in unless you are a very educated and confident person. Even given that, if you are pushed into that position I can tell you that it is far from easy.

Patti,
Lizzie CAN comment as can I. If Jenny posts personnal details like she did then she should expect comments. Although quite what it
has to do with DAFNE escapes me. Please don't tell people they cannot comment that is NOT the philosophy of this website.

I would prefer if you could keep the subject matter DAFNE related or at least clearly Diabetes related. Discussions about OH Doctors or
your opinions of HCP's should be kept for your website, which is aimed more at that kind of debate, our aim is to support DAFNE graduates
and those interested in the DAFNE Course. That doesn't exclude other subject matters, but we don't really want to get into debates
about the validity of HCP's.

Thank you