THE DAFNE DIARIES
The last day! Good God. I couldn’t quite believe I had been taking this course for a full week. Before I had begun I had wondered what on Earth could cause this to need to last for five days. But along the week it had all become clear; we needed to wait for patterns to emerge and to take the time to understand how diabetes affected each part of our bodies and our lives, a single week was nothing compared to a lifetime of struggling had we not attended. Or something less dramatic, maybe.
Friday’s session was much shorter compared to the others, we all talked about our blood test results as we did every day, but mainly we spoke about our goals for the future. My personal goals were to keep my sugars below 17.0 as much as possible, bearing in mind my first blood sugar on the course was 26. My more specific target was to keep it around 13, but to try and reduce this to the DAFNE target of 4.5-8 over a period of months. This is achievable because it allows my body to become used to the blood sugar reduction over time, and means I will hopefully not react so violently to a relatively ‘normal’ blood sugar as I did on Tuesday.
We all had different aims, but mainly we all wanted to continue monitoring our blood sugars as we had done on DAFNE. For me, this is a hugely important factor as I previously always did blood tests, up to 7 a day, but did not record them. Stepping away from the observed situation of sitting with other diabetics and nurses, this may prove more difficult but overall I sincerely hope I continue to be motivated; I understand more now how to deal with high blood sugars and how to resolve them quickly, without feeling like shit for the rest of the day. I was envious of other people’s control, but now I am also quite proud (and pleasantly surprised) that I have come away with the ability to actually make a difference in my own life. I can sniff that chocolate biscuit and not have my foot removed, because I can compensate for what I eat with insulin- like a normal pancreas does. The only difference is it requires more thought and there is room for error, but conversely, this also means there is more information to be gained to hopefully lower my sugars on a day-to-day basis, and to also reflect this in my HBA1C test. Everything is an ongoing experiment, at some point there is going to be some sort of joy.
Oh, contrare! I can now eat as much cake as I like. YAY CAKE.
I used to wake up every day with high blood sugar, I’d feel like shit and would guess how much insulin I needed to deal with it. It was always a conservative amount that virtually did nothing because I was afraid of falling dangerously low, and not being able to deal with it. I didn’t read packets because I had no idea of the particular impact carbohydrates had, and how much they would increase my blood sugar by.
Having done the DAFNE course, I am now so much more confident that I know how to deal with lows and highs, and also how to maintain a steady blood glucose level overall using carbohydrate portions and insulin dosages, of both quick-acting and long-acting. I almost wish I had done this years ago as advised, because to be brutally honest, it’s the most useful advice I have ever received about diabetes.
When I was first diagnosed at the tender age of seven, I was given a comic book which explained how insulin acted in my body. It depicted a river of blood (which sounds darker than it actually was), and insulin was shown as little men with nets ‘scooping’ sugar out of my bloodstream. Up until a week ago, this is how I always pictured it, perhaps with the exception of the men and nets, more like hormones ‘om nom nom’-ing the sugar. I had never heard of beta cells until Monday morning, or the fact that the liver had a huge role to play in the distributing of sugar. Nor did I know anything about when to test for ketones, what to do when I was sick, or what to do when I was drinking alcohol. Several times nurses had told me to count my carbohydrates, but with no indication as to what this would achieve, or what insulin to give, nor indeed did I even know how much one unit of insulin would decrease your blood sugar by.
But I am not ashamed by this; rather, it makes me happy that I took the DAFNE course as there would be no other way at all by which I could discover any of this information, and this was very much the same for many of the others on the course. Being a diabetic for 15 years, doctors perhaps thought that I knew all there was to know about diabetes. But a hospital visit for half an hour every six months doesn’t provide you with the new information which is being discovered every hour of every day for the rest of the year. And often there isn’t enough time to discuss anything so (relatively) important, what with all the blood pressure checks, blood tests and small talk which is naturally made to avoid another awkward silence in the waiting room.
I would thoroughly recommend this course to people with diabetes who are perhaps struggling a little bit, and even for people who have their diabetes under control, because there is so much information to absorb and you will certainly discover something new. I had been living by rules which were 15 years old; together we had 173 years of diabetic experience, but information that was collectively 173 years old. It used to be frequent practice to limit what you ate because your insulin could not be adjusted accordingly, the DAFNE course is totally different in this way.
DAFNE is just another method of managing your diabetes, no doubt in another 15 years another course will be created which I will have to go on then as well. But DAFNE is an international course, diabetics all over Europe are learning the same rules by which to manage their diabetes, and it gives more freedom by allowing you to eat what you want because you can change your insulin at each dose. You basically become a ‘normal’ person in terms of eating (I mean that with the best intention), just with a need to inject to maintain that normality.
But perhaps more importantly than all of that: it works. It lets you manage your sugars.
It lets you take control.
All centered, italicized quotes are from the DAFNE workbook.
All images are stolen from the internet.