Issue 5 - April 2013

DAFNE News - Newsand information fromand for the DAFNECommunityWhat’s in Issue 5?• DAFNE at Diabetes UK Annual ProfessionalConference, Manchester• Results of Educator Group Elections• Educator Group Chair - update• DUAG e-petition• NICE - Eyes on Evidence• Mythbuster Number 5• Best Practice Workshop and Collaborative Meeting -Change of venue• Focus on Outcomes and introduction of KPIs• New DAFNE Publications• Corporate Sponsors• Statistics from Central DAFNE• Hatches, Matches and Dispatches• Healthcare Professional training dates• DAFNE YDEF Fellowships• Location or Staff Changes?• Reminders• DAFtNEws - jokes from dafneonline users

DAFNE abstract wins 2013 DUK

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CorporateSponsorsWe are proud to announcethat during 2013 / 14 a rangeof industry partners will besupporting the DAFNEprogramme.

Education and Self-ManagementAward.Congratulations to Dr Jackie Elliott from Sheffield, whosepresentation: Substantial Savings in EmergencyTreatment Costs Following Structured Education inPatients with Type 1 Diabetes, won the Diabetes UKEducation and Self-Management Award at the recentAnnual Professional Conference. Dr Elliott analysed theincidence of severe hypoglycaemia and DKA prior to and12 months post DAFNEin 939 patients and calculatedemergency treatment costs pre and post DAFNE. Thefrequency of both severe hypoglycaemia and DKAdecreased significantly following DAFNE (>65%reduction) with a total saving in emergency treatmentcosts of £86,787 for the cohort equivalent to £92 perpatient

3 of the 6 abstracts shortlisted for the Award wereDAFNE-related - well done to all concerned!

DAFNE was very well represented in both oralpresentations and posters and featured strongly in ProfStephanie Amiel’s Banting Memorial Lecture. A full listof orals / posters can be viewed on the DAFNE Website.

Conference Self Care VillageFor the first time at the conference, the exhibition standsfor DAFNE, DESMOND, X-PERT and the Year of CarePartnership were grouped together in a ‘Supporting SelfCare Village’, enabling the showcasing of eachprogramme through stands, presentation loop and dailydemonstrations.

Wednesday saw Dr Helen Hopkinson and DUAGmember Ian MacLellan pitching DAFNE to a ClinicalCommissioning Group in a ‘Dragon’s Den’ stylepresentation, with the commissioners played by GillJohnson (NHS Diabetes), Bernie Stribling (DESMOND)and Gill Thompson (DAFNE).

Thursday was a demonstration of a course morning doseadjustment session, with Carolin Taylor and Val Naylor(Sheffield) as Educators, participants role-played by JessMannion (Sheffield), Sarah Mitchell (Sheffield), Kath

Gold Sponsors: NovoNordiskSiliver Sponsors: Eli LillyBronze Sponsors: SanofiAventis Further information regardingDAFNE Sponsorshipopportunities for the nextfinancial year (2014/15) andhow to get involoved can befound on the DAFNE website.

Vital StatisticsAs of 30 April 2013:DAFNE is delivered by 75diabetes services in 138localities across the UK andSouthern Ireland. There are:612 Trained DAFNEEducators62 Trained DAFNE Advisors393 Trained DAFNE Doctors

3,882 DAFNE courses havebeen delivered resultingin 27,475 DAFNE Graduates.

Two additional services aredue to complete training in2013, Northern Health andSocial Care Trust, Belfast inJune 2013 and RoyalBerkshire in September 2013.

News fromCentral DAFNEOffice

“Hatches”, “Matches” &“Dispatches”

"Hatches"A warm welcome to RoyalBerkshire Hospital,Reading who will becommencing their DAFNEtraining in July 2013, and toHelen Chambers, who

Sutton (Norfolk & Norwich) and Julie Taplin (South WestEssex), with Sharon Cassidy (Hull & East Riding) asAuditor.

Friday was a panel discussion chaired by Simon O’Neil(Director of Care, Diabetes UK) involving Dr HelenHopkinson (DAFNE) , Prof. Melanie Davies (DESMOND),Dr Trudi Deakin (X-PERT) and Dr Sue Roberts (YoC).

Throughout the 3 days, the stand (pictured below) was,as usual, manned by Sharon Walker and Gill Thompsonfrom Central DAFNE with support from Ian MacLellanfrom DUAG and Educators. There was a lot of interestfrom healthcare professionals regarding the new 5 weekdelivery format for DAFNE.

Election ResultsCarolin Taylor thanks all candidates who stood forelection in February; warm welcome to the followingEducators who were successfully elected to the EducatorGroup:

Karen Callaby – DSN, Cambridgeshire

joined the Central DAFNEteam as an Administrator on25th February 2013.

"Matches" None to report

"Dispatches"None to report

DAFNE HealthcareProfessional training datesThere are currently 9 DAFNEtraining programmes plannedfor healthcare professionals,providing a total of138 training places.

Training programmes includethose for DAFNE Educators,Doctors and Level-1Advisors, in addition toworkshops on the DAFNEQuality Assurance process,delivery of the DAFNE pumpcurriculum and DAFNE 5x1-day course curriculum.

Further details on the dates,venues and availability forhealthcare professionaltraining can be found on theDAFNE website.

DAFNE YDEF (YoungDiabetologists andEndocrinologists' Forum)FellowshipsThe 10 DDPfellowship places for 2013have been allocated.

2014 Fellowshipssponsored by NovoNordiskCentral DAFNE are acceptingcompleted applications for2014; fellowships will beallocated on a first comebasis. If an individualwithdraws from theirfellowship, the fellowship will

Katy Valentine – Dietitian, Dumfries and GallowaySally Woolgar – Dietitian, ScarboroughSusan Clark – DSN, Durham Diabetes Network

Educator Group Chair – updateCarolin Taylor’s secondment as DAFNE Educator GroupChair will end in November 2013. The Educator GroupChair position will no longer be a seconded role. However, the Executive Board has approved theadvertising of a 0.5 WTE National Educator position via aservice level agreement, for 3 years in the first instance.This will be an exciting opportunity for any suitablyexperienced DAFNE Educator who is passionate aboutcontinuing to deliver and develop the DAFNEprogramme. Look out for the emails advertising this postwithin the next few month. Carolin will be happy todiscuss this post with anyone who may be interested:carolin.taylor@sth.nhs.uk

DUAG still needs over 97,500signatures to raise structureddiabetes education for debate inParliament!Mark Endacott reminds everyone to sign up to the e-petition: http://epetitions.direct.gov.uk/petitions/41345

With over 1,000 HCPs and 26,000 Graduates, ifeveryone signs up and encourages at least 4 otherpeople to do the same this target should be easilyreached by November! Remember, this is generic –does not specify DAFNE or Type 1 diabetes, so relevantto all! Please sign up and help us make the dream ofequity of access to high quality structured educationa reality.

NICE - Eyes on EvidenceThe DAFNE case study accepted for the NHS EvidenceDatabase as part of the QIPP library, has been furtherhighlighted in the April edition of the NICE Eyes onEvidence e-bulletin; which provides commentary onimportant new evidence. The peer reviewed case study

be offered to the next personon the waiting list. For furtherinformation and anapplication form visit theDAFNE Website.

Locationor StaffChanges?Plea from Central DAFNECan we please remind LeadEducators to inform CentralDAFNE of any change ofcircumstance within theirDAFNE team, such as: • Service change of address• Educators on maternityleave or long term absence(sickness, secondment)• Educators leaving service• Doctors leaving service

This will help prevent mailand resources being sent tothe wrong address and willsave your centre redeliverycosts.

RemindersTraining 5 week and pump curriculumtraining workshops nowavailable - visit the DAFNEwebsite for training dates.

ResourcesAll Lead Educators andAdministratorsare reminded to aviod bulkbuying workbooks and CPGuides this year and riskbeing left with excessiveamounts of out-of-date stockwhen the new Workbooksand CP Guides are issued atthe end of the year.

shows that DAFNE can provide savings of 93,133 per100,000 population due to a reduction in the incidence oflong-term complications. Click here to view the article.

DAFNE MythbustersMisconception No 5: More Insulin / DosingMisconceptions

(1) The ‘Berger’ algorithm (on rising and on retiring) forbackground insulin dosing makes use of the morningoverlap to reduce the effects of the Dawn Phenomenon.Further observational studies / audit data on the use ofanalogue background insulin will be required, howeverthe DAFNE recommendation is still to dose BI on risingand on retiring (with overnight doses >7hr apart) (2) The curriculum states that if BG is >11mmol/l the1u:2-3mmol/l correction guide becomes less predictable,so for safety correctives should be used more cautiouslyand perhaps limited to 4u until individual sensitivity isascertained, but this is not an absolute maximum. (3) People should consider the reason for the high BG,e.g. they may have reduced their previous dose of QA(following DAFNE guidelines) to ensure their BG isabove 7mmol/l prior to exercise. The key thing is to thinkabout whether the BG is high due to absence of insulin,specifically BI, in which case BG would be likely to risehigher as a result of exercising and potentially lead toketosis; a dose of QA will prevent this. (4) It is suggested that people start with 1:1 ratio forsnacks and meals, but to adjust the ratio according toBG results following the step-wise approach. It makes

'Core' data collection 'Core' data collection is nowonly required at baseline and1-year post-DAFNE. Weencouragae centres toaim for as near to 100% 1-year post course dataascertainment. This will bescored as part of your 3-yearly centre's Audit.

Core Skills and SessionLearning OutcomesLead Educators are asked tocheck that your DAFNE teamare using current versions ofCore Skills (F03.005, Version4, May 2010) and SessionLearning Outcomes (F03.006,Version 4, August 2012)forms for internal QA and toemail Central DAFNE toconfirm receipt of these. Thecurrent versions are nowdownloadable from the HCPsection of the DAFNEWebsite.

DAFNE Official Website -New DAFNE HCP PasswordProtected areaThe password protected HCParea of the DAFNE website isnow live and contains:• downloadable currentdocumentation for InternalQuality Assurance andExternal Audit• DAFNE Centre Manual• DAFNE resource price listand ordering form• DAFNE Database userguides• Training dates and trainingapplication forms• DAFNE QA Handbook

All members of the DAFNECollaborative should havereceived an email fromCentral DAFNE with logincredentials to access the

sense therefore that if someone is on a 2:1 ratio formeals, they will require a 2:1 ratio for snacks taken too.If their ratios vary for different times of the day, they willneed to establish which ratio to use for snacks aroundthat time (usually the ratio for the closest mealtime) This was first presented by Carolin Taylor on behalf ofthe Executive Board at the 2011 Collaborative Meeting.

Best Practice Workshop andCollaborative Meeting - Change ofvenueDEP Reviewer Best Practice Workshop on Thursday13th June 2013 will now be held at Premier Inn,Piccadilly, ManchesterAnnual DAFNE Collaborative on Friday 14th June 2013will now be held at University of Manchester, SackvilleStreet Campus, Manchester

There are currently 45 DAFNE centres who have not yetsubmitted their attendance form for the Collaborativemeeting. The meeting programme and an applicationform can be found on the DAFNE website . We wouldencourage DAFNE centres to submit their applicationform by Friday 3 May 2013.

There will also be a poster competition again this year. The aim of the award is to encourage and promote thesharing of DAFNE best practice and DAFNE initiativeswith the Collaborative. Judges will be looking for clearpresentation of the idea, relevance to the DAFNE ethos,potential transferability to other DAFNE teams, and ofcourse originality. All DAFNE centres can present dataon local DAFNE initiatives. There is no limit to thenumber of entries per centre.

The winning poster will receive £100 worth ofvouchers and there will be £75 bursary paid to theservice of the winning lead author to be used for travel toattend the 2014 DAFNE Collaborative meeting.

A submission form can be found on the DAFNE website.Closing date for submissions is Friday 24 May.

HCP Password Protectedarea. If you are a member ofthe DAFNE Collaborative andhave not yet received logincredentials please contact theCentral DAFNE office.

If you have any suggestionson what you would like to seein this area please contactCentral DAFNE.

Central ContributionsCentres will be contactedwith details for 2013-2014Central contributions duringMay.

Next issuerelease date31th July 2013Do you have any interestingnews or humorous quotes tocontribute? Please send(brief) ideas tocarolin.taylor@sth.nhs.ukby 25 June 2013.

Editorial BoardCarolin Taylor –DSN/DAFNE Educator GroupChair, SheffieldGill Thompson – NationalProject Director, NorthumbriaHelen Hopkinson –Physician/DAFNE ExecutiveBoard Chair, GlasgowMark Endacott – DUAGMember/dafneonlineAdministrator/DAFNEgraduate, KentSusan Moore - NationalDatabase Manager,Northumbria

Focus on Outcomes and theIntroduction of Key PerformanceIndicators for DAFNE Audits -Change to timelinesAs reported in the previous DAFNE newsletter there willbe a focus on outcomes within the DAFNE Collaborative.

The distribution of annual outcome reports, to eachDAFNE centre, detailing their local centre outcomescompared to national DAFNE outcomes will now becarried out as a phased introduction. This year thefocus is for more complete data collection and thecurrent core data will be presented at the Collaborativemeeting in June, with individual reports being sent toeach DAFNE centre the week following the Collaborativemeeting. Subsequent years will introduce the KPI forimprovement in HbA1c.

New DAFNE PublicationsFrom the UK NIHR DAFNE Study:Lawton J, Rankin D, Cooke D, Elliott J, Amiel S, Heller Sfor the UK NIHR DAFNE Study Group. Self-treatinghypoglycaemia: a longitudinal qualitative investigation ofthe experiences and views of people with type 1diabetes. Diabetic Medicine 30: 209-215

DAFtNEws - jokes fromdafneonlineThere was a diabetic called WoodWho had a weakness for the occasional sponge pudBut she exercised and injectedAnd tested and correctedTo ensure her control was still good!By DianeW, S W Essex Graduate One Fish, Two Fish, Red Fish, Blue FishDAFNE lets me consume a dishof pasta, rice, muesli or breadPrior to DAFNE I was off my headBy Warwick, Melbourne Australia Graduate

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