Since the 1980’s, the diabetes team at the Diabetes Centre in Düsseldorf, led by the late Michael Berger, has developed a five-day structured teaching programme in intensive insulin therapy and self-management. (1-3)
The educational approach is based on the Assal model of “therapeutic education” (4) and patients are taught to match their insulin dose to food intake on a meal-by-meal basis. The principle aim is that in the future they maintain healthy glycaemic control without an increased risk of severe hypoglycaemia with minimal support from healthcare professionals. It is noteworthy that the Düsseldorf course does not specifically address emotional issues which concern living with diabetes but is purely skills based.
The DAFNE approach
The DAFNE (Dose Adjustment For Normal Eating) project examined the feasibility of delivering a course based on the Düsseldorf model but with individuals attending the course on an outpatient basis. (5) A similar outpatient course has been run in Graz, Austria, under the supervision of Thomas Pieber, (6) and his team have produced equally successful 12 year outcomes similar to those demonstrated in Germany. (7) This approach has been widely adapted and developed elsewhere in Europe. (8)
Oz DAFNE
In November 2004 teams from Melbourne, Queensland and Western Australia visited the UK for DAFNE educator training with the intention of offering DAFNE courses to Australian type 1s. This education programme is based on the UK DAFNE and thus is called Oz DAFNE.
