DESMOND and DAFNE

Dose Adjustment for Normal Eating - DAFNE

• DAFNE is a skills-based education programme in which adults with type 1 diabetes learn how to adjust insulin to suit their free choice of food, rather than having to work their life around their insulin doses

Diabetes Education and Self-Management for Ongoing and Newly Diagnosed - DESMOND

• Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) is a structured group education programme for adults with type 2 diabetes. DESMOND has a theoretical and philosophical base; the programme supports people in identifying their own health risks and responding to them by setting their own specific behavioural goals (1)

Evidence base for DESMOND

The cluster randomised controlled trial showed no improvement in HbA1c versus usual care (2).

In the real world evaluation there were less than 10% of the original referrals who contributed to the qualitative analysis (3)

• also there was no comparator and all the HbA1c benefits were put down to attending the programme and there is no evidence for this versus usual care.

Reference:

1. Department of Health and Diabetes UK (15th Jun 2005). Structured Patient Education in Diabetes - Report from the Patient Education Working Group
2. Davies MJ, Heller S, Skinner TC, Campbell MJ, Carey ME, Cradock S, Dallosso HM, Daly H, Doherty Y, Eaton S, Fox C, Oliver L, Rantell K, Rayman G, Khunti K; Diabetes Education and Self Management for Ongoing and Newly Diagnosed Collaborative. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ. 2008 Mar 1;336(7642):491-5.
3. Chatterjee, S., Davies, M.J., Stribling, B., Farooqi, A. and Khunti, K. (2018), Real-world evaluation of the DESMOND type 2 diabetes education and self-management programme. Pract Diab, 35: 19-22a.