Endocrine Abstracts

DAFNE (Dose Adjustment for Normal Eating) is a structured Education programme for patients with Type 1 Diabetes. It is based on the principles of a German course since the 1980’s. Courses started in the UK in 2000 and commenced in Ireland in 2004 with 24 DAFNE centres now in operation. During the COVID Pandemic a new version–Remote DAFNE was developed. DAFNE was selected as a finalist in the “recognising innovation related to the covid-19 pandemic” Bright ideas in health awards. Evidence shows that DAFNE can result in: Improved HbA1c, a 70% reduction in severe hypoglycaemia (SH), a 60% reduction in diabetic ketoacidosis (DKA), a reduction in average insulin doses, Improvements in quality of life, Improvements in treatment satisfaction and fewer participants progressing to insulin pump therapy. Two Pancreatectomy patients and one Immuno-oncology induced DM completed the remote DAFNE programme. One man 64yrs had a whipples 2021 for pancreatic adenocarcinoma- with recurrence had Total Pancreatectomy 06/24, and a history of Lynch syndrome. Started Remote DAFNE Jan 2025, using Libre 2 CGM- refused HSE approval. The second man 69yrs had a total pancreatectomy for neuroendocrine tumour, with hepatic metastases, partial gastrectomy, splenectomy and cholecystectomy. He was also refused CGM by HSE. Both men had reductions in their TDD doses and hypoglycaemic events. The immune-oncology patient a 61yr old female with malignant metastatic melanoma, treated with Nivolumab (PD-1 inhibitor) and Ipilimumab (Mono-clonal antibody treatment targeting immune checkpoint CTLA-4). She presented in 2019 with Severe DKA PH 7.055: Bicarb 8.2: Ketones 7.4.