650-P: An Audit of the Clinical Outcomes of DAFNE Singapore (2011-2018)

Abstract

Background: The Dose Adjustment for Normal Eating (DAFNE) is a type 1 diabetes (T1D) group education program to enable self-management. Shown to improve outcomes in the UK, its application in Asian countries remains uncertain. We assessed the outcomes of Singapore (Sg)DAFNE, which remains the only Asian centre, from 2011-2018. Methods: Prior to DAFNE entry, most had received one-on-one education from DAFNE educators. HbA1c, total daily dose (TDD) of insulin were retrieved at these timepoints: 1y before, at entry, 1y after, latest profile. Paired sample t-tests and Chi square tests were used; data is presented as means±SD. Results: n=115 (33.9% male), age 28.3±8.5y, T1D duration 11.2± 8.4y, follow-up post-DAFNE 3.5 ±2.3y. n=104 completed 1y follow-up post-DAFNE. Mean HbA1c pre-DAFNE fell by entry into DAFNE: pre-vs.-entry: 8.5±1.68% (68 mmol/mol) vs. 7.9±1.4%, p<0.001. This fall was sustained 1y post-DAFNE and at latest follow-up (HbA1c 7.8±1.3%, 7.9±1.3%, all p<0.001). Proportion of those in HbA1c category ≤ 7.5% rose while the proportion in higher HbA1c categories fell post-DAFNE (Figure). TDD insulin fell alongside improvement in glycaemic control (pre-vs.-post-DAFNE: 45.5+14.9 vs. 42.5+12.0, p=0.02). Conclusion: This demonstrates the effectiveness of SgDAFNE. Sustained improved glycaemic control was achieved with reduced insulin dosages, reinforcing that the quality of insulin use matters more than the quantity. Disclosure S. Tan: None. S. Rama Chandran: None. H. Lim: None. K. Adaikan: None. S. Goh: None. D. Gardner: None.