The key to managing diabetes without tears – the treatment and teaching programme for flexible insulin therapy in Germany

Successful implementation of structured education programmes that teach people with type 1 diabetes to use insulin flexibly around normal
lifestyle behaviours is the subject of this and the following four articles in this special issue. Programmes such as the UK's Dose Adjustment for Normal Eating (DAFNE), in which the person affected by type 1 diabetes is central to all disease management decisions, are the object of a number of projects in different countries. While such programmes are increasingly regarded as the state-of-the-art deployment of diabetes resources, their origins lay in Germany early in the last century. Ulrich Müller looks back at the birth and initially arrested development of flexible insulin therapy programmes, describes the approach itself and demonstrates what makes it an optimum therapeutic approach.