Adjusting Dosages

Hi wanted your opinion on dosages. I have been an insulin dependant diabetic for 15 years and have been using the old method. As my diabetes is unstable and has been affecting my work life balance my local hospital has advised e to try the dafne way to ontrol my diabetes. I have been using the dafne way for a number of weeks now. I have not been on a course so a bit unsure as to whether I am adjusting my dosages correctly. I am taking 3 units of insulin for 1 carb for breakfast, 2 units of insulin for 1 carb lunchtimes and 2.5 units of insulin for 1 carb at dinner. Does this seem responsible to take a different dosage for different meals? Your help in this matter would be greatly appreciated. Thanks

Hi, I am new to daphne too about 3 weeks in now. I have had diabetes type 1 for 19 years. When we started the course everybody started on the same ratio i.e. for every 10g of carbs you took 1 unit of insulin. When you start seeing a pattern then you can started to change things. Your carb portions look very high are you using the carb counter link to find out what your carbs are? If like on your wednesday reading you had 20 cps (carb portions) for breakfast really you should have taken 20 units of insulin - that is why I am wondering how you are counting your carbs as this is really high. Most cereals and bread would only be about 4 carb portions although some how you managed to keep well controlled until later on in the day.

I would guess your CP are in grams? CP should be 1 / 10g

I would say you need to up the dose at lunch as you are high at dinner most days

Are you on a list to get on the course, there is lots to learn - I tried before i went on the course, didn't work that well but since the course (Jan '10) A1C is already down by 2

Hey there,

My advice is get on the course and in the meantime have a read at the DAFNE manual.

As I am settled with the dafne principals I am struggling to make sense of your sugars as they are not displayed the way a dafne student would.

For example corrections being shown as +1 or +2 onto your QA.

Your QA insulin is lower than your carb intake, this might be because your writing the carbs down wrong, 1CP being ten grams of carbohydrate. (Nat and Karl noticed this too and explained)

Recording the results in the easiest way possible is paramount in order to spot patterns and also to allow other to help you easily.

Looking closely at the results you are using the principals correctly, which is brilliant.

The first thing I would do is make sure your BI is right, your on one dose so that means Lantus more than likely.

If you take you BI at bed with no food inside you or QA insulin and you wake up with the same reading as you went to bed with you can bet that its doing its job.

If not then you need to up or down the dose a few units, because its lantus (I am assuming), you will have to wait a few days to see the effects, continue until you are held steady over night.

Then you can start with your QA insulin, if the BI alterations didnt iron out your highs through the day then you can start with the lunchtime reading, is it high 3 consecutive days?, if so ratio needs to go up at breakfast, and this works vice versa, if low, ratio down.

Eventually you will get it, then move onto the dinner, altering the lunchtime dose.........

I feel as if I have just rabbled on the basics there so I apologise if you have heard it before......

Have a read at the manual as I say, but it may seem overwhelming if the theory is not explained to you...

DAFNE asap......

Good Luck........

all, sorry she can't read the DAFNE manual without going on the course and the hospital should NOT tell her to 'try the DAFNE way' without sending her on the course !
Caroline did they say they were going to put you on the waiting list for the course ? There is so much to take in and understand you really do need to attend the course. Everyone is welcome to advise and help you thats what the site is for, but ultimately you need the support of a DAFNE team and that means going on the course.

Unfortunately 'users' do not get access to the DAFNE Online manual only 'graduates', this is to protect them as well as DAFNE Central.

Sorry about that, I didnt know what privelages each user class had, makes sense I suppose................

I however was given the basics of dafne a year before attending by my dietician, even then it made a big difference.......

The course cements it all together.........

Thank you very much for all your advice. I am on the waiting list... which could take me into next year! I have been advised to try this method (without a manual) so apologies if my recordings do not make sense. I do mean 1 is 10g. I usually have 30 carbs for breakfast, 40 for lunch and 40 for dinner. My Diabetic Specialist thought this was a right way for me to try it now as a works occupational therapist recommended I tried an aktins diet of not eating carbs for breakfast or lunch but having large carb dinner (thereby only taking insulin twice a day)! I am at the end of my tether with what advice to take as I feel so exhausted most of the time. Sorry to rant on... I will try and obtain a manual from somewhere. Thanks again, I really appreciate speaking to other diabetics in my situation.

I am on Novorapid for the quick acting insulin and Lantus at night time. I have increased the morning insulin from 1c: 2units to 1c :3 units, so hopefully I will get there. I think its knowing how much to adjust by to try and keep in range. If my blood sugar reading is above 10, how much would you take to bring it down again? Im pulling figures out of the air and risk an unwanted hypo.

There are different target ranges for different times of day but ideally you want to be 5.5, so you subtract that from your reading (10) and that gives you 4.5.

1 unit drops you between 2-3 mmol/l, so assume 3, so that would mean you would correct with 1 unit...........

try that for now................the higher you are the less 1 unit brings you down, or thats the case for the majority of people........

Are you confident your lantus keeps you steady overnight....................??

I haven't really played around with the Lantus... it seems to be within a good range from bed to morning just these past few days, so think that is ok for the time being. I will continue to do plenty of blood tests and monitor my sugars and adjust accordingly. Thank you ever so much for your help and support.