Conflicting Adivce - DAFNE Online

January 15, 2011 20:03

Jen1984 2 posts

I recently moved to Scotland and have been on the DAFNE course. Had a few problems with hypos but when I spoke to my new nurse they contradicted some of DAFNE saying 4 is the floor for hypo not 3.5 and only correct back to 8, instead of 4.5 to 7.5! I am confused what to do, my hbalc before dafne was 14 and got down to 10 in two months. Also concerned with weight as got 2.5 stone to loose but they keep telling me not to be hard on myself and things take time but after being in hospital 6 times last year with DKA I am anxious.

Can anyone help/ any weight loss tips?!

Jen

January 16, 2011 18:13

marke Site Administrator
South East Kent PCT 675 posts

Hi, You don't say if your new nurse is DAFNE trained I presume not. The DAFNE Handbook says 3.5 is the 'floor' and with DAFNE you are managing your BG much more tightly so thats why there is a lower figure. With regard to correcting a Hypo, I have never been told a 'range'
to correct too and I can't see anything in the handbook. The aim is not to overtreat a hypo by eating too much, so just increasing your BG higher than the floor is the aim. This invariably leads to your BG being higher than that, but you just don't want it to be +10.
With regard to diet, I would guess their 'take time' advice is due to your DKA. If you try to lose weight too quickly or don't give enough
insulin this is the path to DKA, so slowly and reliably is the way. Easier said than done I guess.
Finally if you contact your original DAFNE Centre or us, we can verify you as a graduate and change your account to reflect this. This will mean
you can check stuff like the above in the online handbook.

March 18, 2011 20:47

DFH_17 DAFNE Graduate
Croydon NHS 22 posts

3.5 is definitely the floor with hypos and you want to do the hypo tretment wait 10 mins then re-test to make sure your BG has gone up. You've done well with decreasing your HBA1C in 2 months.

Regarding weight loss - its all about portion control. Making sure the cp count is correct so that your injecting the correct amount for what you eat. Have found that now I'm carb counting I automatically am more careful about what I eat as I know the more carbs I eat the more I have to inject. You didnt say what ratios your on for each meal?

January 15, 2011 20:03 Jen1984 2 posts	I recently moved to Scotland and have been on the DAFNE course. Had a few problems with hypos but when I spoke to my new nurse they contradicted some of DAFNE saying 4 is the floor for hypo not 3.5 and only correct back to 8, instead of 4.5 to 7.5! I am confused what to do, my hbalc before dafne was 14 and got down to 10 in two months. Also concerned with weight as got 2.5 stone to loose but they keep telling me not to be hard on myself and things take time but after being in hospital 6 times last year with DKA I am anxious. Can anyone help/ any weight loss tips?! Jen
January 16, 2011 18:13 marke Site Administrator South East Kent PCT 675 posts	Hi, You don't say if your new nurse is DAFNE trained I presume not. The DAFNE Handbook says 3.5 is the 'floor' and with DAFNE you are managing your BG much more tightly so thats why there is a lower figure. With regard to correcting a Hypo, I have never been told a 'range' to correct too and I can't see anything in the handbook. The aim is not to overtreat a hypo by eating too much, so just increasing your BG higher than the floor is the aim. This invariably leads to your BG being higher than that, but you just don't want it to be +10. With regard to diet, I would guess their 'take time' advice is due to your DKA. If you try to lose weight too quickly or don't give enough insulin this is the path to DKA, so slowly and reliably is the way. Easier said than done I guess. Finally if you contact your original DAFNE Centre or us, we can verify you as a graduate and change your account to reflect this. This will mean you can check stuff like the above in the online handbook.
March 18, 2011 20:47 DFH_17 DAFNE Graduate Croydon NHS 22 posts	3.5 is definitely the floor with hypos and you want to do the hypo tretment wait 10 mins then re-test to make sure your BG has gone up. You've done well with decreasing your HBA1C in 2 months. Regarding weight loss - its all about portion control. Making sure the cp count is correct so that your injecting the correct amount for what you eat. Have found that now I'm carb counting I automatically am more careful about what I eat as I know the more carbs I eat the more I have to inject. You didnt say what ratios your on for each meal?