Redoing DAFNE??? - DAFNE Online

January 24, 2012 16:22

Lizzie DAFNE Graduate
Guy's and St Thomas' Hospital 87 posts

Thanks, I think the best thing is to set an alarm.

I panic because I am so terrified of complications. I have been told many people panic when they get hypo but I have never worried about that. I am lucky to have good warning signs so all it is is a quick check to make sure I am indeed hypo, then 20g carbs and that's it. I panic because I hate the idea that all the highs are having an effect which I will feel in years to come, like a sword suspended over my head. I worry that although there is no immediate effect, my body is storing it all up to suddenly dump on me in the future. That small unnoticeable changes are happening to tiny cells in my eyes, kidneys and nerve endings, and these will become apparent at some future date when my body decides it is going to let me down again. This probably all sounds crazy to you. I know I worry too much.

I know my weight has nothing to do with my blood sugars, but try telling them that. Everything seems to be about weight. I don't understand why they wanted me to take Metformin as I was losing weight and doing well anyway.

The last time I checked I was on 3:1 but that was before the Metformin. At lunch I tried 2:1.

January 24, 2012 16:29

Simon Site Administrator
Sheffield Teaching Hospitals 578 posts

Lizzie said:
I did try to access the handbook however I only got an error message.

Apologies, Mark and I have been upgrading the site and some errors slipped through the net, the handbook is working again now Very Happy

I think novorapidboi is giving some real sound advice to you here. Don't underestimate the power of writing your readings down - if you can see them on paper (or on the diary here) then you will be able to notice trends and see where adjustments in dosage might need to be made. If you use the diary on here, even if you aren't able to spot the trends in the diary, you can share with other people and ask for advice - there are so many people helping each other out here.

One comment:

Lizzie said:
I only really check my blood sugar when I feel high or low. I have stopped checking on a regular basis and stopped writing it down. I just feel low about it as every reading seems high or low and I don't know why.

I'd say try and test more often, not only will it contribute to keeping a record of your sugars so that you can make adjustments; you may be pleasantly surprised and find that some readings are in range - which could show you that getting on-target readings is possible, and motivate you to keep track of and adjust your insulin doses.

January 24, 2012 16:52

Lizzie DAFNE Graduate
Guy's and St Thomas' Hospital 87 posts

Hi Simon

Thanks for mending the Handbook.

I have entered a couple of tests in the Diary section already, did not realise how good it was.

Thanks both for your help. Will try my best tonight and see how it goes.

January 25, 2012 11:11

Lizzie DAFNE Graduate
Guy's and St Thomas' Hospital 87 posts

[Shared diary only visible when logged in]

Well these are my results so far.

January 25, 2012 12:43

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

Lizzie said:
Well these are my results so far.

WOW, your results are quite good, better than you expected I would imagine............... Laughing

For any roll I take them as 3 CPs, unless they are smaller than a normal sized one............have a look at the carb book on the site, there is also the book carbs and cals that you can get from amazon, this is really helpful also, I have this for mainly calories but comes in useful for carbs too.........

A comment I would make is that you are not giving your insulin 5 hours to work, so leaving 5 hours between MAIN meals.............for example, between 13:40 and 16:41 is only 3 hours, so that 11.5 you corrected for would of still needed an extra hour, hour and a half to come down with the 16 units you injected at 13:40..................if you can do this you will know for sure whether your dose is right, and it looks pretty much there to me.........

Your overnight numbers look to be good also, as you woke up the same as you went to bed with, this would suggest your BI dose of 28 is correct, however, do another couple of nights to confirm it.............

I suspect your low may be down to too much insulin at breakfast or a miscalculation of the carbs, but you can only really go down that path once you know the BI is right............

What did you have for breakfast this morning...................

Well done in doing the tests, you should be proud. I hope that seeing your results, which are really good by the way, has made you feel more confident that your BG control is good............the odd high number in amongst numbers like that will not do any harm whatsoever..........

Again, well done................. Wink

January 25, 2012 14:31

Anele46 DAFNE Graduate
NHS Greater Glasgow and Clyde 109 posts

Lizzie said:
Well these are my results so far.

Hi Lizzie,
Just wanted to say well done for your results so far Smile

They look really good.

The only thing I would like to mention that may help (but hopefully not confuse matters) is I see from your diary that you have always injected in your stomach. Do you inject anywhere else or is it only in your Stomach?
If the same site is used over and over you can develop lumps (Lipo's) and these can cause the absorption rate for the Insulin to be different which may explain some unsual results.

I could be totally off the mark and this could well not be the case with you but just something to bear in mind that rotating injection sites is a good idea but I unserstand that (for me anyway) I find that the stomach is the least painful so I tend to inject maybe once or twice a day or when I am out-side as this is quite a discete place to inject.
Like I say, just a wee thought but well done for all your efforts so far and as Simon said earlier, when you see the good results written down it is a confidence boost that things are going well and helps explain why some readings may not be as good.

I wish you all the very best Very Happy

Cheers,
Anele.

January 25, 2012 14:47

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

Excellent observation Anele................

January 25, 2012 14:59

Anele46 DAFNE Graduate
NHS Greater Glasgow and Clyde 109 posts

novorapidboi26 said:
Excellent observation Anele................

Thanks Novorapidboi26 Very Happy

Lizzie,
Just another thing that I forgot to mention about injection sites, if you do change your injection sites and use one that hasn't been used before or in a long time you may see quite different results as the Insulin could be absorbed more quickly.

Cheers,
Anele.

January 25, 2012 15:18

Lizzie DAFNE Graduate
Guy's and St Thomas' Hospital 87 posts

Novorapidboi, that is a good point about waiting longer before correcting. Like I mentioned before, I tend to panic.

The numbers are not representative though, I am trying hard atm as I know I will be sharing these results with others. I think a large part of the problem as I mentioned is my eating and in order to monitor insulin I have needed to cut down on the CPs a little.

For breakfast I had 2 slices of toast (16g per slice according to bread packet), and a glass of fruit juice (200ml, 20g) so total 5CPs and I estimated 2.5:1 as I have been told people are more resistant in the mornings.

Anelo26, you are right about injecting in my stomach. It is the easiest place as I can just inject quickly under the table, I am not confident injecting through my clothes to my legs or arms and I donâ€™t want to go into a toilet to inject really either, it isnâ€™t hygienic. But I will try to use my thighs when I inject at home. When injected in my thigh before it has hurt, I think I must be doing it wrong somehow. The diagrams I see online say it should be done on the outside of the leg but it seemed less painful on the inside to me. I will try again.

Thanks both of you for your helpful comments.

January 25, 2012 15:28

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

Your carb count seems to be fine..................

People are more resistant in the morning through lack of activity in the muscles, so its quite common to have a higher ratio, I am on 3:1.........

If you unsure just do the tests, 2-3 days results, make a decision..........

Theoretically you should only be injecting once when out at work, for lunch...............I personally wear short sleeved t shirts most of the time so can inject into my arms no problem at work, but also use my stomach, and if I happen to need the toilet at the same time I will do it in there on my legs, I cant really see how its anymore unhygienic than outside the toilet.............it could be argued, but no one could provide any significant evidence to suggest its less hygienic to do it in there..........

You dont really inject on the outside or inside of the leg, its on the front, so the front facing part of the the thigh at the top.................another great location is your bum cheeks, I often inject there also..................I am quite fortunate to be in a good routine regards my sites, a habit I adopted from my younger diabetic brother when he was a child, he was diagnosed at 2, me 15...........

It can be significant though in terms of absorption and so can effect your dose adjustment decisions too..............

Dont beat yourself up about your results, the other alternative to it is not testing, and then you wouldn't know if they were good or bad, but it seems they are better than you expected, would you not agree?.

January 24, 2012 16:22 Lizzie DAFNE Graduate Guy's and St Thomas' Hospital 87 posts	Thanks, I think the best thing is to set an alarm. I panic because I am so terrified of complications. I have been told many people panic when they get hypo but I have never worried about that. I am lucky to have good warning signs so all it is is a quick check to make sure I am indeed hypo, then 20g carbs and that's it. I panic because I hate the idea that all the highs are having an effect which I will feel in years to come, like a sword suspended over my head. I worry that although there is no immediate effect, my body is storing it all up to suddenly dump on me in the future. That small unnoticeable changes are happening to tiny cells in my eyes, kidneys and nerve endings, and these will become apparent at some future date when my body decides it is going to let me down again. This probably all sounds crazy to you. I know I worry too much. I know my weight has nothing to do with my blood sugars, but try telling them that. Everything seems to be about weight. I don't understand why they wanted me to take Metformin as I was losing weight and doing well anyway. The last time I checked I was on 3:1 but that was before the Metformin. At lunch I tried 2:1.
January 24, 2012 16:29 Simon Site Administrator Sheffield Teaching Hospitals 578 posts	Lizzie said: I did try to access the handbook however I only got an error message. Apologies, Mark and I have been upgrading the site and some errors slipped through the net, the handbook is working again now I think novorapidboi is giving some real sound advice to you here. Don't underestimate the power of writing your readings down - if you can see them on paper (or on the diary here) then you will be able to notice trends and see where adjustments in dosage might need to be made. If you use the diary on here, even if you aren't able to spot the trends in the diary, you can share with other people and ask for advice - there are so many people helping each other out here. One comment: Lizzie said: I only really check my blood sugar when I feel high or low. I have stopped checking on a regular basis and stopped writing it down. I just feel low about it as every reading seems high or low and I don't know why. I'd say try and test more often, not only will it contribute to keeping a record of your sugars so that you can make adjustments; you may be pleasantly surprised and find that some readings are in range - which could show you that getting on-target readings is possible, and motivate you to keep track of and adjust your insulin doses.
January 24, 2012 16:52 Lizzie DAFNE Graduate Guy's and St Thomas' Hospital 87 posts	Hi Simon Thanks for mending the Handbook. I have entered a couple of tests in the Diary section already, did not realise how good it was. Thanks both for your help. Will try my best tonight and see how it goes.
January 25, 2012 11:11 Lizzie DAFNE Graduate Guy's and St Thomas' Hospital 87 posts	[Shared diary only visible when logged in] Well these are my results so far.
January 25, 2012 12:43 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	Lizzie said: Well these are my results so far. WOW, your results are quite good, better than you expected I would imagine............... For any roll I take them as 3 CPs, unless they are smaller than a normal sized one............have a look at the carb book on the site, there is also the book carbs and cals that you can get from amazon, this is really helpful also, I have this for mainly calories but comes in useful for carbs too......... A comment I would make is that you are not giving your insulin 5 hours to work, so leaving 5 hours between MAIN meals.............for example, between 13:40 and 16:41 is only 3 hours, so that 11.5 you corrected for would of still needed an extra hour, hour and a half to come down with the 16 units you injected at 13:40..................if you can do this you will know for sure whether your dose is right, and it looks pretty much there to me......... Your overnight numbers look to be good also, as you woke up the same as you went to bed with, this would suggest your BI dose of 28 is correct, however, do another couple of nights to confirm it............. I suspect your low may be down to too much insulin at breakfast or a miscalculation of the carbs, but you can only really go down that path once you know the BI is right............ What did you have for breakfast this morning................... Well done in doing the tests, you should be proud. I hope that seeing your results, which are really good by the way, has made you feel more confident that your BG control is good............the odd high number in amongst numbers like that will not do any harm whatsoever.......... Again, well done.................
January 25, 2012 14:31 Anele46 DAFNE Graduate NHS Greater Glasgow and Clyde 109 posts	Lizzie said: Well these are my results so far. Hi Lizzie, Just wanted to say well done for your results so far They look really good. The only thing I would like to mention that may help (but hopefully not confuse matters) is I see from your diary that you have always injected in your stomach. Do you inject anywhere else or is it only in your Stomach? If the same site is used over and over you can develop lumps (Lipo's) and these can cause the absorption rate for the Insulin to be different which may explain some unsual results. I could be totally off the mark and this could well not be the case with you but just something to bear in mind that rotating injection sites is a good idea but I unserstand that (for me anyway) I find that the stomach is the least painful so I tend to inject maybe once or twice a day or when I am out-side as this is quite a discete place to inject. Like I say, just a wee thought but well done for all your efforts so far and as Simon said earlier, when you see the good results written down it is a confidence boost that things are going well and helps explain why some readings may not be as good. I wish you all the very best Cheers, Anele.
January 25, 2012 14:47 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	Excellent observation Anele................
January 25, 2012 14:59 Anele46 DAFNE Graduate NHS Greater Glasgow and Clyde 109 posts	novorapidboi26 said: Excellent observation Anele................ Thanks Novorapidboi26 Lizzie, Just another thing that I forgot to mention about injection sites, if you do change your injection sites and use one that hasn't been used before or in a long time you may see quite different results as the Insulin could be absorbed more quickly. Cheers, Anele.
January 25, 2012 15:18 Lizzie DAFNE Graduate Guy's and St Thomas' Hospital 87 posts	Novorapidboi, that is a good point about waiting longer before correcting. Like I mentioned before, I tend to panic. The numbers are not representative though, I am trying hard atm as I know I will be sharing these results with others. I think a large part of the problem as I mentioned is my eating and in order to monitor insulin I have needed to cut down on the CPs a little. For breakfast I had 2 slices of toast (16g per slice according to bread packet), and a glass of fruit juice (200ml, 20g) so total 5CPs and I estimated 2.5:1 as I have been told people are more resistant in the mornings. Anelo26, you are right about injecting in my stomach. It is the easiest place as I can just inject quickly under the table, I am not confident injecting through my clothes to my legs or arms and I donâ€™t want to go into a toilet to inject really either, it isnâ€™t hygienic. But I will try to use my thighs when I inject at home. When injected in my thigh before it has hurt, I think I must be doing it wrong somehow. The diagrams I see online say it should be done on the outside of the leg but it seemed less painful on the inside to me. I will try again. Thanks both of you for your helpful comments.
January 25, 2012 15:28 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	Your carb count seems to be fine.................. People are more resistant in the morning through lack of activity in the muscles, so its quite common to have a higher ratio, I am on 3:1......... If you unsure just do the tests, 2-3 days results, make a decision.......... Theoretically you should only be injecting once when out at work, for lunch...............I personally wear short sleeved t shirts most of the time so can inject into my arms no problem at work, but also use my stomach, and if I happen to need the toilet at the same time I will do it in there on my legs, I cant really see how its anymore unhygienic than outside the toilet.............it could be argued, but no one could provide any significant evidence to suggest its less hygienic to do it in there.......... You dont really inject on the outside or inside of the leg, its on the front, so the front facing part of the the thigh at the top.................another great location is your bum cheeks, I often inject there also..................I am quite fortunate to be in a good routine regards my sites, a habit I adopted from my younger diabetic brother when he was a child, he was diagnosed at 2, me 15........... It can be significant though in terms of absorption and so can effect your dose adjustment decisions too.............. Dont beat yourself up about your results, the other alternative to it is not testing, and then you wouldn't know if they were good or bad, but it seems they are better than you expected, would you not agree?.