Redoing DAFNE???

Lizzie said:
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 don’t want to go into a toilet to inject really either, it isn’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.

So more of my usual levels are creeping back even though I am doing my best, I thought it was too good to be true I have no sense of why they were so good yesterday or why they are bad today at all. I ate virtually the same things and measured everything carefully. This is why I can't do this, I can't rely on others to make sense of it but it makes no sense to me

I have included some of my diary entries from last week to show you I get some high too..............Monday was terrible, Wednesday much better...........

Dont be so hard on yourself, you are doing your best, but its apparent that your doses are not right somewhere, so you need to investigate them and while doing the investigating you are not going to get perfect results, in fact you will never get perfect results, its diabetes after all............a 10 and 11 are not that bad.................

My first observation is that you corrected your 11.7 overnight and woke up spot on, so you can assume your 22:20 BI dose of 28 is right, this was the case yesterday as well, so that is looking good...........

My second observation is that your blood sugar held steady from 14:30 to 19:00, which would also suggest your BI needs during the day are also being satisfied, which is again good news for your single BI dose. If it wasn't good enough during the day you might want to consider a split BI dose...........I take 32 in the morning, and 38 at night because of my different needs from night to day..........but as I say, it seems all is well for you at first glance.........

This means its likely your QA insulin/carb ratios that are out, which is normal, these can change from week to week in some folk unfortunately.............

So, your low at 10:00 yesterday may be down to your 2.5:1 ratio, which I see you dropped to 2:1 in an attempt to stop it again, so well done, however, if following the DAFNE principals, you should really wait till you see a pattern of lows before changing your ratio, as the hypo might of just been one of those things...................so I would recommend going back to 2.5:1 and just be prepared for a hypo.........if you get 2-3 days going low, you can be sure to drop it to 2:1...........

Today you were high at 10:49 at 2:1, again one reading cant confirm whats really going on................

Yesterday by 23:45, when your 19:00 dose of 12 should of been finished, you were high, which could suggest your tea time ratio of 2:1 is wrong, so that will need changed, only after you see a pattern [2-3 days] and only after you have finished with the morning ratio.............

You dont necessarily need to get your morning ratio right before you tackle the evening ratio, but you should only focus on one thing at a time to eliminate as many variables as you can.......

Your control is not bad at all, it very reasonable actually, just a few things to tweak, but you need to realize that your whole life will be like this, constantly tweaking your insulin to cater for your ever changing needs................we all have to do it, and that's why getting into the habit of writing everything down is so important...........

If I can add another thought for you - I am on Lantus and Humalog, and I found that whilst the claims for Lantus were that it would last the 24hrs, and so 1 injection a day would suffice, I found that having the 1 and only Lantus injection at 2100hrs every night, resulted in higher readings from about 5pm onwards, and for a while it was causing a bit of confusion. I then split the 9pm dose equally and now have 2 injections, 1 at 0900 and the other at 2100.

I think the reason for this raising, is that, for me, the Lantus was not lasting the 24hrs, it was only lasting 18 or 19 hours which meant that towards the end of the 24hr period the sugar levels were rising. They would continue to rise even after the 2100 inject, as it has a slow rate of absorption, and so would not get working for a few hours. By splitting it there is always some in the system, and for me it was the answer.

SimonC said:
If I can add another thought for you - I am on Lantus and Humalog, and I found that whilst the claims for Lantus were that it would last the 24hrs, and so 1 injection a day would suffice, I found that having the 1 and only Lantus injection at 2100hrs every night, resulted in higher readings from about 5pm onwards, and for a while it was causing a bit of confusion. I then split the 9pm dose equally and now have 2 injections, 1 at 0900 and the other at 2100.

I think the reason for this raising, is that, for me, the Lantus was not lasting the 24hrs, it was only lasting 18 or 19 hours which meant that towards the end of the 24hr period the sugar levels were rising. They would continue to rise even after the 2100 inject, as it has a slow rate of absorption, and so would not get working for a few hours. By splitting it there is always some in the system, and for me it was the answer.

If I had my way everyone would be on a split BI dose............................

Unfortunately, many HCPs just cant see past it, and many patients cant see how a split dose would benefit them..................

If you were on a pump it is likely you would have many more than 2 different delivery rates throughout a 24 hour period..........

Hi Lizzie,
As a nutrition undergraduate and a type 1 diabetic, from my experience I think why your doctors focus on your weight is because being overweight can cause insulin resistance and metformin is a drug designed to overcome insulin resistance. I understand why you seem frustrated with doctors advice, I feel the same sometimes especially when it is clear that they have learnt diabetes from a text book and in real life its not always like that! I have a group of doctors treating me at the moment however that are great. I don't know your weight (and you dont have to tell me ) but keeping your weight as normal as possible ,and you can do this with exercise, both will help the resistance and you may hopefully see a change in your sugars although they look better than you think! Please don't worry too much about the complications, you are trying to look after yourself and that is the important thing, and attending regular checkups will highlight any problems (should any arise) so they are treated immediately. Stay positive

Hi and thanks all for your helpful advice. I just wanted to say I am still persevering and haven't gone away but it was very busy at work yesterday so i didn't have a chance to reply.

If I wanted to split my Lantus (haven't yet decided), does anyone have any advice?

Sarahlou I know being fat can cause insulin resistance. I am prepared to admit that I could lose some weight. But I feel that doctors do not give natural means like healthy diets and exercise enough of a chance. I would love to be given more support to lose weight in that way. If the doctors supported me in trying to eat more healthily and took a positive outlook on the whole thing then I would be happy. But instead they are very negative, scaremongering and nagging all the time and forcing drugs and surgery on people unecessarily. If people want to quit smoking they are given free counselling, quit kits etc all on the NHS. Of course that is right, they should be given support. But I just think people trying to lose weight should get similar support, like counselling or cookery classes, exercise groups etc. It should be given more of a positive slant instead of nagging, you can't eat this, you shouldn't do that. And also they focus too much on weight when they should be focusing on health - losing weight is not necessarily healthy in itself unless it is the result of a balanced diet and exercise. All this is IMHO of course.

Every clinic is different I suppose, but mine dont hassle me about weight, and I am 5 stone overweight..................

They can see I am proactive in my approach to get my blood sugar under control, and they understand that in doing so, I might have to put on a few pounds, or in my case stones..........

I think you should concentrate on you blood glucose control for now, get in to the habit of testing and experimenting with different foods, build up a database of knowledge specific to you, then think about cutting out carbs and eating more healthy...........

For a week I reduced my carb amount significantly, so just meat and veg etc................and the results were brilliant, blood sugars much more easily managed, and the less carbs you have, the less calories are going in.............so for me, this looks like a good plan for the future, not carb free, but reduced carbs....................although I have still to adopt this plan........

novorapidboi26 said:
For a week I reduced my carb amount significantly, so just meat and veg etc................and the results were brilliant, blood sugars much more easily managed, and the less carbs you have, the less calories are going in.............so for me, this looks like a good plan for the future, not carb free, but reduced carbs....................although I have still to adopt this plan........