No DAFNE specialist nurse

The PCT(Medway) that I took my DAFNE with no longer has a specialist DAFNE Diabetes nurse.
I am having problems with my BG control currently and would like to speak to somebody one-to-one to try and sort this out. Despite leaving several messages with the diabetes centre I'm getting no help.
How can I swap to a neighbouring PCT/Hospital? I live in the neihbouring area(Maidstone) but my GP is in the same as Diabetes centre(Medway).
Or is there another alternative?

It would be good to have phone/face to face contact with someone who knows the DAFNE regime, however you can get advice on here from the various HCPs that frequent the forum, and obviously us fellow DAFNE graduates...........

What are the chances of signing up to the clinic where you live, Maidstone?

The location of your GP is irrelevant as he/she shouldn't be dealing with your primary care......

Do they do DAFNE?

Hello Chris
I did my DAFNE course at Maidstone hospital, and very good it was. They have a Diabetes centre - you could try contacting them, the phone number is 224406, but very often there's no one there, but you can leave a message. There is a DAFNE educator called Anne Cox - she might be able to help you.

Thanks for the replies. I could try on here, but it is difficult to put into words the issues. I basically need a refresher/kick-up the backside as I did DAFNE in 2007 and now cant seem to get my BG under control working shifts as I do now. One week I'm running high, the next I suffer from lows.
Alan - I've spoken to Maidstone but need to be referred by my GP. My surgery tells me I need to speak to my consultant - and my consultant said he would write to the SDN team but he didn't. I think I'll have to book an appt with my GP persoanlly to get anything done.

I tried again this afternoon and actually spoke to a SDN who told me she had been working to arrange some help for me since I first called in January. Would have been good if somebody told me!! I've now called and left messages 4 times. I appreciate these people are underpaid/overworked but they could benefit from some communication training.

I'm going to give it a week before I finally give up with Medway. See if they can get me some help.

I hope you can get some face to face care soon....................

In the meantime, how is your background insulin?

What background insulin are you on and when?

Well the diabetes Centre have written to a diabetes Nutritionist they have who knows DAFNE and are awaiting response. In the meantime I'm still struggling so I've booked a GP appt to get me referred to Maidstone.
I've put my last weeks figures down. I'm on Novorapid and Levemir. As you can see I'm struggling.

My first observation is your lows in the afternoon, this seems to be happening because you are eating at about 10-11, injecting for it, then having lunch a few hours later, but you have corrected at the lunch time, when you shouldn't have, also your carb amounts are quite big also, which makes it harder to control..................the less carbs, the easier it is........

Its hard to spot a specific problem but I would be tempted, if I was you, to test the daytime BI dose with some carb free meals. Just to see if that dose can help get the numbers down before you start on your insulin/carb ratios........

your overnight BI dose seems OK, but again, testing is the best way to find out..........

Why shouldn't I correct at lunchtime if still high? Because its too close to the snack? I must admit I struggle to resist the warm bacon rolls when they come around and I've had an early breakfast, this is something I can cut out. However eating carb free is very difficult whan you work in town and rely on Pret/Eat/Subway etc!
My main concern is when I'm high getting my BG down seems difficult. This morning I woke up with a BG of 18!! I had gone to bed with a BG of 9. So I may have gone low overnight, but I adjusted for it with a +6. At 1pm my BG was still 10.
I feel I've lost control. I know if I went back to fixed meals/times it would be easier, but thats the whole reson I went on DAFNE - to cope with my work/lifestyle.

In your particular case you should not of corrected at lunch because you already had insulin working away at this time, at its peak near enough................you only correct if you have no QA insulin active, ie...4-5 hours after last injection............

Resisting snacks is hard, I know from personal experience............I think the most important point for you would be consistency, if you have this snack every day, you can spot patterns and adjust your insulin for it......

When I mentioned carb free I was purely referring to basal insulin testing, it isn't permanent, just sometimes necessary when testing background insulin, but there are many things you can have that are carb free, meats, cheese, salad.........

I would do the same tonight, have your dinner as normal, then nothing till the next morning, set an alarm for 3 am, record your BG at that time.............this will tell you if your going low at night, resulting in the high...........you can repeat this test to confirm..............if all is well overnight you need more BI in the evening........

DAFNE states that 1 unit of insulin drops the blood sugar level by 2-3mmol/l....................but it also states that above 11mmol/l this observation may not apply............this is the case for me.......and in my personal opinion, for everyone else to varying degrees.............so the higher you are the more you need to bring you down.................if I was 18, I would take 13 units to bring me down to 5.5, so 1 unit brings me down 1mmol/l.........

below 10 - 1 unit drops 2.5mmol/l
10-13 - 1 unit drops 2mmol/l
13-17 - 1 unit drops 1.5mmol/l
above 17 - 1 unit drops 1mmol/l

Everyone is different, I worked mine out by assuming 1 unit drops me by 2.5 at all levels, then, provided the carb count is right, recorded how much 1 unit actually dropped me by at certain levels.........

It took time, but was worth it.............I would recommend a similar investigation for yourself............

DAFNE does provide flexibility, but a lesson I have learned over the years is that you need to fine tune those principals for yourself, and sometimes the control you want just cant be achieved without dramatic changes to diet, I have been cutting my daily carb load, reluctantly, but its giving me the results I want............sometimes DAFNE cannot provide all the answers........

Sorry if I rambled on a bit there...............

Don't apologise, all very helpful. The above 11mmol thing I dont remember from my course so I either forgot or it was added later as I did mine in 2007. Would make sense. I'm one of those people that hates even mild hypos so tends to err on the side of caution.
You're right about night testing, haven't done it for a while. Will try and do it sometime this week.