Result. - DAFNE Online

September 24, 2012 19:39

AshleyB DAFNE Graduate
King's College Hospital NHS Foundation Trust 10 posts

Hello, Ive just been looking into your readings. Please don't take it as gospel but this is what my wife and I think.
Firstly you mentioned your not feeling 100% so straight away that makes me think you may need to change your base line insulin.
Also you are eating again after your second base line at dinner coz your going low in the evening\night. Maybe you should lower your evening BI by 2 or 4 units 20%.
Your morning BI could be too low or your morning ratio for breakfast QA is wrong.
I was advised not to change to many things at once. Test you morning BI and evening BI First.
Try carb free dinner etc
Try a carb free breakfast and lunch to get your morning BI right.
Please don't correct After night hypo's, DAFNE's golden rule " hypo in the night ajust evening BI by 2-4 unit 20%".
Maybe you need to inject your QA in your stomach more so you get the insulin quicker.
This is what think, I hope some of this information is helpful, please take a look at the online handbook to look at sick day rules. Maybe useful.
Thanks
AshleyB

September 24, 2012 19:44

AshleyB DAFNE Graduate
King's College Hospital NHS Foundation Trust 10 posts

If you increase morning BI do it by 2 or 3 not 1

Thanks
AshleyB

September 24, 2012 20:17

JayBee DAFNE Graduate
James Paget University Hospitals NHS Foundation Trust 587 posts

AshleyB said:
Hello, Ive just been looking into your readings. Please don't take it as gospel but this is what my wife and I think.

No probs!

Firstly you mentioned your not feeling 100% so straight away that makes me think you may need to change your base line insulin.

Maybe.

Also you are eating again after your second base line at dinner coz your going low in the evening\night.

I eat again after dinner usually because it's desert! ;P I know it's a bad practice to split my meal but at least I'm not snacking to get through the night. Also, that 3.9BG during the night may have been caused by the before bed correction so I'm not going to say BI just yet. That time was pretty strange.. 1QA would drop me by 8BG... I was taking 17 BI in the evening then though.

Maybe you should lower your evening BI by 2 or 4 units 20%.

I do already have some concerns with the evening BI so this is why I'm doing the 3am tonight. Smile

In all honesty, it's work in progress. I'm not 100% on the evening BI being right. I did have it at 15BI briefly before this, but when I hit some highs after dinner before bed (I will add the day on this post - period 14Sept to 18Sept - to help) on that occasion, it was decided that I'd change back to 16 and try adjusting the meal ratio instead first. Hasn't done too bad so far, so I'm back to checking the overnight testing... I've given it at least 4 days too to work out if 1:1 works (which it seems to rather well).

Your morning BI could be too low or your morning ratio for breakfast QA is wrong.

I often hypo without fail for 1:1 meal ratios based on past trials so I'm gonna take this as yes, try 13BI tomorrow and see how it goes... however, I may change my mind if I hypo at 3am... decisions, decisions! I feel so spoilt for choice on what to fix first! XD Hypos any time sure are a pain in the bum!

I appreciate some of the advice - most of it was not needed. Thanks though. Smile

I hope you don't have as much trouble as vic and I have had over the 3 years since doing DAFNE.

AshleyB said:
If you increase morning BI do it by 2 or 3 not 1

I am insulin sensitive so often 2 can be too much. Sad

This is something you may come across if you're an active person... DAFNE is not set in stone - it is just a guide; you will need to learn your needs by adjusting the guide.

September 25, 2012 06:22

AshleyB DAFNE Graduate
King's College Hospital NHS Foundation Trust 10 posts

Just to let you know, I am a man. Don't want any confussion. I didn't take offence JWo. LOL x

Its really P ing me off at the min as i'm always high and making corrections. I can't wait to get on the levimur to get a steady BI.

Over the last 14 days ive averaged 13mmol/L

Vic what BI do you take, mines Lanctus at the minute.

AshleyB a Bloke lol..

September 25, 2012 06:26

AshleyB DAFNE Graduate
King's College Hospital NHS Foundation Trust 10 posts

I miss read JWo, I know you didn't think i'm a woman, I've got my morning eye in. Shocked

September 25, 2012 06:54

AshleyB DAFNE Graduate
King's College Hospital NHS Foundation Trust 10 posts

Thanks Vic, On the course it was proven that my lanctus wasn't lasting the full day with me, maybe because of my fast metabolic rate of burning energy.

Any how once ive moved over to levimur i will upload some diary entries so you guys can have a look.

Hopefully i will have pages of Greens readings,

I do tend to eat a lot and not inject when snacking and add the CP's to the next meal. Maybe I should start actually using the priciples of injecting followed by eating.

Razz

September 25, 2012 11:58

JayBee DAFNE Graduate
James Paget University Hospitals NHS Foundation Trust 587 posts

AshleyB said:
I miss read JWo, I know you didn't think i'm a woman, I've got my morning eye in.

No worries! Don't you just love the confusion of the internet? ;P

The over night results and today's results so far have been interesting! I'm starting to think that perhaps the illness/stress/whatever the hell it was is easing up now and my "normal" numbers are back... have a lookie above (the diary will also automatically update as I do my blood tests still)!

Based on these numbers (especially if they stay fairly consistent to the past few days) I will be putting my morning BI up tomorrow for sure now. Very Happy

My HbA1c has been around 8.9-9% consistently for the last year or so but it has started dropping (my last one back in June/July was 8.4% which for someone who's not seen a drop for a very long time, after a lot of DAFNE work too, this is a massive achievement - something is now working!). With all the extra personal troubles I've had in the past year or so though, to have numbers so much easier to work with, I could cry with happiness now!

Things can only get better! Smile

I'm so glad we can all relate. It's so important to realise that this condition will never been all black and white, and you're only working against yourself if you generalise with the knowledge. DAFNE is a guideline that encourages adjustment through pattern searching - an excellent help to those who need it (which imo should be everyone anyway, especially newly diagnosed!).

Sorry, I'll pipe down now... touched into my "DAFNE advocacy mode" a bit there, lol. XD

AshleyB said:
Any how once ive moved over to levimur i will upload some diary entries so you guys can have a look.
Hopefully i will have pages of Greens readings,

Looking forward to it! Smile

I was another that was on Lantus and then I moved to Levemir. I can't imagine going back. Levemir has been way too helpful. Lantus used to run out shortly after lunch for me and I was like that for years before I did DAFNE. Went split dose after the discovery and after still having problems, I moved to Levemir because "it's an insulin designed for split dosing" I was told. Smile

A lot less trouble - it's almost like it's not as "strong" as Lantus so less prone to hypos. Sweet relief!

September 25, 2012 12:53

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

Spread the joy........ Very Happy

September 25, 2012 19:02

JayBee DAFNE Graduate
James Paget University Hospitals NHS Foundation Trust 587 posts

vic, you've really got to try and stop those every day changes to ratios and BI... it's making it impossible to understand your BG patterns. Best to leave it at least two days to make sure that nothing else caused the lows/highs (like I've done the past few days with illness/stress in consideration). Sad

If you return to the last day you had the least amount of hypos (if none at all, that's even better) and build from there? You know, bit like I did with the 11/17BI change... it'll help get a stable base again to work with (Day I did it showing above - when to those doses because I'd got evidence of the BIs being correct overnight definitely and during the morning only). How stuff has changed since then... I can't be far off now hopefully (though when I start thinking this, often my body decides to be a sod the next day!).

Do really feel for you though. Life was hell when I was adjusting my BI with 1:1 across all meals. Sad

September 25, 2012 19:58

JayBee DAFNE Graduate
James Paget University Hospitals NHS Foundation Trust 587 posts

Has anyone else kept most of their old BG diaries?

I'm trying to pin point when I changed on to Lantus exactly and then Levemir... have learnt that I split Lantus little under two months after doing DAFNE though (May 22nd 2009 to be precise - see above! XD). Those afternoon highs are unmistakable... I can't get over the fact that no one picked up on it sooner considering corrections are all over the place in my even older, pre-DAFNE, diaries. It makes me kind of sad... Sad

Edit: After some more reading, decided to add my findings to my forum profile Smile

I changed from Humalin I to Lantus in 2007.
I first started split dosing on Lantus on 22/05/2009; roughly two months after doing DAFNE.
Changed from Lantus to Levemir on 24/09/2010.
For my QAs, I have been on Humalog for as long as I can remember!

How times change! Very Happy

Edit no.2:
Yes, I am a bit of a hoarder I suppose. Razz

September 24, 2012 19:39 AshleyB DAFNE Graduate King's College Hospital NHS Foundation Trust 10 posts	Hello, Ive just been looking into your readings. Please don't take it as gospel but this is what my wife and I think. Firstly you mentioned your not feeling 100% so straight away that makes me think you may need to change your base line insulin. Also you are eating again after your second base line at dinner coz your going low in the evening\night. Maybe you should lower your evening BI by 2 or 4 units 20%. Your morning BI could be too low or your morning ratio for breakfast QA is wrong. I was advised not to change to many things at once. Test you morning BI and evening BI First. Try carb free dinner etc Try a carb free breakfast and lunch to get your morning BI right. Please don't correct After night hypo's, DAFNE's golden rule " hypo in the night ajust evening BI by 2-4 unit 20%". Maybe you need to inject your QA in your stomach more so you get the insulin quicker. This is what think, I hope some of this information is helpful, please take a look at the online handbook to look at sick day rules. Maybe useful. Thanks AshleyB
September 24, 2012 19:44 AshleyB DAFNE Graduate King's College Hospital NHS Foundation Trust 10 posts	If you increase morning BI do it by 2 or 3 not 1 Thanks AshleyB
September 24, 2012 20:17 JayBee DAFNE Graduate James Paget University Hospitals NHS Foundation Trust 587 posts	AshleyB said: Hello, Ive just been looking into your readings. Please don't take it as gospel but this is what my wife and I think. No probs! Firstly you mentioned your not feeling 100% so straight away that makes me think you may need to change your base line insulin. Maybe. Also you are eating again after your second base line at dinner coz your going low in the evening\night. I eat again after dinner usually because it's desert! ;P I know it's a bad practice to split my meal but at least I'm not snacking to get through the night. Also, that 3.9BG during the night may have been caused by the before bed correction so I'm not going to say BI just yet. That time was pretty strange.. 1QA would drop me by 8BG... I was taking 17 BI in the evening then though. Maybe you should lower your evening BI by 2 or 4 units 20%. I do already have some concerns with the evening BI so this is why I'm doing the 3am tonight. In all honesty, it's work in progress. I'm not 100% on the evening BI being right. I did have it at 15BI briefly before this, but when I hit some highs after dinner before bed (I will add the day on this post - period 14Sept to 18Sept - to help) on that occasion, it was decided that I'd change back to 16 and try adjusting the meal ratio instead first. Hasn't done too bad so far, so I'm back to checking the overnight testing... I've given it at least 4 days too to work out if 1:1 works (which it seems to rather well). Your morning BI could be too low or your morning ratio for breakfast QA is wrong. I often hypo without fail for 1:1 meal ratios based on past trials so I'm gonna take this as yes, try 13BI tomorrow and see how it goes... however, I may change my mind if I hypo at 3am... decisions, decisions! I feel so spoilt for choice on what to fix first! XD Hypos any time sure are a pain in the bum! I appreciate some of the advice - most of it was not needed. Thanks though. I hope you don't have as much trouble as vic and I have had over the 3 years since doing DAFNE. AshleyB said: If you increase morning BI do it by 2 or 3 not 1 I am insulin sensitive so often 2 can be too much. This is something you may come across if you're an active person... DAFNE is not set in stone - it is just a guide; you will need to learn your needs by adjusting the guide.
September 25, 2012 06:22 AshleyB DAFNE Graduate King's College Hospital NHS Foundation Trust 10 posts	Just to let you know, I am a man. Don't want any confussion. I didn't take offence JWo. LOL x Its really P ing me off at the min as i'm always high and making corrections. I can't wait to get on the levimur to get a steady BI. Over the last 14 days ive averaged 13mmol/L Vic what BI do you take, mines Lanctus at the minute. AshleyB a Bloke lol..
September 25, 2012 06:26 AshleyB DAFNE Graduate King's College Hospital NHS Foundation Trust 10 posts	I miss read JWo, I know you didn't think i'm a woman, I've got my morning eye in.
September 25, 2012 06:54 AshleyB DAFNE Graduate King's College Hospital NHS Foundation Trust 10 posts	Thanks Vic, On the course it was proven that my lanctus wasn't lasting the full day with me, maybe because of my fast metabolic rate of burning energy. Any how once ive moved over to levimur i will upload some diary entries so you guys can have a look. Hopefully i will have pages of Greens readings, I do tend to eat a lot and not inject when snacking and add the CP's to the next meal. Maybe I should start actually using the priciples of injecting followed by eating.
September 25, 2012 11:58 JayBee DAFNE Graduate James Paget University Hospitals NHS Foundation Trust 587 posts	AshleyB said: I miss read JWo, I know you didn't think i'm a woman, I've got my morning eye in. No worries! Don't you just love the confusion of the internet? ;P The over night results and today's results so far have been interesting! I'm starting to think that perhaps the illness/stress/whatever the hell it was is easing up now and my "normal" numbers are back... have a lookie above (the diary will also automatically update as I do my blood tests still)! Based on these numbers (especially if they stay fairly consistent to the past few days) I will be putting my morning BI up tomorrow for sure now. My HbA1c has been around 8.9-9% consistently for the last year or so but it has started dropping (my last one back in June/July was 8.4% which for someone who's not seen a drop for a very long time, after a lot of DAFNE work too, this is a massive achievement - something is now working!). With all the extra personal troubles I've had in the past year or so though, to have numbers so much easier to work with, I could cry with happiness now! Things can only get better! I'm so glad we can all relate. It's so important to realise that this condition will never been all black and white, and you're only working against yourself if you generalise with the knowledge. DAFNE is a guideline that encourages adjustment through pattern searching - an excellent help to those who need it (which imo should be everyone anyway, especially newly diagnosed!). Sorry, I'll pipe down now... touched into my "DAFNE advocacy mode" a bit there, lol. XD AshleyB said: Any how once ive moved over to levimur i will upload some diary entries so you guys can have a look. Hopefully i will have pages of Greens readings, Looking forward to it! I was another that was on Lantus and then I moved to Levemir. I can't imagine going back. Levemir has been way too helpful. Lantus used to run out shortly after lunch for me and I was like that for years before I did DAFNE. Went split dose after the discovery and after still having problems, I moved to Levemir because "it's an insulin designed for split dosing" I was told. A lot less trouble - it's almost like it's not as "strong" as Lantus so less prone to hypos. Sweet relief!
September 25, 2012 12:53 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	Spread the joy........
September 25, 2012 19:02 JayBee DAFNE Graduate James Paget University Hospitals NHS Foundation Trust 587 posts	vic, you've really got to try and stop those every day changes to ratios and BI... it's making it impossible to understand your BG patterns. Best to leave it at least two days to make sure that nothing else caused the lows/highs (like I've done the past few days with illness/stress in consideration). If you return to the last day you had the least amount of hypos (if none at all, that's even better) and build from there? You know, bit like I did with the 11/17BI change... it'll help get a stable base again to work with (Day I did it showing above - when to those doses because I'd got evidence of the BIs being correct overnight definitely and during the morning only). How stuff has changed since then... I can't be far off now hopefully (though when I start thinking this, often my body decides to be a sod the next day!). Do really feel for you though. Life was hell when I was adjusting my BI with 1:1 across all meals.
September 25, 2012 19:58 JayBee DAFNE Graduate James Paget University Hospitals NHS Foundation Trust 587 posts	Has anyone else kept most of their old BG diaries? I'm trying to pin point when I changed on to Lantus exactly and then Levemir... have learnt that I split Lantus little under two months after doing DAFNE though (May 22nd 2009 to be precise - see above! XD). Those afternoon highs are unmistakable... I can't get over the fact that no one picked up on it sooner considering corrections are all over the place in my even older, pre-DAFNE, diaries. It makes me kind of sad... Edit: After some more reading, decided to add my findings to my forum profile I changed from Humalin I to Lantus in 2007. I first started split dosing on Lantus on 22/05/2009; roughly two months after doing DAFNE. Changed from Lantus to Levemir on 24/09/2010. For my QAs, I have been on Humalog for as long as I can remember! How times change! Edit no.2: Yes, I am a bit of a hoarder I suppose.