DAFNE to PUMP conversion

June 05, 2015 14:32

Hightower DAFNE Graduate
St Columcille's, Dublin 8 posts

Hi David, I have completed the DAFNE Pump course here in Dublin. The general rule is that if the hypo is close to your mealtime (within 3 hrs) its usually your bolus that needs to be adjusted. If its after this time it your basal. Have you been shown how to adjust your bolus and basal settings depending on readings.

June 22, 2015 05:57

Kahanamoku DAFNE Graduate
Monash Health Community, Victoria 8 posts

Hightower said:
The general rule is that if the hypo is close to your mealtime (within 3 hrs) its usually your bolus that needs to be adjusted. If its after this time it your basal.

I think you have your Basal and Bolus confused... Bolus is the Meal Dose along with any associated +/- corrections (subject to your pumps Insulin Duration - typically 3-4 hours)... Basal being the always delivered rate. Basal is what you adjust if you are having drop offs in BSL outside of your active insulin durations.

June 22, 2015 05:58

Kahanamoku DAFNE Graduate
Monash Health Community, Victoria 8 posts

ooooh,, you meant "close to mealtime" as in closely "after" Confused
I read that as Close to your NEXT meal.

June 22, 2015 15:27

David Hales DAFNE Graduate
Calderdale and Huddersfield NHS Foundation Trust 12 posts

I'm more confused than ever now
To clarify for a person of small brain (me)...
if a hypo is within three hours after a meal, it is the bolus that needs adjusting and if a hypo is over three hours after a meal then look at the basal.
What if the blood sugar is HIGH before a meal? Which needs adjustment then? I suppose - like most things with the balance conundrum - "it depends".
All the people that help are much appreciated - it helps me to think about things and learn from other people's experience.

June 23, 2015 08:59

Susanf DAFNE Graduate
St Columcille's, Dublin 29 posts

Kahanamoku said:
ooooh,, you meant "close to mealtime" as in closely "after"
I read that as Close to your NEXT meal.

Yes - within 3 hours of your recent meal

June 23, 2015 09:15

Susanf DAFNE Graduate
St Columcille's, Dublin 29 posts

Hi David,

If you have a hypo within 3 hours of your meal/bolus then its the bolus that needs to be reduced. If you have a high blood sugar before a meal it can be that you didnt take enough bolus at your last meal or your basal is not sufficient. What you would need to do to rule out your basal is do the fasts.

If you want to test your morning basal you Test your blood sugar on waking and continue to fast from the night before until lunchtime. When you take your BS at lunchtime it should be within 1.7mmol of your breakfast BS reading. If it is higher or lower you need to adjust your Basal accordingly.

If you want to test your lunchtime to teatime basal you have your breakfast, take your normal bolus and then test again at lunchtime but fast until tea time. Again it should be within 1.7mmol of your lunch BS reading. If it is higher or lower you need to adjust your Basal accordingly.

And so on then for your evening Basal. Once you have ruled your basal out then you can start adjusting your bolus ratios.

Hope this makes more sense Very Happy

June 24, 2015 10:42

David Hales DAFNE Graduate
Calderdale and Huddersfield NHS Foundation Trust 12 posts

That's great. You are a star - very clear and helpful. Thanks very much. javascript:emoticon(' Very Happy ')

June 05, 2015 14:32 Hightower DAFNE Graduate St Columcille's, Dublin 8 posts	Hi David, I have completed the DAFNE Pump course here in Dublin. The general rule is that if the hypo is close to your mealtime (within 3 hrs) its usually your bolus that needs to be adjusted. If its after this time it your basal. Have you been shown how to adjust your bolus and basal settings depending on readings.
June 22, 2015 05:57 Kahanamoku DAFNE Graduate Monash Health Community, Victoria 8 posts	Hightower said: The general rule is that if the hypo is close to your mealtime (within 3 hrs) its usually your bolus that needs to be adjusted. If its after this time it your basal. I think you have your Basal and Bolus confused... Bolus is the Meal Dose along with any associated +/- corrections (subject to your pumps Insulin Duration - typically 3-4 hours)... Basal being the always delivered rate. Basal is what you adjust if you are having drop offs in BSL outside of your active insulin durations.
June 22, 2015 05:58 Kahanamoku DAFNE Graduate Monash Health Community, Victoria 8 posts	ooooh,, you meant "close to mealtime" as in closely "after" I read that as Close to your NEXT meal.
June 22, 2015 15:27 David Hales DAFNE Graduate Calderdale and Huddersfield NHS Foundation Trust 12 posts	I'm more confused than ever now To clarify for a person of small brain (me)... if a hypo is within three hours after a meal, it is the bolus that needs adjusting and if a hypo is over three hours after a meal then look at the basal. What if the blood sugar is HIGH before a meal? Which needs adjustment then? I suppose - like most things with the balance conundrum - "it depends". All the people that help are much appreciated - it helps me to think about things and learn from other people's experience.
June 23, 2015 08:59 Susanf DAFNE Graduate St Columcille's, Dublin 29 posts	Kahanamoku said: ooooh,, you meant "close to mealtime" as in closely "after" I read that as Close to your NEXT meal. Yes - within 3 hours of your recent meal
June 23, 2015 09:15 Susanf DAFNE Graduate St Columcille's, Dublin 29 posts	Hi David, If you have a hypo within 3 hours of your meal/bolus then its the bolus that needs to be reduced. If you have a high blood sugar before a meal it can be that you didnt take enough bolus at your last meal or your basal is not sufficient. What you would need to do to rule out your basal is do the fasts. If you want to test your morning basal you Test your blood sugar on waking and continue to fast from the night before until lunchtime. When you take your BS at lunchtime it should be within 1.7mmol of your breakfast BS reading. If it is higher or lower you need to adjust your Basal accordingly. If you want to test your lunchtime to teatime basal you have your breakfast, take your normal bolus and then test again at lunchtime but fast until tea time. Again it should be within 1.7mmol of your lunch BS reading. If it is higher or lower you need to adjust your Basal accordingly. And so on then for your evening Basal. Once you have ruled your basal out then you can start adjusting your bolus ratios. Hope this makes more sense
June 24, 2015 10:42 David Hales DAFNE Graduate Calderdale and Huddersfield NHS Foundation Trust 12 posts	That's great. You are a star - very clear and helpful. Thanks very much. javascript:emoticon('')