DAFNE Myths

As long as you dont starve yourself for a good length of time, theoretically meals can be missed, but as you say, ketones will be produced if energy is not coming from the carbs, but this is OK, if there is insulin present to process them.........

I agree with Athena - It would be good to have someone explain why these statements are false because they are clearly confusing some of us.

Just to touch back on my question about correcting after hypos - if I am supposed to be able to correct within the 24 hours after a hypo like I have not been able to without having another hypo, is it reasonable to assume that I have too much background if I do hypo again, especially when I'm 100% sure the CP calculation is correct (on the basis that all my ratios are 1:1 currently that is)?

To be honest, it would suit me a lot more if I could do that to make adjustments a lot sooner than having to wait for the 24 hour period before pattern searching again - however, considering no one is defending the statements (I know some have responded to questions, like myself but I mean defending the original item itself), it is difficult to take this thread seriously.

If you suspect your BI dose or doses are out, then test them, then you will know...........and the end result may be that you are just too sensitive after a hypo that you need to wait a while before correcting.......

The way the presentation is written up, with just a list of myths and misconceptions, is very unclear to me. Can someone explain them in more detail? Why are these things myths? I too was taught about having slow acting carbs after a hypo, and about night hypos causing high morning readings, and that BG should be tested at 3am to make sure a hypo isn’t the cause of high fasting BGLs, and that a 2-hr post-prandial BG is helpful to assess QA:CP ratio, and that low GI foods could still affect blood sugars hours after eating. In fact almost all of these have been covered if not at my DAFNE then by doctors and nurses before and since. Are these things completely wrong or is it just that they are not hard and fast rules for everyone? I think we need to know much more detail on this and if these are not true, then what are the correct versions of these statements? It seems a bad idea to basically tell us a lot of what we have been told is wrong, without telling us what is right. For example, if a night hypo is never the cause of high morning BG, then what is? If a 2 hour reading is not right, then how long should we wait before testing after a meal? If low GI foods are not affecting BGs 5 hrs after a meal, then a) what is, and b) how long do they take to have an effect?

A lot of the things that were illustrated were actually misconceptions, so they are valid, its just that peoples interpretations of them are wrong, that's a problem with the way they have been explained.......

After DAFNE, I never ever had a slow acting carb after treating with a quick acting one because then my blood sugar would be above target, that's my understanding of the maths anyway, I suppose it could be debated if you had a hypo long before your next meal and it was likely to drop further, but assuming the doses are correct or nearly there, this wouldn't normally happen, for me personally, hypos happen close to the next meal time, excluding alcohol effects....

night time hypos can cause high morning readings, but its not the only reason, again, I think when it comes to general rules, the people making them up need to assume that doses are right, dawn phenomenon might be the most common cause..

I would of though that the lower GI foods that are released slowly could still effect your blood glucose later on, but maybe after the 5 hour mark is the key point, unlike a high fat food like a pizza etc that could possibly spike your BG hours later, the low GI food although a much slower release would stil be out your system, I think that point may need to be clarified...

the 2 hr test cant help you evaluate your ratio, only once the QA and CPs are finished can you tell, the post meal tests can confirm whether the timing of the dose has been successful......usually 1.5-2 hours is the peak of your food and insulin.......so this may be your highest reading between meals....

Remember to note the difference between myth (untrue) and misconception (misunderstood).....

Hi novorapidboi

I don't understand what you mean when you say "they are valid, its just that peoples interpretations of them are wrong, that's a problem with the way they have been explained......" Could you use one of the examples and explain how people's interpretation is wrong and what is correct?

I currently feel quite worried and scared as I thought most of these things were true and based on my experience they are - eg I have had high morning BGs and the next night tested during the night, and seen a hypo. I worry that if these things are misconceptions what other things might be wrong? And the whole thing seems impossibly confusing to me now. I am struggling right now with my diabetes anyway. DAFNE was great but there has been no followup and since then several things have brought me off the rails. I have tried to get support but it is not there especially now with all the cuts. This is the last thing I need right now, it makes me wonder what the point of trying is if all these things I thought were right are misconceptions, I will never understand any of it and might as well give up.

Hi there...........

The presentation described a misconception as being: A mistaken idea or view resulting from a misunderstanding of something

Maximum of 4 units correction - Misconception

This has been told to people, but they have misunderstood, or may not have been explained to that this is only for safety when everyone is investigating their doses in the classroom environment.

So in some respects it is 'valid' or correct, but in reality people need more than 4 units when running HIGH....[this is your own responsibility to investigate what you need to correct, as everyone is different]

A Myth described as: A widely held but mistaken belief

This could be used to describe your thoughts on the 2 hour post meal test, in that it can be used to assess your insulin carb ratio, my personal understanding suggests that this is wrong, so a myth. If a doctor or nurse told you these exact words, they are wrong.....in my educated by DAFNE opinion...

Try not to get upset about your control as it may only make it more harder to asses......are you in contact with your DAFNE trained DSN.

I often find a fresh pair of eyes gazing over my blood results can produce some new strategies that I might not have thought about if its getting too much...

Is there anything specifically you would like to discuss about your control, you say you wake up high, and have tested to discover a low, is this recently? This would suggest a high QA:CP ratio for food you had before you went to bed or too much BI....

I think this thread/presentation has confused a number of people, but just ignore it, the best thing to do is to go through the handbook, it is all clear in there....

Hi Lizzie,

Pleae don't worry. I think the presentation was posted so that we could see what was happening but with a view to seeing what the response was outof curiosity. In essence, I think we are all saying that these things are not myths to us. Across the country, thisi is what they are teaching in DAFNE courses. I suspect that this presentation was donenby a non DAFNE DSN who does not know the course and does not realise that these things are tried and tested and work for the majority of people. I think that a lot of non - trained DSN's do not realise that a high bg in the morning may be the result of a hypo overnight. Novorapid boi is right in that there could be other reasone, the wrong BI at bed time, the dawn phenomenan, but definitely one of the potential causes is a night time hypo.I didn't know this until I did DAFNE as no-one had ever said to me that this might be the cause.

Put your mind at rest, a nd go by what you were taught. This is DAFNE and I am sure that MArke will get back to the DAFNE user group to say that we have all been posting saying that we think this si what is taught and that these are not myths at all but DAFNE principles.

I hope that you get better soon. I feel awful with diabetes too. Every day is a struggle so you have my sympathy.
I hope that you feel better soon.

take care and good luck!

Hi Lizzie,
I totally agree with Athena.
I'll be honest, since I read that DAFNE Myths and Misconceptions presentation it totally confused me and initially led me to doubt what I'd learned on my course but I've decided to ignore the myths and misconceptions and carry on with what I was taught on my course. I am going to see my (DAFNE) DSN at the end of July and am going to ask their thoughts on the presentation and go with what they advise.

All the best, good luck and please don't give up (I know that is a lot harder to do than it is to say).

Thanks for the supportive replies.