Adjusting my doses help

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wrijoanne DAFNE Graduate
North East London NHS Foundation Trust (Havering and Redbridge)
5 posts
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Hi been on Dafne for 1 week but having problems
With bi and ratios could some one please give
Me any advice thanks

grandma carol DAFNE Graduate
North Cumbria Integrated Care NHS Foundation Trust
61 posts

what were you like before you went on Dafne were they the same as this. I was like you and had high BG when I did Dafne took me a long time to get things okay a bit what insulin are you on and do you test through night to see if your BI is right and what is your insulin sencitivety to bring down your BG when you do the corrections hope things improve for you soon

wrijoanne DAFNE Graduate
North East London NHS Foundation Trust (Havering and Redbridge)
5 posts

wrijoanne said:
Hi been on Dafne for 1 week but having problems
With bi and ratios could some one please give
Me any advice thanks

Hi thankyou for your response iv been diabetis for 20years uncontrolled for last 5 years but my morning bg was always between 4 and 6 ,
i am on nova rapid during the day and levemir for the last week before that humlin i for 6 months before that lanctus for as long as i can remember, i was told to eat carb free today and just look at bg insulin levels which is what i am doing and i test at 3am everynight sometimes its hig last night 3am it was 9.4
im really looking for advice regarding which way to start off bg insulin or qa insulin (which should i change and look at first)

Garry DAFNE Graduate
North Lincolnshire and Goole NHS Foundation Trust
328 posts

Welcome to the forum Smile
Please do not be overly concerned that things are awry at the moment....they will sort themselves out once you are able to steady things up. Two off-target days are no big deal and it may simply be due to having an infection.
However in your situation you can not have enough information to help make informed choices. So can I suggest that you need to do more testing, especially when starting out with this new way of looking at things.
DAFNE rules for me are.....s l o w and steady changes improve results.
Cause and effect. Change something by a small amount and watch for the effect over a few days of results. Making changes one at a time helps us better understand the impact of change. If we do too many things at once we never get to the bottom of the effect.
Please remember that our bodies respond to the different insulin types in different ways. The effects of your Background Insulin change will not normally be seen for around 3 days. So the change in BI that you made is not likely to show any improvement in results until Saturday.

Don't fret, take your time and logically understand changes.

If you are unclear about what is happening please have the confidence and make time, to talk to and get advice from your Health Care Professionals.

Stick with it Very Happy
Best Wishes Garry

wrijoanne DAFNE Graduate
North East London NHS Foundation Trust (Havering and Redbridge)
5 posts

Garry said:
Welcome to the forum Smile
Please do not be overly concerned that things are awry at the moment....they will sort themselves out once you are able to steady things up. Two off-target days are no big deal and it may simply be due to having an infection.
However in your situation you can not have enough information to help make informed choices. So can I suggest that you need to do more testing, especially when starting out with this new way of looking at things.
DAFNE rules for me are.....s l o w and steady changes improve results.
Cause and effect. Change something by a small amount and watch for the effect over a few days of results. Making changes one at a time helps us better understand the impact of change. If we do too many things at once we never get to the bottom of the effect.
Please remember that our bodies respond to the different insulin types in different ways. The effects of your Background Insulin change will not normally be seen for around 3 days. So the change in BI that you made is not likely to show any improvement in results until Saturday.

Don't fret, take your time and logically understand changes.

If you are unclear about what is happening please have the confidence and make time, to talk to and get advice from your Health Care Professionals.

Stick with it Very Happy
Best Wishes Garry

Thank you Garry its all very scary trying to change things and coming to grips with new information thats so different to what i have known for 20years just feel very scared ha ha im 40years old now and i really want to take charge and do this right thankyou for your advice Smile

grandma carol DAFNE Graduate
North Cumbria Integrated Care NHS Foundation Trust
61 posts

As Garry said stick with it and things will pan out do things slowley.
I have been Diabetic for 37 years and like you never had good controll I was always high in the mornings never did carbcounting or ratios just had the same insulin every day if was very hard for me to change still have my bad days but getting there.
Take care Very Happy

marke Site Administrator
South East Kent PCT
675 posts

Hi it looks like your BI is not right, however you shouldn't be changing 2 doses at the same time really. If you up your evening BI by 2 you should first see what effect it has before upping the morning one as well. The problem is if one of the BI doses is not right it will mean you start off higher than you should be and it will mislead you about the other BI dose. You really need to provide a bit more data for us to go on, I'm afraid. Any change you make will take a couple of days to really show in your results so just 2 days of data is not really enough to spot a pattern.
Another thing to point out is you will most likely find that correction doses if you are 20+ BG will not have the same effect as a correction at 10 and below. Thus if the corrections don't seem to be working don't be to worried. The key is to get your BI right as everything else hinges on that. Try a carb-free lunch if you can and compare your BG in the morning and evening. If it is going up ( by at least 2) your BI is not right. The idea is the BI should keep your blood sugar roughly the same if you don't eat. If you can get this right then your QA will just be needed for what you eat and hopefully not dramatic corrections.
If you can record a few more days and post I'm sure you will get a lot of responses with advice and information. It is a bit daunting to start with especially if things don't seem to be going right. Try not to worry about it, stress increases your BG, and just keep plugging away. You can always ask your DAFNE Educators for advice if things are still not improving in a week.

P.S Please only post the question to one subject, I replied to your other post that is the same but under a different name. It just easier to get responses by having one post.

PNThompson DAFNE Graduate
North East London NHS Foundation Trust (Havering and Redbridge)
57 posts

It took me several weeks of messing around with ratios before my levels settled down. Recently I found that I need to adjust my ratios depending on what i'm eating. Foods like Soup, Chocolate I have found I need to reduce the Ratio as the foods are absorbed quicker and the Insulin is still working long after.

Before I went on the DAFNE Course I had my BI (LANTUS) split, but I found that once things started to improve with the control I went back to one injection for BI.

Unfortunately what works for one person may not work for another. I also adjust every injection unless it is exactly in the centre of the BG Ranges.

This has helped me and I still have instances where my BG reading go off track so, as several others have said, don't worry about it too much.
As Marke advised, just change one bit at a time rather than trying to fix all the readings in one go.
The time that you take the BI can have an impact as well. I started with the BI just before bed, but after completing DAFNE I gradually changed the BI to be the same time as dinner and have needed to adjust it a little but cannot advise if it has gone up or down.

Hopefully you can sort something out from the various comments.

wrijoanne DAFNE Graduate
North East London NHS Foundation Trust (Havering and Redbridge)
5 posts

Thankyou for your advise , i am going to concentrate on my bi first and have a carb free day again tomorrow problem is im starving ha ha if im doing a free carb day and my readings are still high is it ok to take a plus qa dose or should i not take anything, ???

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

for a good accurate basal test, its best not to have any QA, but if your uncomfortably high, don't hesitate...........