new to dafne

Ive just completed dafne this week and it seems I was on too much BI (14u lantus) at night and would drop or hypo! So reduced BI to 10u and it seems im climbing from night to morning plus with a carb free b/fast I still climb yet the rest of the day im near enough on target and my corrections work. We were discussing changing my BI to split insulin do you think its still to early to tell from looking at my diary? Any help would be grateful

Hannah x

Hi Hannah, and welcome to DAFNE.

I suspect that your Friday BI dose actually happened on Saturday, otherwise you took 10 units of BI twice only a couple of hours apart and with no hypos afterwards, that seems unlikely :-)

Lantus isn't particularly responsive to changes and can take up to three days before you see a pattern change. Can I ask why it was dropped by 4 units? The golden rules of DAFNE suggest changing BI by only 10% or 1-2 units at a time. 10% of 14 is 1.4, so you would usually only be looking to drop it by 1-2 units to 12 or 13. It may be though that there was a really good reason for dropping it by more than that.

Based on your diary, I don't think that you need to split based on what is shown so far. I would suggest increasing BI to 12 or 13 units though and leaving it for three days to see what happens.

I am on Lantus myself, and I split it about a year ago. The reason I did that was that previously I was on a before bed once daily BI injection, but I found that my BGs would rise between having a meal and going to bed. Increasing my QA ratio caused me to have hypos, so it became apparent that my BI was running out early, hence the need to split the dose.

There isn't enough data yet in your diary since you dropped the BI to tell if this is happening with you. It will be interesting to see your diary a week after increasing the BI to 12 or 13.

If you do decide to split it, it needs to be done carefully to avoid hypos or hypers. Basically, it involves dropping a unit from your evening BI injection and adding it to the morning injection, You keep doing that until you are happy with the splits. You don't necessarily need to do half and half. If you find that 12 units of BI are what you need each day, you could have two lots of 6, or one of 4 in the morning and one of 8 at night depending on your needs.

Cheers,
Warwick.

Hi warwick.

This is my diary the week I was on my dafne course and because my hypo was at 2.2 it took me ages to get back out of it plus I dont always have a breakfast and although I may sit on target or near enough on target at night I always seem to creep up during the day with a carb free breakfast then find myself correcting alot and thats why the dafne team and I decided to drop bi by 4 units as was suggesting I had too much insulin if that makes sense?
Last night I went to my bed at 5.3 and woke up this morning at 11.7 which would suggest I dont have enough bi to keep me stable through the night?? Last night being my 4th night of reducing my bi I think tonight I will change to 12 units and continue for the next week to see the difference in my resulys when waking in the am!
Thanks for your reply. Will upload diary in a few days and see if it makes a difference!
Hannah x

Welcome hannahlaw
Some consultants suggest dropping BI by 20% to ensure that you see the result. Your HCP team are of the same mindset.
Please give it time. Don't make changes on the back of one overnight result. You dinner may have been slowly digested and, and, and....lots of things get in the way. The body is a mighty complex thing and takes time to adjust.
As Warwick suggested, a minimum of 3 days with consistent results to review to help you decide.
Regards
Garry

Ive uploaded my diary since reducing my background to 10u but I still seem to run high and not in target despite my corrections! Should I up my bi to 12u? I dont want to be running high and out of target
Thanks for your reply also Garry. I hope to get some more advice based on my results above
Cheers hannah x

Tuesday 04/03 - your corrections have not worked...as you may be insulin resistent at the moment.
Do you have a cold coming on today?
I personally find that two days before I get an infection, my BGs start to drift off.
That may be what is happening for you too.
Anyway, I see lots of green in your diary and that's good. OK a few bumps along the way...but if you use the graph facility after you have entered data it helps you see an averaged result for each time of day and assists in seeing the trends better.
I notice that Thursday 27/02 and Friday 28/02 both show your BI dose. I take it only one 10u was taken?
We need get the data right as in the background, the diary can help you total your daily intake of QA and BI using the Show Summary View hyperlink at the very top of the diary page. This is of help if you need apply sick day rules at any time.
You are on the right track. Frustrating I know, for things not to pan out immediately, but that's the way it is.
So many factors are in the mix in your body - hormones, food types and their associated GIs, exercise and hormone released during exercise, illness.....I could carry on!
You are doing fine. Tuning in progress...until the temperature changes and then like a piano you are out of tune again!
Just stick at it.
Regards
Garry