Recent Posts - DAFNE Online

Feb 6, 2015

HelenH 9 posts

Eventually settled for a "make up" bag from bags etc (shops + also website) has removable brush holders &/or mesh bags + various pockets inside. Holds novopen, Meter, finger pricker, strips, hypo-treatments, mobile, tissues and still room left. Usual price Â£15 - got mine half price! Several colours available - ideal & cheap!

Feb 4, 2015

LeanneHR 2 posts

Topic: General Discussion / Any ideas for Research needed around DAFNE?

Hi there,

I did DAFNE around 2 years ago and it has changed the way I mannage my diabetes in a massive way. I did find that in the classroom environment it was a lot simpler to get your QA and CP intake almost perfect. It is a different story once you hit the real world again, it would be great if there was a online follow up support system that you could email for advice. This website isn't the best for a forum... I have the DAFNE App for my readings etc but it would be good to have something a bit more user friendly as a forum like a DAFNE Twitter or FB... Just for diabetes â˜ºï¸

Thanks

Feb 4, 2015

Fudge 2 posts

Topic: DAFNE Online Mobile / Can a ipad app talk to the iPhone?

Thanks Simon. All working well now. Very Happy

Feb 2, 2015

Peter 109 posts

Topic: General Discussion / Input on new draft NICE Guideline on Diagnosis and Management of Type 1 Diabetes in Adults

I have another request from the DAFNE Executive for you input please.

NICE are in the process of updating their National Clinical Guideline on the treatment which should provided to all Type 1 Diabetics in the UK. This will be the first major update since 2004. The update will be published later this year (target in August) and will define the care we should be receiving in the next 10 years, and is therefore critical to all of us. The draft version has now been published for review. It covers a total of 183 recommendations in the following areas:

Diagnosis
Care process and support
Education programmes and self-care
Blood glucose control
Insulin therapy
Referral for islet or pancreas transplantation
Impaired awareness of hypoglycaemia
Ketone monitoring and management of diabetic ketoacidosis
Associated illness
Arterial risk control
Inpatient management
Management of complications

The revised recommendations range from the number of test strips which should be made available per day (at least 4 and up to 10 in some circumstances) to the preferred basal regime (twice-daily insulin detemir) and needle selection (choose needles with the lowest acquisition cost to use with pre-filled and reusable insulin pen injectors).

Within the Guideline encouragingly there are multiple mentions of DAFNE (e.g. Offer all adults with type 1 diabetes a structured education programme of proven benefit, for example the DAFNE programme). As a result the DAFNE Executive are stakeholders of the programme and are currently putting together a response to this draft and they have asked for input from graduates.

The whole Guideline runs to over 600 pages (excluding appendices)! There is also a summary available which covers all the recommendations, but excludes the scientific evidence justifying each. This is "only" 81 pages long. Both can be found here: Nice Type 1 Draft Guideline.

Any feedback you have can be submitted by responding to me directly at [email protected] or by replying to this topic. All suggestions will be passed to the DAFNE Executive for consideration in their response.

Finally, note your feedback is required urgently. Unfortunately the deadline I've been given for sending responses to the DAFNE Executive means that I need your comments within one week i.e. by the end of Monday 9th February. Sorry for the short notice with such lengthy documents.

Many thanks.

Feb 2, 2015

BeccyB 50 posts

Topic: General Discussion / Another step closer to the Artificial Pancreas

marke said:
at Â£10K it would need to get a lot cheaper a lot quicker to become viable. ..

The 10k is in Australian dollars, so the good news is it's nearer to Â£5k - still can't see it on the NHS for a while yet though!

Feb 2, 2015

BeccyB 50 posts

Topic: General Discussion / Any ideas for Research needed around DAFNE?

novorapidboi26 said:
Does the sensitivity to correction doses increase the higher the blood sugar level is............

So will a correction drop you by 2mmol at levels above 15mmol for example......

I like this suggestion Smile

Feb 1, 2015

Simon 578 posts

Topic: DAFNE Online Mobile / Can a ipad app talk to the iPhone?

Hi Fudge,

The apps on two different devices won't sync like calendar and contacts as they don't use iCloud; however if you add in your DAFNE online username and password to the app settings tab, and set diary upload to on, the app will then upload your new entries to the website. From your other device you can then swipe down on the diary tab (as if you were checking for new email) to download your entries from the site.

Hope this makes sense, let me know if you'd like any further help.

Feb 1, 2015

Peter 109 posts

Topic: General Discussion / Any ideas for Research needed around DAFNE?

Thanks for the input. I'll be forwarding the ideas to the DAFNE research team in a couple of weeks, so still more time for any other suggestions.....

Re Stew B's comments, DUAG did some research at the end of 2012 both with patients on what they wanted on follow-up care, and with HCPs on what their services provided. The conclusions. which were fed back to the DAFNE Executive and Research teams for input into the current grant application, were as follows:

Two surveys were set up on Survey Monkey â€“ one aimed at HCPs looking at what follow up they deliver and any changes; the second aimed at graduates asking what follow up they received and what they wanted. Both have now been closed with approximately 70 responses in each case.

Graduates
72% of the respondents said they definitely felt the need for support after DAFNE training. Another 24% said there may be a need for the training â€“ a total of 96% saying they wanted follow up training. However there was a whole range of answers to questions on the format and frequency follow-up training should take. As a result it is difficult to provide a single conclusion on what users want.
For a question asking graduates if they would be interested in assisting there were over 30 positive responses where names and contact details were provided. These have been passed to the relevant Lead Educators via Central DAFNE.
Educators
72 replies were received from 75 active centres, however it could be that more than 1 person replied in some centres. In response to a question on whether their centre currently provides any additional Training or Support apart from the 12-week post-course training a range of responses was received. 59% gave regular full-day, half-day or evening sessions and 9% held special events as follow-up. 41% provided follow-up to graduates by a one-off telephone call, while 3 centres (4.5%) provided a regular follow-up call.
The main follow-up appears to be at the â€œDiabetic Clinicâ€ with 68% providing follow-up there, although 76% also provided a central telephone number for graduates. Interestingly no centres indicated that they did not provide any follow-up training in addition to the mandated session.
The costs of follow-up were also split with 14 centres incurring no costs, 16 centres absorbing the costs into the DAFNE budget and 27 centres where the costs are covered by the DAFNE team members themselves. In the other centres the costs are met through a range of administrative measures and meter companies.
18 centres stated that they were planning changes to follow-up training with most either indicating that the changes were due to requests from DAFNE Graduates or due to a review of current operations by the local Educator team. For those not planning any changes the reasons given were that no demand had been identified, previous sessions had been poorly attended, there was no staff hire available or no funding available.

Jan 30, 2015

stephenbrowne 37 posts

Topic: General Discussion / English v. Scottish Diabetes care

Hi Ghostie78,
I can understand your desire to be under hospital review. I've had type 1 diabetes for nearly 48 years and have been grateful for being provided with regular consultant care for all that time. I'm now retired but worked in general practice for 35 years. There was a pressure for GPs to take over the care of as many patients with diabetes as possible leaving the hospital to manage "complicated cases". This, I think, was because of the increasing number of patients with diabetes and hospital diabetes clinics being overcrowded and because hospital care is more expensive than GP care. My personal view is that all patients with type 1 diabetes should be followed up by hospital as well as by their GP. I seem to remember that the PCT in those days agreed that hospital care was appropriate for all patients with type 1 diabetes. I do hope you will be able to negotiate to receive some hospital review.
Every good wish,

Jan 30, 2015

marke 681 posts

Topic: General Discussion / Another step closer to the Artificial Pancreas

You would assume that it is some kind of CGM but not in the way you would expect it. It detects low BG but thats it, so it could be just a sensor that returns a 1 for low BG and and 0 otherwise. This would be a lot simpler than the CGM's that actually record the BG level.
Also at Â£10K it would need to get a lot cheaper a lot quicker to become viable. So not really an artificial pancreas but a step on the road to one.
BTW, the changed the link in the original post so you could click on the link and removed the marketing tracking information in it.....

Jan 30, 2015

novorapidboi26 1,819 posts

Topic: General Discussion / Any ideas for Research needed around DAFNE?

Does the sensitivity to correction doses increase the higher the blood sugar level is............

So will a correction drop you by 2mmol at levels above 15mmol for example......

Jan 30, 2015

novorapidboi26 1,819 posts

Topic: General Discussion / Another step closer to the Artificial Pancreas

The article doesn't mention how it works.....

how is the blood sugar measured, CGM?

Where is that in the image provided?

Jan 30, 2015

Warwick 423 posts

Topic: General Discussion / Another step closer to the Artificial Pancreas

http://www.abc.net.au/news/2015-01-21/perth-boy-becomes-first-patient-fitted-with-artifical-pancreas/6032388

Jan 29, 2015

BeccyB 50 posts

Topic: General Discussion / Any ideas for Research needed around DAFNE?

Has there been any research into the effects of 'monthly' hormone changes and/or the menopause?

Obviously would only effect half the population, but there's probably half of us that will never do anaerobic exercise too Smile

Jan 29, 2015

Fudge 2 posts

Topic: DAFNE Online Mobile / Can a ipad app talk to the iPhone?

Hi,
Just graduated from Dane, started using the online diary. I was wondering if I could get the data I enter in one to automatically appear in the other.....as my calendars, contacts etc do?? Any advice welcome. I have iPhone 4 and version 2.0.3 of the app.
Thanks

Jan 29, 2015

Warwick 423 posts

Topic: General Discussion / Any ideas for Research needed around DAFNE?

I'm with John on the role of protein in raising BGs. For myself, I find that protein eaten with large amounts of carbohydrates doesn't tend to have much influence on BGLs, but protein without any carbs sends my BGLs very high unless I take QA with it.

For myself, it is pretty much a straight swap - i.e. for 40g of carbohydrate, I'd take 2 units of QA, and for 40g protein, I'd again take 2 units of QA. The difference I find is that my BGLs stay within the target range following the protein, whereas they tend to go high after carb before dropping to the normal range 3-4 hours following the meal.

Jan 29, 2015

Samantha San... 4 posts

Topic: General Discussion / Traveling: Storing Medication

Thanks for the advice! I'll definitely give Frio a search Smile

Jan 28, 2015

Warwick 423 posts

Topic: General Discussion / Traveling: Storing Medication

+1 for the Frio. It keeps my insulin cool even in our Australian 40+ degree heat. You just need to soak the gel bag for 2-3 minutes every now and again (can be a few days, or a few weeks depending on climate. One of the greatest diabetic aids ever.

Jan 28, 2015

Muncle 9 posts

Topic: General Discussion / Traveling: Storing Medication

Hi Samantha,

Have a look at http://www.friouk.com/ I have a gel pack & wallet and also purchased the travel bag which I use daily as it keeps all of my diabetes stuff in nice & neatly Wink

HTH

Mick

Jan 28, 2015

Samantha San... 4 posts

Topic: General Discussion / Traveling: Storing Medication

Hi,

I am going travelling to Southeast Asia and Australia's East Coast soon and was wondering if anyone had any tips or advice, particularly when it comes to medication and storing your insulin.

Many thanks

Feb 6, 2015 HelenH 9 posts	Topic: General Discussion / Kit bags Eventually settled for a "make up" bag from bags etc (shops + also website) has removable brush holders &/or mesh bags + various pockets inside. Holds novopen, Meter, finger pricker, strips, hypo-treatments, mobile, tissues and still room left. Usual price Â£15 - got mine half price! Several colours available - ideal & cheap!

Feb 4, 2015 LeanneHR 2 posts	Topic: General Discussion / Any ideas for Research needed around DAFNE? Hi there, I did DAFNE around 2 years ago and it has changed the way I mannage my diabetes in a massive way. I did find that in the classroom environment it was a lot simpler to get your QA and CP intake almost perfect. It is a different story once you hit the real world again, it would be great if there was a online follow up support system that you could email for advice. This website isn't the best for a forum... I have the DAFNE App for my readings etc but it would be good to have something a bit more user friendly as a forum like a DAFNE Twitter or FB... Just for diabetes â˜ºï¸ Thanks

Feb 4, 2015 Fudge 2 posts	Topic: DAFNE Online Mobile / Can a ipad app talk to the iPhone? Thanks Simon. All working well now.

Feb 2, 2015 Peter 109 posts	Topic: General Discussion / Input on new draft NICE Guideline on Diagnosis and Management of Type 1 Diabetes in Adults I have another request from the DAFNE Executive for you input please. NICE are in the process of updating their National Clinical Guideline on the treatment which should provided to all Type 1 Diabetics in the UK. This will be the first major update since 2004. The update will be published later this year (target in August) and will define the care we should be receiving in the next 10 years, and is therefore critical to all of us. The draft version has now been published for review. It covers a total of 183 recommendations in the following areas: Diagnosis Care process and support Education programmes and self-care Blood glucose control Insulin therapy Referral for islet or pancreas transplantation Impaired awareness of hypoglycaemia Ketone monitoring and management of diabetic ketoacidosis Associated illness Arterial risk control Inpatient management Management of complications The revised recommendations range from the number of test strips which should be made available per day (at least 4 and up to 10 in some circumstances) to the preferred basal regime (twice-daily insulin detemir) and needle selection (choose needles with the lowest acquisition cost to use with pre-filled and reusable insulin pen injectors). Within the Guideline encouragingly there are multiple mentions of DAFNE (e.g. Offer all adults with type 1 diabetes a structured education programme of proven benefit, for example the DAFNE programme). As a result the DAFNE Executive are stakeholders of the programme and are currently putting together a response to this draft and they have asked for input from graduates. The whole Guideline runs to over 600 pages (excluding appendices)! There is also a summary available which covers all the recommendations, but excludes the scientific evidence justifying each. This is "only" 81 pages long. Both can be found here: Nice Type 1 Draft Guideline. Any feedback you have can be submitted by responding to me directly at [email protected] or by replying to this topic. All suggestions will be passed to the DAFNE Executive for consideration in their response. Finally, note your feedback is required urgently. Unfortunately the deadline I've been given for sending responses to the DAFNE Executive means that I need your comments within one week i.e. by the end of Monday 9th February. Sorry for the short notice with such lengthy documents. Many thanks.

Feb 2, 2015 BeccyB 50 posts	Topic: General Discussion / Another step closer to the Artificial Pancreas marke said: at Â£10K it would need to get a lot cheaper a lot quicker to become viable. .. The 10k is in Australian dollars, so the good news is it's nearer to Â£5k - still can't see it on the NHS for a while yet though!

Feb 2, 2015 BeccyB 50 posts	Topic: General Discussion / Any ideas for Research needed around DAFNE? novorapidboi26 said: Does the sensitivity to correction doses increase the higher the blood sugar level is............ So will a correction drop you by 2mmol at levels above 15mmol for example...... I like this suggestion

Feb 1, 2015 Simon 578 posts	Topic: DAFNE Online Mobile / Can a ipad app talk to the iPhone? Hi Fudge, The apps on two different devices won't sync like calendar and contacts as they don't use iCloud; however if you add in your DAFNE online username and password to the app settings tab, and set diary upload to on, the app will then upload your new entries to the website. From your other device you can then swipe down on the diary tab (as if you were checking for new email) to download your entries from the site. Hope this makes sense, let me know if you'd like any further help.

Feb 1, 2015 Peter 109 posts	Topic: General Discussion / Any ideas for Research needed around DAFNE? Thanks for the input. I'll be forwarding the ideas to the DAFNE research team in a couple of weeks, so still more time for any other suggestions..... Re Stew B's comments, DUAG did some research at the end of 2012 both with patients on what they wanted on follow-up care, and with HCPs on what their services provided. The conclusions. which were fed back to the DAFNE Executive and Research teams for input into the current grant application, were as follows: Two surveys were set up on Survey Monkey â€“ one aimed at HCPs looking at what follow up they deliver and any changes; the second aimed at graduates asking what follow up they received and what they wanted. Both have now been closed with approximately 70 responses in each case. Graduates 72% of the respondents said they definitely felt the need for support after DAFNE training. Another 24% said there may be a need for the training â€“ a total of 96% saying they wanted follow up training. However there was a whole range of answers to questions on the format and frequency follow-up training should take. As a result it is difficult to provide a single conclusion on what users want. For a question asking graduates if they would be interested in assisting there were over 30 positive responses where names and contact details were provided. These have been passed to the relevant Lead Educators via Central DAFNE. Educators 72 replies were received from 75 active centres, however it could be that more than 1 person replied in some centres. In response to a question on whether their centre currently provides any additional Training or Support apart from the 12-week post-course training a range of responses was received. 59% gave regular full-day, half-day or evening sessions and 9% held special events as follow-up. 41% provided follow-up to graduates by a one-off telephone call, while 3 centres (4.5%) provided a regular follow-up call. The main follow-up appears to be at the â€œDiabetic Clinicâ€ with 68% providing follow-up there, although 76% also provided a central telephone number for graduates. Interestingly no centres indicated that they did not provide any follow-up training in addition to the mandated session. The costs of follow-up were also split with 14 centres incurring no costs, 16 centres absorbing the costs into the DAFNE budget and 27 centres where the costs are covered by the DAFNE team members themselves. In the other centres the costs are met through a range of administrative measures and meter companies. 18 centres stated that they were planning changes to follow-up training with most either indicating that the changes were due to requests from DAFNE Graduates or due to a review of current operations by the local Educator team. For those not planning any changes the reasons given were that no demand had been identified, previous sessions had been poorly attended, there was no staff hire available or no funding available.

Jan 30, 2015 stephenbrowne 37 posts	Topic: General Discussion / English v. Scottish Diabetes care Hi Ghostie78, I can understand your desire to be under hospital review. I've had type 1 diabetes for nearly 48 years and have been grateful for being provided with regular consultant care for all that time. I'm now retired but worked in general practice for 35 years. There was a pressure for GPs to take over the care of as many patients with diabetes as possible leaving the hospital to manage "complicated cases". This, I think, was because of the increasing number of patients with diabetes and hospital diabetes clinics being overcrowded and because hospital care is more expensive than GP care. My personal view is that all patients with type 1 diabetes should be followed up by hospital as well as by their GP. I seem to remember that the PCT in those days agreed that hospital care was appropriate for all patients with type 1 diabetes. I do hope you will be able to negotiate to receive some hospital review. Every good wish,

Jan 30, 2015 marke 681 posts	Topic: General Discussion / Another step closer to the Artificial Pancreas You would assume that it is some kind of CGM but not in the way you would expect it. It detects low BG but thats it, so it could be just a sensor that returns a 1 for low BG and and 0 otherwise. This would be a lot simpler than the CGM's that actually record the BG level. Also at Â£10K it would need to get a lot cheaper a lot quicker to become viable. So not really an artificial pancreas but a step on the road to one. BTW, the changed the link in the original post so you could click on the link and removed the marketing tracking information in it.....

Jan 30, 2015 novorapidboi26 1,819 posts	Topic: General Discussion / Any ideas for Research needed around DAFNE? Does the sensitivity to correction doses increase the higher the blood sugar level is............ So will a correction drop you by 2mmol at levels above 15mmol for example......

Jan 30, 2015 novorapidboi26 1,819 posts	Topic: General Discussion / Another step closer to the Artificial Pancreas The article doesn't mention how it works..... how is the blood sugar measured, CGM? Where is that in the image provided?

Jan 30, 2015 Warwick 423 posts	Topic: General Discussion / Another step closer to the Artificial Pancreas http://www.abc.net.au/news/2015-01-21/perth-boy-becomes-first-patient-fitted-with-artifical-pancreas/6032388

Jan 29, 2015 BeccyB 50 posts	Topic: General Discussion / Any ideas for Research needed around DAFNE? Has there been any research into the effects of 'monthly' hormone changes and/or the menopause? Obviously would only effect half the population, but there's probably half of us that will never do anaerobic exercise too

Jan 29, 2015 Fudge 2 posts	Topic: DAFNE Online Mobile / Can a ipad app talk to the iPhone? Hi, Just graduated from Dane, started using the online diary. I was wondering if I could get the data I enter in one to automatically appear in the other.....as my calendars, contacts etc do?? Any advice welcome. I have iPhone 4 and version 2.0.3 of the app. Thanks

Jan 29, 2015 Warwick 423 posts	Topic: General Discussion / Any ideas for Research needed around DAFNE? I'm with John on the role of protein in raising BGs. For myself, I find that protein eaten with large amounts of carbohydrates doesn't tend to have much influence on BGLs, but protein without any carbs sends my BGLs very high unless I take QA with it. For myself, it is pretty much a straight swap - i.e. for 40g of carbohydrate, I'd take 2 units of QA, and for 40g protein, I'd again take 2 units of QA. The difference I find is that my BGLs stay within the target range following the protein, whereas they tend to go high after carb before dropping to the normal range 3-4 hours following the meal.

Jan 29, 2015 Samantha San... 4 posts	Topic: General Discussion / Traveling: Storing Medication Thanks for the advice! I'll definitely give Frio a search

Jan 28, 2015 Warwick 423 posts	Topic: General Discussion / Traveling: Storing Medication +1 for the Frio. It keeps my insulin cool even in our Australian 40+ degree heat. You just need to soak the gel bag for 2-3 minutes every now and again (can be a few days, or a few weeks depending on climate. One of the greatest diabetic aids ever.

Jan 28, 2015 Muncle 9 posts	Topic: General Discussion / Traveling: Storing Medication Hi Samantha, Have a look at http://www.friouk.com/ I have a gel pack & wallet and also purchased the travel bag which I use daily as it keeps all of my diabetes stuff in nice & neatly HTH Mick

Jan 28, 2015 Samantha San... 4 posts	Topic: General Discussion / Traveling: Storing Medication Hi, I am going travelling to Southeast Asia and Australia's East Coast soon and was wondering if anyone had any tips or advice, particularly when it comes to medication and storing your insulin. Many thanks