Recent Posts - DAFNE Online

Sep 22, 2014

Gareth H 12 posts

i would imagine that there will need to be some changes, all our apps (im a developer) are having to be tweaked for iOS8

Sep 21, 2014

SimonC 78 posts

Topic: DAFNE Online Mobile / iPhone 6

Not an app developer, but has the app been configured to run on IoS8

Sep 21, 2014

AUSTEN74 4 posts

Topic: DAFNE Online Mobile / iPhone 6

Hi I have just upgraded to the new IPhone 6 and when I added my DAFNE app it would only let me download entries up to 14 days I have tried resetting the app to 30 days and All but it still will only show the previous 14 days? I have tried removing the app and it did the same thing. Any help would be appreciated?

Sep 18, 2014

SarahB 2 posts

Topic: Site Development / Online pump diaries

Hello!
I have just received a hard copy of the DAFNE pump diary from my diabetest centre, and I wondered if this is something that will be added to the site, i.e. an online pump glucose diary?
Thanks
Sarah

Sep 16, 2014

Alan 49 284 posts

Topic: General Discussion / Change of routine and injection times

I think the '3am bit' is the time you will be getting up so that you can get to the airport and check-in at 4am.

I always make sure my BGs are fairly high when I fly anywhere - the last thing you want is a hypo at an airport, or worse still, on the plane. I test my BGs more frequestly as well.

Sep 16, 2014

Gemsa 20 posts

Topic: General Discussion / Change of routine and injection times

Diane, as lantus can stay working for more than 24 hours adjusting like this by adding extra on to extend time between injections is not advisable. I got a bit confused by the times you have listed - flight arrives at 6am and just for the night of the flight your bedtime & wake up will be 2 hours earlier than usual - where does the 3am bit come from?

If your bedtime and wake up on flight day will just be 2 hours different then perhaps the day or two days before you can take doses an hour earlier than usual (no adjusting to size should be needed, but do make sure you have a snack with you post injection just in case), and on the day then you can increase to 2 hours earlier. Then do in reverse (presumably your wake up and bed times will be later whilst on holiday?).

But if there is no difference in the time zones between UK and holiday destination I'd suggest it will probably just be easier to keep injecting at your usual times (actual clock times rather than activity/eating/bed times) even if that includes one wake up at a time that you'd rather not whilst flying. The stress of worrying whether you did the maths right and which times you should be doing what might be worse than just doing it at an inconvenient time once or twice.

Sep 16, 2014

novorapidboi26 1,819 posts

Topic: General Discussion / Change of routine and injection times

I would personally avoid any complicated timing and just inject at 9pm instead of your usual 11pm, then inject at 6am when you fly out, that way your getting the same amount of insulin over the same amount of time.......

when you get to your destination, in theory your 6am dose will run out 2 hours earlier than normal, in reality it may still be working, or may have ran out long before then, regardless, you can just go back to your normal timing and compensate with the higher/lower BG with QA or CPs....

enjoy your time away.......

Sep 16, 2014

Gemsa 20 posts

Topic: General Discussion / Online version of DAFNE?

I thought I was dose adjusting 'fine' before DAFNE but it was a real eye opener in terms of bad habits I'd picked up based on little evidence or understanding. (10 years since I passed my driving test I know I don't drive to test standard now even though I think I know all the principles!). It is more than just carb counting - but it is hard to tell from your post whether you already know more than carb counting, or just the carb counting side.

If you really are unable to take the time off work, and feel you have the skills to self do it, then the book "Think like a pancreas" by Gary Schiener might be good for you (it is American so you'll have to do conversions on his blood scores). DAFNE will give you the formula to use, that book as well as DAFNE will give you the understanding of why the formula work. After reading the book you'll know how much extra you do or don't need to know and whether it is worth doing DAFNE to get the magical formula.

Don't forget that most hospitals will write to employers explaining the benefits to them of you doing DAFNE (better control therefore both better productivity and less sickness) and an increasing amount of employers will offer it as either sick leave, or paid leave as ultimately it is still medical 'treatment' (or disability treatment if you want to play that card) and not just you going on a jolly for a week. Obviously this is harder for you with temporary work and some employers or agencies are less understanding, but it might still be worth asking them the question.

Sep 16, 2014

Gemsa 20 posts

Topic: General Discussion / So many things to watch our for.....

I would focus on the bedtime to fasting level differences if this is causing concern. If your waking sugars are either high or hypo resulting in a rebound high it can take you up to 4 hours during the day to correct from that which adds onto the 7 hours overnight that it also probably wasn't quite right. If you focus just on your meals then that only really alters just 4 hours at a time. My HBA went from 7.4% to 5.9% in 6 months as a result of nailing my overnight - because a large proportion of my "day" (hours in the day) was wrong but didn't stand out on paper as much because most of my daytime scores were happy little averages but because I didn't have the same volume of night time tests on paper I hadn't seen as dominantly where my average was being pulled up by.

Sep 16, 2014

Gemsa 20 posts

Topic: General Discussion / Differing hBa1c results

Diane - just thought I'd mention two things:
1) during your operation was there a chance you received blood? This would obviously affect a HBA.
2) agree with the post about the differing emphasis on what timescales add up to the average. I was told that during pregnancy the blood 'refreshes' itself (whatever that means) much quicker and so that is why HBAs are done every month rather than every 3 months. I don't know if recovery from an operation would also affect the rate your blood is 'refreshing' and therefore shortening the length of time the average has come from.

At the end of the day though, you can take it with a pinch of salt. Focus on the here and now. Regardless of whatever your last HBA was, you want to be looking at your blood score today and the impact that will have on your next HBA - worrying about previous data isn't going to help with that. Operations are stressful and throws a whole load of other factors into the mix so expect a couple of bad ones but look forward instead.

Sep 16, 2014

Gemsa 20 posts

Topic: General Discussion / Insulin Stacking

If you know your breakfast ratio is right and that the carbs you counted were definitely what you ate, then just matching CP with QA is the spot on way to do it if eating less than 4 hours after you last ate. If however you have a high post-meal rise and you aren't sure if your ratio is right or not, or if you guessed the carbs and think you may have guessed less than you actually ate, then you can also correct. Some blood test machines will give you an indication of how much insulin from the previous injection is still in your system (Freestyle Insulinx or Accu-chek Avivva Expert and probably others too) but if yours doesn't do this you can use some maths if you want to:
30mins after injection you'll have around 90% of the dose still unused
1 hour after, about 70% remains
1 1/2 hours after, about 50% remains
2 hours after, about 35% remains
2 1/2 hours after, about 20% remains
3 hours after, about 5% remains
4 hours after, about 0% remains
Although this will vary for individuals it's a good guestimation to go on.

So an example of avoiding 'insulin stacking' this morning for me; I woke at 18.0mmol and dosed up 3.4units. Two hours after I was 17.4mmol, and my machine predicted I had 1.2units left in my system. I knew the 1.2units left wouldn't get me down as low as I wanted to go but also knew re-dosing the original 3.4units again would be far too much as even though it didn't look like it was working, it still had time to do so. So the maths based on my correction ratio meant that the remaining 1.2units in my system would probably get me down to 12.6mmol and so I needed an additional top up of 1.2units to get me down to the 7s. If I had just taken that 17.4mmol score on its own without the history and dosed up for purely that score I'd end up close to hypo based on what was already in my system, because I dosed up based on roughly what I thought was in my system I should be almost normal now. (I'm on a pump so can get the exact dose values, but you still use the same maths for pens just round up or down to the nearest whole number). Injecting each time you eat doesn't risk stacking as the additional QA should be matching the additional CPs and so will happily be used on what it was intended for - correcting each time you eat does however risk stacking as your previous correction may not have had chance to do its job and then the additional correction will be 'correcting' (or 'mis-correcting'!) something that given time doesn't need correcting.

Sep 16, 2014

Gemsa 20 posts

Topic: General Discussion / Planning for a Baby...Advice Needed

Hi lffat, you've had some really good responses so far to give you an idea.

To reiterate Warwicks point 1 - pregnancy really makes your hormones etc change which really makes your blood sugar and insulin requirements change. If you want a smooth pregnancy (and by this I don't mean a complication free one, although that would help too, but a low-stress not worrying about your bloods every couple of hours one) then you need to really understand the different sort of tweaks that can be done and what reactions to look out for etc.

Speak to your Diabetes team at the hospital, as VickyP said most offer a pre-conception clinic where you'll be seen more regularly and they'll help prepare you in advance of it happening. They will be able to offer advice as to how soon after diagnosis is a good idea for you taking into account the likelihood of the honeymoon phase. I found it took me 15 months after doing DAFNE to get my bloods good enough - the length of time will vary for individuals of course.

In an ideal world you need to be taking the 5mg folic acid dose a minimum of 3 months before conception to ensure there is enough in your system - so it would be good to wait that long at least. It does you no harm to take for a much longer period if your bloods don't get good enough as quickly as you thought, or you don't fall pregnancy as quickly as you'd expect so don't worry on that front.

But whatever happens, as sometimes 'accidents' do happen, if you find yourself pregnant and your bloods aren't where you'd want them to be - don't feel like a naughty schoolgirl and hide from the medical team, get yourself into the antenatal diabetes clinic within the week and you can start working together to make things better. My consultant always joked she asked patients to tell her the result of the pregnancy test before they tell their husband! The early days are very important both for baby's development, but also for you (increase of hypos + reduced symptoms can lead to a stressful period that may knock you under more than morning sickness) and so get all the help you are offered as it will have an impact. They don't want to criticise you, they want to get a healthy baby and healthy mum out of it at the end.

Sep 16, 2014

DianeW 115 posts

Topic: General Discussion / Change of routine and injection times

Hi, any advice welcome. I take Lantus before breakfast and before bed. I am flying abroad (no change in time zones) meaning that I will go to bed about 9pm and be up at 3am. I normally take my bedtime dose about 11pm and morning one about 8am. My flight is at 6am. I am thinking the best thing is to take the Lantus at 9pm but take extra to cover me from then up to the approximate time we get to the hotel mid morning, which would save me having to inject at 3am. If I work out how much Lantus I take an hour I should be able to calculate the extra. Hope this makes sense.

Sep 14, 2014

mum2westiesGill 502 posts

Topic: General Discussion / My BGs - lots of drops here

Can anyone see any trends?

Any help in identifying trends and/or advice on how to improve my control would be greatly appreciated

Thank you

Sep 12, 2014

Neville COL 23 posts

Topic: Carbohydrate Counting / Carb counting Coke Life?

http://www.marketingweek.co.uk/opinion/ritson/coke-life-is-the-harbinger-of-death-for-coca-cola/4011475.article Heres a link to an article I just found on Google predicting a short life for this curious substance....! As for artificial sweeteners, I ll take the risk....!, My dad got to 96 on saccharine......!

Sep 12, 2014

Debcj75 4 posts

Topic: Carbohydrate Counting / Carb counting Coke Life?

Thats what I thought, slightly lighter normal coke! The only reason I even looked at it was that I happily drink quite a bit of diet coke, but am fed up of people telling me how bad it is with all the aspartame in it. This new one seemed to be Cokes 'healthier' (I use that term loosely) choice, and I was hoping it would be. Oh well Confused

Sep 12, 2014

Neville COL 23 posts

Topic: Carbohydrate Counting / Carb counting Coke Life?

I d avoid that like the plague! It looks like low sugar 'ordinary' Coke to me, sugar being a natural sweetener ! They seem to be trying to con the unwary slimmer......save the insulin for something more worthy! Very Happy

Sep 12, 2014

Debcj75 4 posts

Topic: Carbohydrate Counting / Good carb counting resource?

I really like the My fitness pal app, especially for the barcode reading function, sometimes if the nutritional values are printed really tiny, or in a different language etc, it really helps!

Sep 12, 2014

Debcj75 4 posts

Topic: Carbohydrate Counting / Carb counting Coke Life?

Hi, I don't know if this one has been asked before (apologies if it has) but I remember from my DAFNE course something about not counting items with sweeteners like truvia etc. The new drink from Coca Cola, Coke Life, says it is lower calorie and sweetened by natural sources. Carbs are 6.7 per 100ml, so 30 ish for the 500 bottle. I presume this should be injected for, if drinking it, but just wanted to check.

Many thanks in advance for any help/ideas.


Sep 22, 2014 Gareth H 12 posts	Topic: DAFNE Online Mobile / iPhone 6 i would imagine that there will need to be some changes, all our apps (im a developer) are having to be tweaked for iOS8

Sep 21, 2014 SimonC 78 posts	Topic: DAFNE Online Mobile / iPhone 6 Not an app developer, but has the app been configured to run on IoS8

Sep 21, 2014 AUSTEN74 4 posts	Topic: DAFNE Online Mobile / iPhone 6 Hi I have just upgraded to the new IPhone 6 and when I added my DAFNE app it would only let me download entries up to 14 days I have tried resetting the app to 30 days and All but it still will only show the previous 14 days? I have tried removing the app and it did the same thing. Any help would be appreciated?

Sep 18, 2014 SarahB 2 posts	Topic: Site Development / Online pump diaries Hello! I have just received a hard copy of the DAFNE pump diary from my diabetest centre, and I wondered if this is something that will be added to the site, i.e. an online pump glucose diary? Thanks Sarah

Sep 16, 2014 Alan 49 284 posts	Topic: General Discussion / Change of routine and injection times I think the '3am bit' is the time you will be getting up so that you can get to the airport and check-in at 4am. I always make sure my BGs are fairly high when I fly anywhere - the last thing you want is a hypo at an airport, or worse still, on the plane. I test my BGs more frequestly as well.

Sep 16, 2014 Gemsa 20 posts	Topic: General Discussion / Change of routine and injection times Diane, as lantus can stay working for more than 24 hours adjusting like this by adding extra on to extend time between injections is not advisable. I got a bit confused by the times you have listed - flight arrives at 6am and just for the night of the flight your bedtime & wake up will be 2 hours earlier than usual - where does the 3am bit come from? If your bedtime and wake up on flight day will just be 2 hours different then perhaps the day or two days before you can take doses an hour earlier than usual (no adjusting to size should be needed, but do make sure you have a snack with you post injection just in case), and on the day then you can increase to 2 hours earlier. Then do in reverse (presumably your wake up and bed times will be later whilst on holiday?). But if there is no difference in the time zones between UK and holiday destination I'd suggest it will probably just be easier to keep injecting at your usual times (actual clock times rather than activity/eating/bed times) even if that includes one wake up at a time that you'd rather not whilst flying. The stress of worrying whether you did the maths right and which times you should be doing what might be worse than just doing it at an inconvenient time once or twice.

Sep 16, 2014 novorapidboi26 1,819 posts	Topic: General Discussion / Change of routine and injection times I would personally avoid any complicated timing and just inject at 9pm instead of your usual 11pm, then inject at 6am when you fly out, that way your getting the same amount of insulin over the same amount of time....... when you get to your destination, in theory your 6am dose will run out 2 hours earlier than normal, in reality it may still be working, or may have ran out long before then, regardless, you can just go back to your normal timing and compensate with the higher/lower BG with QA or CPs.... enjoy your time away.......

Sep 16, 2014 Gemsa 20 posts	Topic: General Discussion / Online version of DAFNE? I thought I was dose adjusting 'fine' before DAFNE but it was a real eye opener in terms of bad habits I'd picked up based on little evidence or understanding. (10 years since I passed my driving test I know I don't drive to test standard now even though I think I know all the principles!). It is more than just carb counting - but it is hard to tell from your post whether you already know more than carb counting, or just the carb counting side. If you really are unable to take the time off work, and feel you have the skills to self do it, then the book "Think like a pancreas" by Gary Schiener might be good for you (it is American so you'll have to do conversions on his blood scores). DAFNE will give you the formula to use, that book as well as DAFNE will give you the understanding of why the formula work. After reading the book you'll know how much extra you do or don't need to know and whether it is worth doing DAFNE to get the magical formula. Don't forget that most hospitals will write to employers explaining the benefits to them of you doing DAFNE (better control therefore both better productivity and less sickness) and an increasing amount of employers will offer it as either sick leave, or paid leave as ultimately it is still medical 'treatment' (or disability treatment if you want to play that card) and not just you going on a jolly for a week. Obviously this is harder for you with temporary work and some employers or agencies are less understanding, but it might still be worth asking them the question.

Sep 16, 2014 Gemsa 20 posts	Topic: General Discussion / So many things to watch our for..... I would focus on the bedtime to fasting level differences if this is causing concern. If your waking sugars are either high or hypo resulting in a rebound high it can take you up to 4 hours during the day to correct from that which adds onto the 7 hours overnight that it also probably wasn't quite right. If you focus just on your meals then that only really alters just 4 hours at a time. My HBA went from 7.4% to 5.9% in 6 months as a result of nailing my overnight - because a large proportion of my "day" (hours in the day) was wrong but didn't stand out on paper as much because most of my daytime scores were happy little averages but because I didn't have the same volume of night time tests on paper I hadn't seen as dominantly where my average was being pulled up by.

Sep 16, 2014 Gemsa 20 posts	Topic: General Discussion / Differing hBa1c results Diane - just thought I'd mention two things: 1) during your operation was there a chance you received blood? This would obviously affect a HBA. 2) agree with the post about the differing emphasis on what timescales add up to the average. I was told that during pregnancy the blood 'refreshes' itself (whatever that means) much quicker and so that is why HBAs are done every month rather than every 3 months. I don't know if recovery from an operation would also affect the rate your blood is 'refreshing' and therefore shortening the length of time the average has come from. At the end of the day though, you can take it with a pinch of salt. Focus on the here and now. Regardless of whatever your last HBA was, you want to be looking at your blood score today and the impact that will have on your next HBA - worrying about previous data isn't going to help with that. Operations are stressful and throws a whole load of other factors into the mix so expect a couple of bad ones but look forward instead.

Sep 16, 2014 Gemsa 20 posts	Topic: General Discussion / Insulin Stacking If you know your breakfast ratio is right and that the carbs you counted were definitely what you ate, then just matching CP with QA is the spot on way to do it if eating less than 4 hours after you last ate. If however you have a high post-meal rise and you aren't sure if your ratio is right or not, or if you guessed the carbs and think you may have guessed less than you actually ate, then you can also correct. Some blood test machines will give you an indication of how much insulin from the previous injection is still in your system (Freestyle Insulinx or Accu-chek Avivva Expert and probably others too) but if yours doesn't do this you can use some maths if you want to: 30mins after injection you'll have around 90% of the dose still unused 1 hour after, about 70% remains 1 1/2 hours after, about 50% remains 2 hours after, about 35% remains 2 1/2 hours after, about 20% remains 3 hours after, about 5% remains 4 hours after, about 0% remains Although this will vary for individuals it's a good guestimation to go on. So an example of avoiding 'insulin stacking' this morning for me; I woke at 18.0mmol and dosed up 3.4units. Two hours after I was 17.4mmol, and my machine predicted I had 1.2units left in my system. I knew the 1.2units left wouldn't get me down as low as I wanted to go but also knew re-dosing the original 3.4units again would be far too much as even though it didn't look like it was working, it still had time to do so. So the maths based on my correction ratio meant that the remaining 1.2units in my system would probably get me down to 12.6mmol and so I needed an additional top up of 1.2units to get me down to the 7s. If I had just taken that 17.4mmol score on its own without the history and dosed up for purely that score I'd end up close to hypo based on what was already in my system, because I dosed up based on roughly what I thought was in my system I should be almost normal now. (I'm on a pump so can get the exact dose values, but you still use the same maths for pens just round up or down to the nearest whole number). Injecting each time you eat doesn't risk stacking as the additional QA should be matching the additional CPs and so will happily be used on what it was intended for - correcting each time you eat does however risk stacking as your previous correction may not have had chance to do its job and then the additional correction will be 'correcting' (or 'mis-correcting'!) something that given time doesn't need correcting.

Sep 16, 2014 Gemsa 20 posts	Topic: General Discussion / Planning for a Baby...Advice Needed Hi lffat, you've had some really good responses so far to give you an idea. To reiterate Warwicks point 1 - pregnancy really makes your hormones etc change which really makes your blood sugar and insulin requirements change. If you want a smooth pregnancy (and by this I don't mean a complication free one, although that would help too, but a low-stress not worrying about your bloods every couple of hours one) then you need to really understand the different sort of tweaks that can be done and what reactions to look out for etc. Speak to your Diabetes team at the hospital, as VickyP said most offer a pre-conception clinic where you'll be seen more regularly and they'll help prepare you in advance of it happening. They will be able to offer advice as to how soon after diagnosis is a good idea for you taking into account the likelihood of the honeymoon phase. I found it took me 15 months after doing DAFNE to get my bloods good enough - the length of time will vary for individuals of course. In an ideal world you need to be taking the 5mg folic acid dose a minimum of 3 months before conception to ensure there is enough in your system - so it would be good to wait that long at least. It does you no harm to take for a much longer period if your bloods don't get good enough as quickly as you thought, or you don't fall pregnancy as quickly as you'd expect so don't worry on that front. But whatever happens, as sometimes 'accidents' do happen, if you find yourself pregnant and your bloods aren't where you'd want them to be - don't feel like a naughty schoolgirl and hide from the medical team, get yourself into the antenatal diabetes clinic within the week and you can start working together to make things better. My consultant always joked she asked patients to tell her the result of the pregnancy test before they tell their husband! The early days are very important both for baby's development, but also for you (increase of hypos + reduced symptoms can lead to a stressful period that may knock you under more than morning sickness) and so get all the help you are offered as it will have an impact. They don't want to criticise you, they want to get a healthy baby and healthy mum out of it at the end.

Sep 16, 2014 DianeW 115 posts	Topic: General Discussion / Change of routine and injection times Hi, any advice welcome. I take Lantus before breakfast and before bed. I am flying abroad (no change in time zones) meaning that I will go to bed about 9pm and be up at 3am. I normally take my bedtime dose about 11pm and morning one about 8am. My flight is at 6am. I am thinking the best thing is to take the Lantus at 9pm but take extra to cover me from then up to the approximate time we get to the hotel mid morning, which would save me having to inject at 3am. If I work out how much Lantus I take an hour I should be able to calculate the extra. Hope this makes sense.

Sep 14, 2014 mum2westiesGill 502 posts	Topic: General Discussion / My BGs - lots of drops here Can anyone see any trends? Any help in identifying trends and/or advice on how to improve my control would be greatly appreciated Thank you

Sep 12, 2014 Neville COL 23 posts	Topic: Carbohydrate Counting / Carb counting Coke Life? http://www.marketingweek.co.uk/opinion/ritson/coke-life-is-the-harbinger-of-death-for-coca-cola/4011475.article Heres a link to an article I just found on Google predicting a short life for this curious substance....! As for artificial sweeteners, I ll take the risk....!, My dad got to 96 on saccharine......!

Sep 12, 2014 Debcj75 4 posts	Topic: Carbohydrate Counting / Carb counting Coke Life? Thats what I thought, slightly lighter normal coke! The only reason I even looked at it was that I happily drink quite a bit of diet coke, but am fed up of people telling me how bad it is with all the aspartame in it. This new one seemed to be Cokes 'healthier' (I use that term loosely) choice, and I was hoping it would be. Oh well

Sep 12, 2014 Neville COL 23 posts	Topic: Carbohydrate Counting / Carb counting Coke Life? I d avoid that like the plague! It looks like low sugar 'ordinary' Coke to me, sugar being a natural sweetener ! They seem to be trying to con the unwary slimmer......save the insulin for something more worthy!

Sep 12, 2014 Debcj75 4 posts	Topic: Carbohydrate Counting / Good carb counting resource? I really like the My fitness pal app, especially for the barcode reading function, sometimes if the nutritional values are printed really tiny, or in a different language etc, it really helps!

Sep 12, 2014 Debcj75 4 posts	Topic: Carbohydrate Counting / Carb counting Coke Life? Hi, I don't know if this one has been asked before (apologies if it has) but I remember from my DAFNE course something about not counting items with sweeteners like truvia etc. The new drink from Coca Cola, Coke Life, says it is lower calorie and sweetened by natural sources. Carbs are 6.7 per 100ml, so 30 ish for the 500 bottle. I presume this should be injected for, if drinking it, but just wanted to check. Many thanks in advance for any help/ideas.