Recent Posts - DAFNE Online

Aug 27, 2014

wigworld 19 posts

Topic: General Discussion / Faulty Novopens

Insulin should be OK at room temperature for 30 days. I've never had a problem with my Novopen not working - my problem is forgetting to take it out with me! Confused

Aug 27, 2014

wigworld 19 posts

Topic: General Discussion / Faulty Novopens

Insulin should be OK at room temperature for 30 days. I've never had a problem with my Novopen not working - my problem is forgetting to take it out with me! Confused

Aug 27, 2014

michaelj 45 posts

Topic: Carbohydrate Counting / totally lost with nutritional info

You can use both but it's easier to go for the individual portion calculations. You can work out how much carbohydrate you will consume whether its a biscuit or slice of bread or a banana When I did my Daphne course they got us to try different ratios to see how we got on. Would suggest a 1-1 ratio to start and see how that works. My personal settings now are
Breakfast 2-1 2 units per 1o gms carbohydrate 3 portions- 30 gms - 6units
Lunch 1-1 1 " " " 4 portions - 40 gms - 4 units
Evening 1.5-1 1.5 " " " 6 portions - 60 gms - 9 units
Things like pasta, rice ect will usually give you the value per 100gms you just decide how much you want and divide the weight by carbs. same with things like potato, It takes getting used to but don't panic if you get it wrong occasionally we all do.
When out for a meal things like a potato the size of a small egg will count as roughly1 portion or 10 gms carb - 6 chips are about the same, a medium slice of bread.roughly just over 10 gms or 1 portion burger bap roughly 20 gms or 2 portions As a beginner its best to stay away from the sweet stuff until you get a bit more practiced at calculation what you're eating.
Hope that's been of some help and just don't panic it will work after a while. You will have to experiment a little but you will get there.

Aug 27, 2014

eeefa91 1 post

Topic: Carbohydrate Counting / totally lost with nutritional info

Hi I just graduated Dafne and I was.wondering could someone please explain how I estimate how much insulin to give in relation to looking at the per 100g section of a pack? Compared to e.g. per slice of bread/per biscuit. Which do I look at? Per 100g or the individual if its there?
ðŸ˜ž

Aug 26, 2014

Phil Maskell 194 posts

Topic: General Discussion / Faulty Novopens

I've had this, but I've also had a cartridge fail, the plunger went down, but I knew none (or very little) insulin had gone in as the rest had come out the sides of the cartridge due to a small crack.

I too wasn't prepared, was working in London, living in Nottingham, had to go all day at work with little or no insulin and use a new cartridge when got home. I only keep a spare cartridge with me on a daily basis if I'm nearly out as I don't want them out of the fridge too long.

Do other people carry spares? Is it ok out of the fridge? Suppose it must be, once in my pen its out for a few days.

Aug 26, 2014

michaelj 45 posts

Topic: Carbohydrate Counting / Jelly Babies

Gluco juice from Boots or from Amazon works very well. Each 60ml bottle contains 15 gms carb and being liquid are absorbed very quickly. I always carry a couple when out and about. Advantage is you can accurately count how much you have taken carbwise.

Aug 26, 2014

michaelj 45 posts

Topic: Carbohydrate Counting / Grapes/fruit generally

Grapes, otherwise known as sugar bombs. Have a passion for grapes and will always get a high B/S read later in the day if I go mad.
Most fruit contains Fructose (another form of glucose) and will have an effect on readings. As fruit ripens it naturally contains more to produce the sweetness. Having said that I don't think you need to worry overmuch. Most dietary carb calculations are based on food which are fit to eat and therefore ripe.
Black are best and sweeter.

Aug 26, 2014

mum2westiesGill 502 posts

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

Thanks Warwick Very Happy

.

Please watch this space for more diary sharing Very Happy

Aug 25, 2014

Warwick 423 posts

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

Humalog's action time is 3-4 hours, so you are right that a bedtime reading only 2 hours after your evening meal will not accurately reflect what is going on as only about 2/3 of the insulin will be used up. I struggle with that too. I tend to eat quite late, then try and still be in bed by a reasonable time. After 3 hours, 90-95% of the QA will be used, so you would probably be OK with that reading.

Aug 25, 2014

mum2westiesGill 502 posts

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

The only real disadvantage to splitting is that there is an extra injection each day.
- This wouldn't really bother me because I already have x4 injections

However, if you have ever forgotten to take basal insulin before, the benefit of splitting is that your BGs shouldn't rise quite so much if that happens as there will still be some in your body from the previous injection.
- Very Happy

Splitting is reasonably easy, just drop a unit at night and add one each morning. You may find that your overall basal insulin needs will increase if your basal has been running out, so do keep an eye on that. I went from 18 units nightly, to 2 x 10 unit injections morning and night. I lost the spikes between dinner and bedtime though so I found it was worth it.
- Yes all understood Very Happy

You may want to monitor your BGs for another week or so before you decide. If you do that, try to avoid eating anything after dinner, and just take correctional doses if required before bed. If you have good BGs before bed, then schedule a 3 am test to see if they are holding, dropping or increasing.
- Maybe a good idea to monitor for another week or so. Also I'm only going to do bedtime tests at least 4/5 hours after dinnertime to give a truer reflection of bedtime tests. I sometimes eat dinner at 7:30pm - 8pm ish then bedtime test is only 2 hours after which doesn't give a true reflection of my bedtime tests does it?

I do bedtime tests at 10:30pm ish because this is when I take my BI as a way of remembering to take it.

Aug 25, 2014

Warwick 423 posts

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

The only real disadvantage to splitting is that there is an extra injection each day. However, if you have ever forgotten to take basal insulin before, the benefit of splitting is that your BGs shouldn't rise quite so much if that happens as there will still be some in your body from the previous injection.

Splitting is reasonably easy, just drop a unit at night and add one each morning. You may find that your overall basal insulin needs will increase if your basal has been running out, so do keep an eye on that. I went from 18 units nightly, to 2 x 10 unit injections morning and night. I lost the spikes between dinner and bedtime though so I found it was worth it.

You may want to monitor your BGs for another week or so before you decide. If you do that, try to avoid eating anything after dinner, and just take correctional doses if required before bed. If you have good BGs before bed, then schedule a 3 am test to see if they are holding, dropping or increasing.

Aug 25, 2014

mum2westiesGill 502 posts

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

Hi Warwick,
Thank you for your reply.

What BI and QA are you using?
BI - lantus and QA - Humalog

I don't think that splitting your BI will help your overnight differences.
Ok

You may want to split your BI though if your BGs are consistently rising between dinner and bedtime as that would be a sign that your BI is running out. There is some evidence in your diary to indicate that this may be occurring. Splitting may fix that, and if that gets fixed, then it may also lead to an improvement in overnight stability.
Ok but don't know whether to do a couple of nights basal testing first or do a split straight away. Splitting is absolutely fine with my practice nurse who looks after my diabetes.

Aug 25, 2014

Muna A H 34 posts

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

My honeymoon period was straight after giving birth to my son, and that was the best part of the whole pregnancy. I wish I have that again Wink

Aug 24, 2014

Warwick 423 posts

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

It's pretty difficult to see a pattern. Sometimes, your BGs aren't changing much, indicating that your BI is correct, other times they drop a lot, like on 13/8 when half a unit of QA dropped your levels overnight from 14.8 to 7.7. Usually half a unit of QA would only be expected to drop your BGs by about 1.5, so that is a surprise.

What BI and QA are you using? I don't think that splitting your BI will help your overnight differences. You may want to split your BI though if your BGs are consistently rising between dinner and bedtime as that would be a sign that your BI is running out. There is some evidence in your diary to indicate that this may be occurring. Splitting may fix that, and if that gets fixed, then it may also lead to an improvement in overnight stability.

I split at the beginning of last year because I was constantly getting a rise between dinner and bedtime. Increasing my dinner time QA led to hypos, so it became obvious that my BI (Lantus at the time) was not lasting the full 24 hours.

Aug 24, 2014

Warwick 423 posts

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

Wow, that must be a big shock. Being male, I have absolutely no experience of being diabetic and pregnant, however, I would like to give some advice anyway.

1) If you can, try and get a good handle on diabetes before you start trying for a baby. Even leaving things for 6 months will give you much more experience than you currently have. You will want to have that experience and knowledge when you are pregnant and your BGs aren't responding in the way that you want them to.

2) HbA1c is a very blunt tool in determining your management of diabetes. For example, having lots of hypos can lead to a low HbA1c, but having lots of hypos is not good management. Rather than aiming for a specific HbA1c, try for steady blood sugars within the 4-8 mmol/L range without too many spikes and troughs. This is quite difficult to achieve though - after 4 years of being type 1, I'm still struggling to do that. If you do that however, a good HbA1c will naturally follow.

3) Don't be hard on yourself when you have highs and lows. We all get these (and mentally beat ourselves up over it before realising that really, we are doing a pretty good job of managing a difficult condition).

4) I've been finding for myself, that reducing the number of carbs I eat, is helping a lot in terms of managing the spikes and troughs. Less carbs, mean less insulin and so there is less chance of hypos. I'm not advocating an extreme low-carb diet (which would be dangerous during pregnancy), but I recommend finding out what the recommended range of daily carbs is for a pregnant mother, and trying to stick to that as much as possible. (I do understand about pregnancy cravings though! Razz

) I also find that aiming to eat protein every meal is helping me cut out snacks as I feel full in between meal times. Having adequate protein will also be important when you are pregnant.

5) You are probably still in the honeymoon period where your pancreas still produces some insulin ( and could be for 18 months or so). That may or may not be an advantage while pregnant, but is something to discuss with your medical team when talking about preparing for pregnancy. It can make your BGs a little more unpredictable because your doses of insulin may coincide with your pancreas sending out some insulin and leading to a hypo.

All the best with it. I was diagnosed at my daughter's 6 week check-up, so for me fatherhood and diabetes started only 6 weeks apart. I've met a lot of type 1 mums in the last 4 years who have delivered healthy babies, (some whose children are now in their twenties), so I'm confident that with the care and support that you will get while pregnant, you will be fine.

Aug 24, 2014

mum2westiesGill 502 posts

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

Hi Warwick, thank you for your reply. Here is my shared DAFNE diary with the dates from 12/08 - 22/08

Aug 24, 2014

Vickyp 137 posts

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

I was told hba1c of around 43 and target bs levels are between 4 and 7.5 (including the post parandial test).
Your diabetes team should arrange preconception clinic appointments, rather than just the standard diabetes clinic, as there are other drugs you should take....high dose (5mg) folic acid (prescription only) and vitamin D are the 2 I was told.

Aug 24, 2014

madcow6 1 post

Topic: Carbohydrate Counting / Grapes/fruit generally

It's recently been pointed out to me that some fruits release/create more sugars as they ripen. Could this change the sugar content with any great significance? I specifically mention grapes because I tend to eat quite a lot in one serving (200g +) so with this quantity I'm wondering if it'd make a difference.
Thanks!

Aug 24, 2014

Iffat 2 posts

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

Hello...

I have been married almost a year and would love to have a baby. What advice can other mums with type 1 give to me? I haven't started trying as only got diagnosed a month ago and my last HBA1C was 104 so i know this needs to come down?

What is a healthy HBA1C to start trying for a baby?

What do my BGL need to be? At the moment i have managed to stabilise my blood sugar levels so its going from approx 4.5-11, most days it stays around 6-8 since i've started taking insulin.

Any advice would be massively appreciated xx

Aug 23, 2014

Warwick 423 posts

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

With the high readings, did you take correctional doses to bring them down, or did they drop naturally? In general, it is much easier for us to give advice if you can share your DAFNE diary with the thread. Just enter the dates that you want to share with the thread and it will post those to this thread. We can then see what is happening during the course of the day too. With just the night to morning results, I don't think anyone would be brave enough to suggest a course of action. We need to know what is happening during the day too.

Aug 23, 2014

HelenH 9 posts

Topic: General Discussion / Faulty Novopens

Happened a few times to me - usually after a change of cartridge. Plunger had been stuck so didn't depress rubber stopper - always double check now.

Aug 27, 2014 wigworld 19 posts	Topic: General Discussion / Faulty Novopens Insulin should be OK at room temperature for 30 days. I've never had a problem with my Novopen not working - my problem is forgetting to take it out with me!

Aug 27, 2014 wigworld 19 posts	Topic: General Discussion / Faulty Novopens Insulin should be OK at room temperature for 30 days. I've never had a problem with my Novopen not working - my problem is forgetting to take it out with me!

Aug 27, 2014 michaelj 45 posts	Topic: Carbohydrate Counting / totally lost with nutritional info You can use both but it's easier to go for the individual portion calculations. You can work out how much carbohydrate you will consume whether its a biscuit or slice of bread or a banana When I did my Daphne course they got us to try different ratios to see how we got on. Would suggest a 1-1 ratio to start and see how that works. My personal settings now are Breakfast 2-1 2 units per 1o gms carbohydrate 3 portions- 30 gms - 6units Lunch 1-1 1 " " " 4 portions - 40 gms - 4 units Evening 1.5-1 1.5 " " " 6 portions - 60 gms - 9 units Things like pasta, rice ect will usually give you the value per 100gms you just decide how much you want and divide the weight by carbs. same with things like potato, It takes getting used to but don't panic if you get it wrong occasionally we all do. When out for a meal things like a potato the size of a small egg will count as roughly1 portion or 10 gms carb - 6 chips are about the same, a medium slice of bread.roughly just over 10 gms or 1 portion burger bap roughly 20 gms or 2 portions As a beginner its best to stay away from the sweet stuff until you get a bit more practiced at calculation what you're eating. Hope that's been of some help and just don't panic it will work after a while. You will have to experiment a little but you will get there.

Aug 27, 2014 eeefa91 1 post	Topic: Carbohydrate Counting / totally lost with nutritional info Hi I just graduated Dafne and I was.wondering could someone please explain how I estimate how much insulin to give in relation to looking at the per 100g section of a pack? Compared to e.g. per slice of bread/per biscuit. Which do I look at? Per 100g or the individual if its there? ðŸ˜ž

Aug 26, 2014 Phil Maskell 194 posts	Topic: General Discussion / Faulty Novopens I've had this, but I've also had a cartridge fail, the plunger went down, but I knew none (or very little) insulin had gone in as the rest had come out the sides of the cartridge due to a small crack. I too wasn't prepared, was working in London, living in Nottingham, had to go all day at work with little or no insulin and use a new cartridge when got home. I only keep a spare cartridge with me on a daily basis if I'm nearly out as I don't want them out of the fridge too long. Do other people carry spares? Is it ok out of the fridge? Suppose it must be, once in my pen its out for a few days.

Aug 26, 2014 michaelj 45 posts	Topic: Carbohydrate Counting / Jelly Babies Gluco juice from Boots or from Amazon works very well. Each 60ml bottle contains 15 gms carb and being liquid are absorbed very quickly. I always carry a couple when out and about. Advantage is you can accurately count how much you have taken carbwise.

Aug 26, 2014 michaelj 45 posts	Topic: Carbohydrate Counting / Grapes/fruit generally Grapes, otherwise known as sugar bombs. Have a passion for grapes and will always get a high B/S read later in the day if I go mad. Most fruit contains Fructose (another form of glucose) and will have an effect on readings. As fruit ripens it naturally contains more to produce the sweetness. Having said that I don't think you need to worry overmuch. Most dietary carb calculations are based on food which are fit to eat and therefore ripe. Black are best and sweeter.

Aug 26, 2014 mum2westiesGill 502 posts	Topic: General Discussion / My BGs - lots of drops here Thanks Warwick . Please watch this space for more diary sharing

Aug 25, 2014 Warwick 423 posts	Topic: General Discussion / My BGs - lots of drops here Humalog's action time is 3-4 hours, so you are right that a bedtime reading only 2 hours after your evening meal will not accurately reflect what is going on as only about 2/3 of the insulin will be used up. I struggle with that too. I tend to eat quite late, then try and still be in bed by a reasonable time. After 3 hours, 90-95% of the QA will be used, so you would probably be OK with that reading.

Aug 25, 2014 mum2westiesGill 502 posts	Topic: General Discussion / My BGs - lots of drops here The only real disadvantage to splitting is that there is an extra injection each day. - This wouldn't really bother me because I already have x4 injections However, if you have ever forgotten to take basal insulin before, the benefit of splitting is that your BGs shouldn't rise quite so much if that happens as there will still be some in your body from the previous injection. - Splitting is reasonably easy, just drop a unit at night and add one each morning. You may find that your overall basal insulin needs will increase if your basal has been running out, so do keep an eye on that. I went from 18 units nightly, to 2 x 10 unit injections morning and night. I lost the spikes between dinner and bedtime though so I found it was worth it. - Yes all understood You may want to monitor your BGs for another week or so before you decide. If you do that, try to avoid eating anything after dinner, and just take correctional doses if required before bed. If you have good BGs before bed, then schedule a 3 am test to see if they are holding, dropping or increasing. - Maybe a good idea to monitor for another week or so. Also I'm only going to do bedtime tests at least 4/5 hours after dinnertime to give a truer reflection of bedtime tests. I sometimes eat dinner at 7:30pm - 8pm ish then bedtime test is only 2 hours after which doesn't give a true reflection of my bedtime tests does it? I do bedtime tests at 10:30pm ish because this is when I take my BI as a way of remembering to take it.

Aug 25, 2014 Warwick 423 posts	Topic: General Discussion / My BGs - lots of drops here The only real disadvantage to splitting is that there is an extra injection each day. However, if you have ever forgotten to take basal insulin before, the benefit of splitting is that your BGs shouldn't rise quite so much if that happens as there will still be some in your body from the previous injection. Splitting is reasonably easy, just drop a unit at night and add one each morning. You may find that your overall basal insulin needs will increase if your basal has been running out, so do keep an eye on that. I went from 18 units nightly, to 2 x 10 unit injections morning and night. I lost the spikes between dinner and bedtime though so I found it was worth it. You may want to monitor your BGs for another week or so before you decide. If you do that, try to avoid eating anything after dinner, and just take correctional doses if required before bed. If you have good BGs before bed, then schedule a 3 am test to see if they are holding, dropping or increasing.

Aug 25, 2014 mum2westiesGill 502 posts	Topic: General Discussion / My BGs - lots of drops here Hi Warwick, Thank you for your reply. What BI and QA are you using? BI - lantus and QA - Humalog I don't think that splitting your BI will help your overnight differences. Ok You may want to split your BI though if your BGs are consistently rising between dinner and bedtime as that would be a sign that your BI is running out. There is some evidence in your diary to indicate that this may be occurring. Splitting may fix that, and if that gets fixed, then it may also lead to an improvement in overnight stability. Ok but don't know whether to do a couple of nights basal testing first or do a split straight away. Splitting is absolutely fine with my practice nurse who looks after my diabetes.

Aug 25, 2014 Muna A H 34 posts	Topic: General Discussion / Planning for a Baby...Advice Needed My honeymoon period was straight after giving birth to my son, and that was the best part of the whole pregnancy. I wish I have that again

Aug 24, 2014 Warwick 423 posts	Topic: General Discussion / My BGs - lots of drops here It's pretty difficult to see a pattern. Sometimes, your BGs aren't changing much, indicating that your BI is correct, other times they drop a lot, like on 13/8 when half a unit of QA dropped your levels overnight from 14.8 to 7.7. Usually half a unit of QA would only be expected to drop your BGs by about 1.5, so that is a surprise. What BI and QA are you using? I don't think that splitting your BI will help your overnight differences. You may want to split your BI though if your BGs are consistently rising between dinner and bedtime as that would be a sign that your BI is running out. There is some evidence in your diary to indicate that this may be occurring. Splitting may fix that, and if that gets fixed, then it may also lead to an improvement in overnight stability. I split at the beginning of last year because I was constantly getting a rise between dinner and bedtime. Increasing my dinner time QA led to hypos, so it became obvious that my BI (Lantus at the time) was not lasting the full 24 hours.

Aug 24, 2014 Warwick 423 posts	Topic: General Discussion / Planning for a Baby...Advice Needed Wow, that must be a big shock. Being male, I have absolutely no experience of being diabetic and pregnant, however, I would like to give some advice anyway. 1) If you can, try and get a good handle on diabetes before you start trying for a baby. Even leaving things for 6 months will give you much more experience than you currently have. You will want to have that experience and knowledge when you are pregnant and your BGs aren't responding in the way that you want them to. 2) HbA1c is a very blunt tool in determining your management of diabetes. For example, having lots of hypos can lead to a low HbA1c, but having lots of hypos is not good management. Rather than aiming for a specific HbA1c, try for steady blood sugars within the 4-8 mmol/L range without too many spikes and troughs. This is quite difficult to achieve though - after 4 years of being type 1, I'm still struggling to do that. If you do that however, a good HbA1c will naturally follow. 3) Don't be hard on yourself when you have highs and lows. We all get these (and mentally beat ourselves up over it before realising that really, we are doing a pretty good job of managing a difficult condition). 4) I've been finding for myself, that reducing the number of carbs I eat, is helping a lot in terms of managing the spikes and troughs. Less carbs, mean less insulin and so there is less chance of hypos. I'm not advocating an extreme low-carb diet (which would be dangerous during pregnancy), but I recommend finding out what the recommended range of daily carbs is for a pregnant mother, and trying to stick to that as much as possible. (I do understand about pregnancy cravings though! ) I also find that aiming to eat protein every meal is helping me cut out snacks as I feel full in between meal times. Having adequate protein will also be important when you are pregnant. 5) You are probably still in the honeymoon period where your pancreas still produces some insulin ( and could be for 18 months or so). That may or may not be an advantage while pregnant, but is something to discuss with your medical team when talking about preparing for pregnancy. It can make your BGs a little more unpredictable because your doses of insulin may coincide with your pancreas sending out some insulin and leading to a hypo. All the best with it. I was diagnosed at my daughter's 6 week check-up, so for me fatherhood and diabetes started only 6 weeks apart. I've met a lot of type 1 mums in the last 4 years who have delivered healthy babies, (some whose children are now in their twenties), so I'm confident that with the care and support that you will get while pregnant, you will be fine.

Aug 24, 2014 mum2westiesGill 502 posts	Topic: General Discussion / My BGs - lots of drops here Hi Warwick, thank you for your reply. Here is my shared DAFNE diary with the dates from 12/08 - 22/08

Aug 24, 2014 Vickyp 137 posts	Topic: General Discussion / Planning for a Baby...Advice Needed I was told hba1c of around 43 and target bs levels are between 4 and 7.5 (including the post parandial test). Your diabetes team should arrange preconception clinic appointments, rather than just the standard diabetes clinic, as there are other drugs you should take....high dose (5mg) folic acid (prescription only) and vitamin D are the 2 I was told.

Aug 24, 2014 madcow6 1 post	Topic: Carbohydrate Counting / Grapes/fruit generally It's recently been pointed out to me that some fruits release/create more sugars as they ripen. Could this change the sugar content with any great significance? I specifically mention grapes because I tend to eat quite a lot in one serving (200g +) so with this quantity I'm wondering if it'd make a difference. Thanks!

Aug 24, 2014 Iffat 2 posts	Topic: General Discussion / Planning for a Baby...Advice Needed Hello... I have been married almost a year and would love to have a baby. What advice can other mums with type 1 give to me? I haven't started trying as only got diagnosed a month ago and my last HBA1C was 104 so i know this needs to come down? What is a healthy HBA1C to start trying for a baby? What do my BGL need to be? At the moment i have managed to stabilise my blood sugar levels so its going from approx 4.5-11, most days it stays around 6-8 since i've started taking insulin. Any advice would be massively appreciated xx

Aug 23, 2014 Warwick 423 posts	Topic: General Discussion / My BGs - lots of drops here With the high readings, did you take correctional doses to bring them down, or did they drop naturally? In general, it is much easier for us to give advice if you can share your DAFNE diary with the thread. Just enter the dates that you want to share with the thread and it will post those to this thread. We can then see what is happening during the course of the day too. With just the night to morning results, I don't think anyone would be brave enough to suggest a course of action. We need to know what is happening during the day too.

Aug 23, 2014 HelenH 9 posts	Topic: General Discussion / Faulty Novopens Happened a few times to me - usually after a change of cartridge. Plunger had been stuck so didn't depress rubber stopper - always double check now.