Recent Posts - DAFNE Online

Mar 18, 2014

Garry 328 posts

Topic: General Discussion / New to dafne

Welcome Andy Watt Smile

Good outcome for you I'm pleased to see. Tackle the hypos as soon as possible.
Take it steady. Ensure some consistant days worth of results between dose changes as most people find outcomes can be a little unpredictable over short time scales.
When you get things under control you may feel confident enough to run a little high for three months to help try and re-establish your hypo warning symptoms. This tactic certainly worked for me.
Regards
Garry

Mar 18, 2014

Andy Watt 2 posts

Topic: General Discussion / New to dafne

Hi Lucy, I have just done the DAFNE course Mon - Fri last week and I also had my BI changed from Lantus to Levemir. I work 12 hour shifts and most of my low BG results happen at my work, I also have no Hypo awareness at all. I went back to work on Saturday night, and because I work 7 till 7 day or night, we decided to go for 06.30 and 18.30 for my Levemir injections, I was on 20 units of Lantus so I started on 10 units of Levemir am/pm, when I take my injection before I start my shift I only take 8 units and because my job is really physical I was told to knock 1 unit off my QA injections, I still had a few really low BG results (1.4 + 1. Cool

on Saturday so on Sunday night I knocked 3 units off my QA injections and when I got home yesterday morning I was sitting at 8.6 , which I was really happy with. I'm going to stick with that theory when i'm working and see how I get on... Hope you get sorted, mind it will take time to get what works best for you .

Mar 17, 2014

Lucyx78 11 posts

Topic: General Discussion / New to dafne

Thanks so much for the advice and support. I'm really hoping it works for me. I'm a little frustrated with my BG readings at the moment but like you said it was an absolute eye opener the DAFNE course.

Mar 17, 2014

Robert P 1 post

Topic: General Discussion / New to dafne

Mollymynett- Keep with it, I did the course a couple of months ago now, still I have those 'up & down days.' I've been diagnosed for only 2 years and have only every been on the twice a day insuline (I'm rubbish with insulin names!). The DAFNE course was amazing, real eye opener.You will get there.

Mollymynett said:
Hi I've just recently done the dafne . I've been an insulin dependent diabetic for 33years . Since I was 3 .ive had my ups and downs . Feeling a little down as changed from lantus to lev emir now twice daily . Can't seem to get my levels down from double figures . Feeling slightly frustrated is this normal . Thanks in advance

Mar 16, 2014

alturn 78 posts

Topic: General Discussion / New to dafne

Sorry if I appear vague but always wary of offering advice in case it causes problems - and everybody is different.

First I would ignore readings during DAFNE course - different timings, activities, brain activity, DAFNE course etc.

Dropping 26+20 to 14+14 seems a large change at one go to me, but that's done so onwards and better BG Exclamation

, it's all for the best for you.

If you can get your BI so you change between meals/overnight is about +2/-2 (DAFNE target) then your BI is probably correct - change am or pm and monitor for 2/3 days, may need to have carb-free meals. When BI is stable, then adjust your ratios. That's the theory. This is not a quick process, so keep at it, I still find it very difficult to accept I have to change QA/BI. So often there is no correct answer, so we just have to make a decision and get on with it - any decision may be better than none.

When high (over 10 in my opinion), insulin may nor work the same so you may need larger adjustments to bring it down. You could publish your BG diary which might help others to advise (assume you input your readings, possibly in a new forum)?. And continuous adjustments probably means BI is incorrect.

Work (I used to do that), physical or mental, can affect you by causing highs and lows, so yes - trial and error. Have you looked at other forums to see if there is anything you could learn? You may need different regime for work/not work.

Best wishes for your first day at work. Laughing

Mar 16, 2014

Lucyx78 11 posts

Topic: General Discussion / New to dafne

Hi
Thank you for your reply and advice. Yeah I am on am and pm levemir. My diabetes specialist nurse dropped my am from 26 units to 14 and 20 units to 14. All last week whilst on the course they were reading high. I've increased my pm BI to 16 and the am has come down slightly but still not within range. Would you also suggest increasing my am BI first before I increase QA to see if it had an affect on day time Bg? I am doing corrections with every meal I have but not having much affect. And these high readings make me feel a bit rubbish. I go back to work tomorrow and it's quite an active job so I will also have to consider how that has an effect on my BG. Trial and error. I suppose

Mar 16, 2014

Lucyx78 11 posts

Topic: General Discussion / New to dafne

Hi
Thank you for your reply and advice. Yeah I am on am and pm levemir. My diabetes specialist nurse dropped my am from 26 units to 14 and 20 units to 14. All last week whilst on the course they were reading high. I've increased my pm BI to 16 and the am has come down slightly but still not within range. Would you also suggest increasing my am BI first before I increase QA to see if it had an affect on day time Bg? I am doing corrections with every meal I have but not having much affect. And these high readings make me feel a bit rubbish. I go back to work tomorrow and it's quite an active job so I will also have to consider how that has an effect on my BG. Trial and error. I suppose

Mar 16, 2014

alturn 78 posts

Topic: General Discussion / New to dafne

Welcome

I wouldn't be concerned about HBA1C (it's a long term test) but concentrate on BG and adjust according to DAFNE rules - if BG is within range and avoiding hights and lows, HBA1C should come within target. This may take several months - think my best HBA1C was a year after DAFNE (Sep 2012). After DAFNE my aim was to reduce the highs (causing blurred vision, not occurred since DAFNE) and lows (2.0 and less) and my HBA1C eventually came down to virtually perfect - but since then I've had a relapse. It's a bit of a game - me versus BG!

I also had to increase my Levemir after DAFNE (from 16 pre-DAFNE now at 24 per day split am and pm) which took some time to show up. The timing of Levemir may also affect BG.

BG/HBA1C may depend on external factors - stress, different regime, even getting used to DAFNE from what you did before, eating differently.

If your levels are reasonably consistent it's probably easier to fix.

If high am and lunch time, possibly need to adjust evening Levemir (assuming you are on on Levemir am and pm, and QA for meals). Remember BI changes can take a few days to show up in BG.

Hope this make sense and helps.

Mar 16, 2014

Lucyx78 11 posts

Topic: General Discussion / New to dafne

Hi
I am a new dafne graduate I completed the course last week. I am just wondering how long roughly does it take to notice real changes to hba1c ? I am still adjusting my levemir at the moment as my morning and before lunch time readings are in double figures.
If anyone can give any advice I would really appreciate it

Mar 16, 2014

Glock87 2 posts

Topic: General Discussion / ratios

Thanks for the replys guys

Mar 16, 2014

Warwick 425 posts

Topic: General Discussion / ratios

Hi Mark,

Best to use trial and error. If you find your BGs go high on a lower ratio, then up the ratio until you get results you like. Shift work can alter so many different things in your body that it is impossible to say without seeing what happens from trial and error.

When I did shift work, I only needed 5 hours sleep per day, but when I switched back to day shift, I would need 8 or 9. That can have a big effect on blood glucose levels and ratios.

Cheers,
Warwick.

Mar 14, 2014

alturn 78 posts

Topic: General Discussion / ratios

You could try 2.5:1.

Or use the ratio of the meal nearest to your "late" meal, possibly adjusting.

If you have two meals, and QA insulin for each, and the the second QA is taken while the first QA is still persists (believe QA persists for 4-5 hours) is there a risk of hypo, especially as ratios are highish? Perhaps someone else can clarify?

Mar 14, 2014

Glock87 2 posts

Topic: General Discussion / ratios

Hi,

Im on 3:1 ratio at breakfast and 2:1 from lunch onwards.

My job sometimes means I work nights and that means I dont get up till later, does that mean I do 3:1 on my first meal or do I do 2:1?

Mar 14, 2014

novorapidboi26 1,819 posts

Topic: Questions for HCPs / glycogen replenishment?

My understanding, which could be wrong, is that, glucagon, is sent form the pancreas [alpha cells], to the liver, which then releases glycogen as a source of fuel......

In terms of when to replenish your livers energy stores I don't know unfortunately.........

good question though...

Mar 13, 2014

dunkers7 24 posts

Topic: Questions for HCPs / glycogen replenishment?

My understanding is, adrenaline is the trigger for glycogen being sent from the liver, which raises blood glucose as a result.

I have seen increasing blood glucose after exercise frequently, which I think suggests some glycogen was used as a result of exercise induced adrenaline.

As a diabetic, at what point should I be thinking about eating to replenish glycogen stores?

Mar 13, 2014

Louise1988 69 posts

Topic: General Discussion / Need to nip this in the bud...

Thanks for the encouragement, will see how I go Smile

Mar 13, 2014

Rafa 99 posts

Topic: General Discussion / Need to nip this in the bud...

I would agree you are doing well. Would love those readings at bed, 3am and morning.

Mar 13, 2014

youone 102 posts

Topic: Carbohydrate Counting / reliable metre readings

Hi Vicky
I'm still not happy with the test strips supplied, There gave a 2 difference to my glucomen lx plus and a friends metre,
So until things settle I'm staying with the glucomen.
yes the CGM would aid you with your pregnancy.
I missed the countmein visit to the house of paliment the this week, which has gone well,
I really hope the government increase research funding for diabetes also funding for pumps and other devices.
I guess like you, I can't believe how much my pump has changed my life
Keep us informed on any good news
Brian

Mar 12, 2014

alturn 78 posts

Topic: General Discussion / Need to nip this in the bud...

I would consider -2 or +2 change from bed to breakfast is within range (I dropped 7 one night recently and also gone up by 4 so planning is difficult). As your Levemir is in relatively small amounts, any change could have a dramatic effect. I would err on the cautious side and prefer to be a bit high than risk an overnight hypo - of which you are very aware.

So if I was you I would continue to monitor and change by small amounts (1/2 unit change) if overnight changes get larger. Based on info provided, I think your doing Ok.

Hope this helps.

Mar 12, 2014

Louise1988 69 posts

Topic: General Discussion / Need to nip this in the bud...

For the past few days or so, I've noticed a slight increase from my before bed to before breakfast. It's only an increase of 1-2, but it's something I want to try to tackle. I've done a couple of 3am checks and I seem to dip slightly during the night. For example last night -

I went to bed at 10pm, by bg was 6.8. 3am this morning I was 6.4, and before breakfast at 7am, I was 7.3.

I've recently split my levemir, 3u at 9pm, and 3u at 9am. This is working really well for me, as I'm not going to bed high, and I'm not waking up low in the morning.

I was contemplating upping my 9pm dose, but I'm weary of the slight drop during the night, I don't want to drop and hypo.

Any suggestions?

Mar 11, 2014

mihaela 7 posts

Topic: General Discussion / miss

ok i started my night bi at 8pm now and im having 2 units qa in the morning so ill see how i go Smile

Mar 11, 2014

mum2westiesGill 502 posts

Topic: General Discussion / Targets - too many BGs out of target

So after having breakfast then find I'm high at lunchtime alter the breakfast ratio?

Mar 11, 2014

novorapidboi26 1,819 posts

Topic: General Discussion / Targets - too many BGs out of target

you seem to be rising from when you get up, to when you actually eat something, but that unrelated to QA ratios.....

start with your breakfast ratio, or your first meal if you want to call it that, if you are high at the next meal, 4-5 hours later, then you can up your ratio to 1.5:1 [1.5 units to 10g]...you should only up the ratio after observing your readings for 2-3 days though, and don't change your BI dose when doing this.....

Mar 11, 2014

novorapidboi26 1,819 posts

Topic: General Discussion / Type 1 as a disability

I too don't see it as a disability, and I suppose the only time its relevant and useful is in employment where we would fall under the disability discrimination act.

I personally probably wouldn't try and get a discount at the gym, but financially I am OK, but for some the cost of a gym membership is just a bit too much...

So my advice to you is go for it, think about the benefit to your health and how much easier your BG control will be due to increased activity......

Mar 18, 2014 Garry 328 posts	Topic: General Discussion / New to dafne Welcome Andy Watt Good outcome for you I'm pleased to see. Tackle the hypos as soon as possible. Take it steady. Ensure some consistant days worth of results between dose changes as most people find outcomes can be a little unpredictable over short time scales. When you get things under control you may feel confident enough to run a little high for three months to help try and re-establish your hypo warning symptoms. This tactic certainly worked for me. Regards Garry

Mar 18, 2014 Andy Watt 2 posts	Topic: General Discussion / New to dafne Hi Lucy, I have just done the DAFNE course Mon - Fri last week and I also had my BI changed from Lantus to Levemir. I work 12 hour shifts and most of my low BG results happen at my work, I also have no Hypo awareness at all. I went back to work on Saturday night, and because I work 7 till 7 day or night, we decided to go for 06.30 and 18.30 for my Levemir injections, I was on 20 units of Lantus so I started on 10 units of Levemir am/pm, when I take my injection before I start my shift I only take 8 units and because my job is really physical I was told to knock 1 unit off my QA injections, I still had a few really low BG results (1.4 + 1. on Saturday so on Sunday night I knocked 3 units off my QA injections and when I got home yesterday morning I was sitting at 8.6 , which I was really happy with. I'm going to stick with that theory when i'm working and see how I get on... Hope you get sorted, mind it will take time to get what works best for you .

Mar 17, 2014 Lucyx78 11 posts	Topic: General Discussion / New to dafne Thanks so much for the advice and support. I'm really hoping it works for me. I'm a little frustrated with my BG readings at the moment but like you said it was an absolute eye opener the DAFNE course.

Mar 17, 2014 Robert P 1 post	Topic: General Discussion / New to dafne Mollymynett- Keep with it, I did the course a couple of months ago now, still I have those 'up & down days.' I've been diagnosed for only 2 years and have only every been on the twice a day insuline (I'm rubbish with insulin names!). The DAFNE course was amazing, real eye opener.You will get there. Mollymynett said: Hi I've just recently done the dafne . I've been an insulin dependent diabetic for 33years . Since I was 3 .ive had my ups and downs . Feeling a little down as changed from lantus to lev emir now twice daily . Can't seem to get my levels down from double figures . Feeling slightly frustrated is this normal . Thanks in advance

Mar 16, 2014 alturn 78 posts	Topic: General Discussion / New to dafne Sorry if I appear vague but always wary of offering advice in case it causes problems - and everybody is different. First I would ignore readings during DAFNE course - different timings, activities, brain activity, DAFNE course etc. Dropping 26+20 to 14+14 seems a large change at one go to me, but that's done so onwards and better BG , it's all for the best for you. If you can get your BI so you change between meals/overnight is about +2/-2 (DAFNE target) then your BI is probably correct - change am or pm and monitor for 2/3 days, may need to have carb-free meals. When BI is stable, then adjust your ratios. That's the theory. This is not a quick process, so keep at it, I still find it very difficult to accept I have to change QA/BI. So often there is no correct answer, so we just have to make a decision and get on with it - any decision may be better than none. When high (over 10 in my opinion), insulin may nor work the same so you may need larger adjustments to bring it down. You could publish your BG diary which might help others to advise (assume you input your readings, possibly in a new forum)?. And continuous adjustments probably means BI is incorrect. Work (I used to do that), physical or mental, can affect you by causing highs and lows, so yes - trial and error. Have you looked at other forums to see if there is anything you could learn? You may need different regime for work/not work. Best wishes for your first day at work.

Mar 16, 2014 Lucyx78 11 posts	Topic: General Discussion / New to dafne Hi Thank you for your reply and advice. Yeah I am on am and pm levemir. My diabetes specialist nurse dropped my am from 26 units to 14 and 20 units to 14. All last week whilst on the course they were reading high. I've increased my pm BI to 16 and the am has come down slightly but still not within range. Would you also suggest increasing my am BI first before I increase QA to see if it had an affect on day time Bg? I am doing corrections with every meal I have but not having much affect. And these high readings make me feel a bit rubbish. I go back to work tomorrow and it's quite an active job so I will also have to consider how that has an effect on my BG. Trial and error. I suppose

Mar 16, 2014 Lucyx78 11 posts	Topic: General Discussion / New to dafne Hi Thank you for your reply and advice. Yeah I am on am and pm levemir. My diabetes specialist nurse dropped my am from 26 units to 14 and 20 units to 14. All last week whilst on the course they were reading high. I've increased my pm BI to 16 and the am has come down slightly but still not within range. Would you also suggest increasing my am BI first before I increase QA to see if it had an affect on day time Bg? I am doing corrections with every meal I have but not having much affect. And these high readings make me feel a bit rubbish. I go back to work tomorrow and it's quite an active job so I will also have to consider how that has an effect on my BG. Trial and error. I suppose

Mar 16, 2014 alturn 78 posts	Topic: General Discussion / New to dafne Welcome I wouldn't be concerned about HBA1C (it's a long term test) but concentrate on BG and adjust according to DAFNE rules - if BG is within range and avoiding hights and lows, HBA1C should come within target. This may take several months - think my best HBA1C was a year after DAFNE (Sep 2012). After DAFNE my aim was to reduce the highs (causing blurred vision, not occurred since DAFNE) and lows (2.0 and less) and my HBA1C eventually came down to virtually perfect - but since then I've had a relapse. It's a bit of a game - me versus BG! I also had to increase my Levemir after DAFNE (from 16 pre-DAFNE now at 24 per day split am and pm) which took some time to show up. The timing of Levemir may also affect BG. BG/HBA1C may depend on external factors - stress, different regime, even getting used to DAFNE from what you did before, eating differently. If your levels are reasonably consistent it's probably easier to fix. If high am and lunch time, possibly need to adjust evening Levemir (assuming you are on on Levemir am and pm, and QA for meals). Remember BI changes can take a few days to show up in BG. Hope this make sense and helps.

Mar 16, 2014 Lucyx78 11 posts	Topic: General Discussion / New to dafne Hi I am a new dafne graduate I completed the course last week. I am just wondering how long roughly does it take to notice real changes to hba1c ? I am still adjusting my levemir at the moment as my morning and before lunch time readings are in double figures. If anyone can give any advice I would really appreciate it

Mar 16, 2014 Glock87 2 posts	Topic: General Discussion / ratios Thanks for the replys guys

Mar 16, 2014 Warwick 425 posts	Topic: General Discussion / ratios Hi Mark, Best to use trial and error. If you find your BGs go high on a lower ratio, then up the ratio until you get results you like. Shift work can alter so many different things in your body that it is impossible to say without seeing what happens from trial and error. When I did shift work, I only needed 5 hours sleep per day, but when I switched back to day shift, I would need 8 or 9. That can have a big effect on blood glucose levels and ratios. Cheers, Warwick.

Mar 14, 2014 alturn 78 posts	Topic: General Discussion / ratios You could try 2.5:1. Or use the ratio of the meal nearest to your "late" meal, possibly adjusting. If you have two meals, and QA insulin for each, and the the second QA is taken while the first QA is still persists (believe QA persists for 4-5 hours) is there a risk of hypo, especially as ratios are highish? Perhaps someone else can clarify?

Mar 14, 2014 Glock87 2 posts	Topic: General Discussion / ratios Hi, Im on 3:1 ratio at breakfast and 2:1 from lunch onwards. My job sometimes means I work nights and that means I dont get up till later, does that mean I do 3:1 on my first meal or do I do 2:1?

Mar 14, 2014 novorapidboi26 1,819 posts	Topic: Questions for HCPs / glycogen replenishment? My understanding, which could be wrong, is that, glucagon, is sent form the pancreas [alpha cells], to the liver, which then releases glycogen as a source of fuel...... In terms of when to replenish your livers energy stores I don't know unfortunately......... good question though...

Mar 13, 2014 dunkers7 24 posts	Topic: Questions for HCPs / glycogen replenishment? My understanding is, adrenaline is the trigger for glycogen being sent from the liver, which raises blood glucose as a result. I have seen increasing blood glucose after exercise frequently, which I think suggests some glycogen was used as a result of exercise induced adrenaline. As a diabetic, at what point should I be thinking about eating to replenish glycogen stores?

Mar 13, 2014 Louise1988 69 posts	Topic: General Discussion / Need to nip this in the bud... Thanks for the encouragement, will see how I go

Mar 13, 2014 Rafa 99 posts	Topic: General Discussion / Need to nip this in the bud... I would agree you are doing well. Would love those readings at bed, 3am and morning.

Mar 13, 2014 youone 102 posts	Topic: Carbohydrate Counting / reliable metre readings Hi Vicky I'm still not happy with the test strips supplied, There gave a 2 difference to my glucomen lx plus and a friends metre, So until things settle I'm staying with the glucomen. yes the CGM would aid you with your pregnancy. I missed the countmein visit to the house of paliment the this week, which has gone well, I really hope the government increase research funding for diabetes also funding for pumps and other devices. I guess like you, I can't believe how much my pump has changed my life Keep us informed on any good news Brian

Mar 12, 2014 alturn 78 posts	Topic: General Discussion / Need to nip this in the bud... I would consider -2 or +2 change from bed to breakfast is within range (I dropped 7 one night recently and also gone up by 4 so planning is difficult). As your Levemir is in relatively small amounts, any change could have a dramatic effect. I would err on the cautious side and prefer to be a bit high than risk an overnight hypo - of which you are very aware. So if I was you I would continue to monitor and change by small amounts (1/2 unit change) if overnight changes get larger. Based on info provided, I think your doing Ok. Hope this helps.

Mar 12, 2014 Louise1988 69 posts	Topic: General Discussion / Need to nip this in the bud... For the past few days or so, I've noticed a slight increase from my before bed to before breakfast. It's only an increase of 1-2, but it's something I want to try to tackle. I've done a couple of 3am checks and I seem to dip slightly during the night. For example last night - I went to bed at 10pm, by bg was 6.8. 3am this morning I was 6.4, and before breakfast at 7am, I was 7.3. I've recently split my levemir, 3u at 9pm, and 3u at 9am. This is working really well for me, as I'm not going to bed high, and I'm not waking up low in the morning. I was contemplating upping my 9pm dose, but I'm weary of the slight drop during the night, I don't want to drop and hypo. Any suggestions?

Mar 11, 2014 mihaela 7 posts	Topic: General Discussion / miss ok i started my night bi at 8pm now and im having 2 units qa in the morning so ill see how i go

Mar 11, 2014 mum2westiesGill 502 posts	Topic: General Discussion / Targets - too many BGs out of target So after having breakfast then find I'm high at lunchtime alter the breakfast ratio?

Mar 11, 2014 novorapidboi26 1,819 posts	Topic: General Discussion / Targets - too many BGs out of target you seem to be rising from when you get up, to when you actually eat something, but that unrelated to QA ratios..... start with your breakfast ratio, or your first meal if you want to call it that, if you are high at the next meal, 4-5 hours later, then you can up your ratio to 1.5:1 [1.5 units to 10g]...you should only up the ratio after observing your readings for 2-3 days though, and don't change your BI dose when doing this.....

Mar 11, 2014 novorapidboi26 1,819 posts	Topic: General Discussion / Type 1 as a disability I too don't see it as a disability, and I suppose the only time its relevant and useful is in employment where we would fall under the disability discrimination act. I personally probably wouldn't try and get a discount at the gym, but financially I am OK, but for some the cost of a gym membership is just a bit too much... So my advice to you is go for it, think about the benefit to your health and how much easier your BG control will be due to increased activity......