Recent Posts - DAFNE Online

Feb 9, 2014

Peg Leg Chewit 5 posts

I've been type 1 for over 15 years and through bad control and high bg, I've only ever had 3 hypos. I have just done the dafne course and my bloods are between 5 and 8 most of the time and it's a great feeling, but now I am paranoid that I'm going to start having hypos. I carry dextrose tablets and a cerealbar everywhere and have lucozade stashed all over the house and in the car...

Feb 9, 2014

brendashore 1 post

Topic: Questions for HCPs / The 2 hour check

I attended a Dafne meeting last November and heard mention that the 2 hour after meal blood check is no longer used. Was going to ask more but as usual at these meetings got sidetracked by different subjects all being discussed at the same time.
Thought the Dafne rule was to sometimes do a blood check 2 hours after eating and make sure BG is not over 10mm.
Did I hear right.
Thanks. Bren.

Feb 8, 2014

Peter 109 posts

Topic: General Discussion / MDI - Basal/Bolus - Meals

There is nothing in the DAFNE course which says you have to have 3 meals a day. You're taught how to handle the situation where you have fewer (or more for that matter). It's a pity you can't get on course to find out all the details.

Feb 8, 2014

Peter 109 posts

Topic: General Discussion / different bg reading

The other factor which may have an impact is whether you squeeze the finger to promote faster/sufficient blood flow. The meter manufacturers advise against doing this but, in my case, without doing so I'd have insufficient blood to perform a test much of the time and so I ignore that advice. However, I guess, that if you were inconsistent in how you obtained the sample then that could have played a part in the range of figures. The biggest reason, as others have said, is likely to be the unreliability of the meters.

Feb 8, 2014

Vickyp 137 posts

Topic: Carbohydrate Counting / Carbs - Rounding Off

If my BGs are below target then I round down, if on/above target I round up to nearest 5, again round as a total rather than individually.

Feb 7, 2014

Rich h 1 post

Topic: Site Development / diary configaration

Hi all

Is there any way to change the diary so it looks more like the paper version?

Feb 7, 2014

Glynis 3 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Sorry Simon, but all I seem to be able to do is open DAFNE app, then add new diary entry, then type in Blood Glucose, then have to press Done, then type in Carbs then press Done again, then type in Insulin Dose and then type Done again and only then can I press Save. On the Android app I just entered all the info in one go and then pressed Save. Looking for help on this one as it takes a while to put each entry in individually, surely there must be an easier way

Feb 7, 2014

Glynis 3 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Sorry Simon, but all I seem to be able to do is open DAFNE app, then add new diary entry, then type in Blood Glucose, then have to press Done, then type in Carbs then press Done again, then type in Insulin Dose and then type Done again and only then can I press Save. On the Android app I just entered all the info in one go and then pressed Save. Looking for help on this one as it takes a while to put each entry in individually, surely there must be an easier way

Feb 7, 2014

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Carbs - Rounding Off

I would also round the above example to 50g...........

I would only round up the final count however as opposed to rounding up each separate carb item.....

Feb 7, 2014

novorapidboi26 1,819 posts

Topic: General Discussion / Stem Cell Cure

This is the whole problem about diabetic cures...........

It will never be a cure until that exact auto immune response is rectified.

And that requires genetic manipulation of some sort.......which is difficult and faces other moral challenges etc....

So at best this article describes a treatment for diabetes, which is great, really great, as I think we will get a fully functioning treatment that will keep our blood sugars steady using our own bodies blood glucose measurement a long time before any cure as I described above.....

Smile

Feb 7, 2014

Warwick 425 posts

Topic: General Discussion / Stem Cell Cure

More progress being made:

http://www.theguardian.com/society/2014/feb/06/scientists-closer-stem-cell-cure-type-1-diabetes

The problem as I see it though is that the mice were made diabetic, they weren't naturally diabetic. So if this goes on to help human diabetics, then our auto-immune systems will probably just kill off the new beta cells. It needs another step to turn off the auto-immune factor that kills off the cells in the first place.

Feb 6, 2014

alturn 78 posts

Topic: Carbohydrate Counting / Carbs - Rounding Off

I normally round to nearest 5 up or down depending on last BG reading, what I plan to later, how I feel and meal time (different ratio for each meal).

A simpler option is to decide as a decision has to made, an adjustment can be made at next meal - there is no right or wrong answer. Normally I don't think it will make a significant difference.

Normally I would round 48g to 50g

Feb 6, 2014

mum2westiesGill 502 posts

Topic: Carbohydrate Counting / Carbs - Rounding Off

Hi,

Just a little refresher for me please

Were you taught to round off carbs to the nearest 5? How would you round off carbs for something which says on the packet 42.3g per pie?

Also if you had a meal which was:
sandwich - 36g
soup - 12g
total = 48g how would you round this off to the nearest 5?

Feb 5, 2014

Simon 578 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Hi Glynis - you can put all the information in when you add a new entry, are you not seeing this?

Feb 5, 2014

novorapidboi26 1,819 posts

Topic: General Discussion / My Recent BGs - comments wanted please

Ahh, I see now about the corrections.....

As far as a split BI dose goes, its really because its always in the back of my mind that your highs could be down to your BI dose running out and/or you needing more/less in the AM/PM part of the day.

Yes, a 50/50 split would be the best to start off on, but the whole idea of a split is to accommodate for a different ratio of needs over the day and night, so you may need more overnight than you do during the day, so it might end up a 60/40 or 70/30....

you do have a good understanding of your own blood sugars and the possible fixes you can try though, which is good seeing as you haven't done DAFNE.....well done....

Feb 5, 2014

Phil Maskell 194 posts

Topic: General Discussion / gym and insulin qty

Warwick, another factor I have found to add to the list is stress.

I can have higher BG after a day at work, but plummet when I get on the bike cos whatever the body is doing to raise BG during stress is relieved during exercise on the bike, double whammy a hypo or carbs needed if caught.

Feb 5, 2014

Warwick 425 posts

Topic: General Discussion / New to dafne

Hello,

Are you using the same doses for Levemir as you were for Lantus? It is quite common to need to increase doses of Levemir to get the same effect as Lantus - sometimes by up to 25%. So if for example, you were on 20 units of Lantus daily, and you have switched to 2 x 10-unit doses of Levemir per day, then you may need to be on as much as 12 or 13 units per Levemir dose.

As Phil says though, test your overnight levels, and if you do increase the dose, then only do it by 10% at a time, and leave for 2-3 days before any further increases.

Feb 5, 2014

Warwick 425 posts

Topic: General Discussion / gym and insulin qty

I am reading the Daiabetic Athlete's Handbook by Sheri R. Colberg at the moment which is very good and highly recommended.

Here is what she lists as affecting blood glucose responses to exercise:

Energy system used (exercise duration and intensity)
Blood sugars at start of activity.
Training status (i.e., new versus usual activity)
Prior exercise (same day or day before)
Types of insulin you use
Time you last ate
Temperature and other environmental conditions
Recent or current illness
Phase of menstrual cycle
Type of exercise
Time of day of exercise
Previous episode of hypoglycemia
Timing of last insulin dose
Other glucose-lowering medications that you take
Type of food that you ate
Level of hydration
Pregnancy

So lots of things to consider when exercising. It is still worth it though, even when we get it wrong :-)

Feb 5, 2014

Warwick 425 posts

Topic: General Discussion / gym and insulin qty

Changing the t of day that you are exercising can help with this. Exercising before breakfast means that you don't have any QA lingering to worry about, and can also help with dawn phenomenon. I find that I can go for an hour-long run before breakfast and return with BGs similar to what I started with.

Cycling to work after breakfast gives me no trouble, but cycling home 5 hours after lunch is a different issue, where my BGs tend to plunge unless I eat about 30 grams of carbs beforehand.

It is really hard to keep BGs in the right place during exercise though, and frequent testing does seem to be the best way. I did a long-distance triathlon last weekend, and pre-swim was 14.5 (I like to be about 13 beforehand as the swim in open water is the worst place to have a hypo), around 9.5 at transition 1 (swim to bike), but had gone to 24.5 at transition 2 (bike to run).

I still don't know what shot me that high. It had never happened in training. Possibly the meter was at fault - I had it in a bag on my back which was in direct sunlight and the temperature was over 30 degrees so it might have been giving high readings as a result.

I injected 4 units of insulin, and half an hour later was down to 7 while running, and then had to keep on eating to avoid a hypo for the rest of the run.

I was also battling the early stages of a cold and that had been sending my BGs higher recently too, so maybe that was part of the issue too.

I think when it comes down to it though, it becomes a matter of trial and error, and the more you exercise, the better you get to know your body's BG response. 90% of the time, I know how much carb I need before my evening cycle commute. 10 % of the time, I'll get home with high BGs, or occasionally a hypo, and given how many variables there are that affect blood glucose levels, I think that is as good as I am going to get it.

Feb 5, 2014

aprilp 4 posts

Topic: General Discussion / gym and insulin qty

I have so much respect for any diabetic who does such huge amounts of exercise as you do, Phil. I find it mind boggling, although I used to run 10 miles in training when I was younger. I hope Neil that you will continue like me to do what we can to stay fit, but I think I feel diabetes as more of a handicap when exercising than at any other time. I am sure you are right, Phil about how it varies each time.

Feb 4, 2014

Mollymynett 2 posts

Topic: General Discussion / New to dafne

Thanks for your advice . I know i will get there just so many changes and I feel awful when in double figures . I will stay positive and be patient . You know what it's like maybe it's just me expecting results straight away . I spoke with my nurse today and she has mentioned something called the dawn phenomina . She has also talked about me going on the pump which I'm not sure about . So much to think about

Feb 4, 2014

alturn 78 posts

Topic: General Discussion / New to dafne

Welcome, hope you find the forums useful.

Try not be frustrated by your levels, it may take a while to adjust to DAFNE and split Levemir. I've just checked my units (keep them all in a spreadsheet as well as in DAFNE) and I increased my Levemir from 9am/7pm to 13am/11pm over about 4 months after DAFNE. BGs vary, had a lot in the 9-13 range recently which really dislike as feel out of control, but with DAFNE now avoiding (most of) very high levels and very low. So last HBA1C was spot-on - but next will probably be a bit higher. It's a continuous process of monitor and adjust.

Feb 4, 2014

Glynis 3 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Used to use DAFNE app on Android phone but now have been given my sons old iPhone 4 and have been using DAFNE app on it. Was very disappointed when I found out they are not the same. Gradually getting used to it but surely there must be a way to put all the entries in at once eg blood glucose, carbs and then dose? Hoping it is just me and I have missed something, if so can you advise me how to do it, if not can you fix it so that you can put all entries in and the save. Thanks G Rennie

Feb 4, 2014

neilbunting 8 posts

Topic: General Discussion / gym and insulin qty

Thanks phil that does make sense. But putting in to practice is harder. Aprilp you are right it is scary working out. The thought of putting insulin in when exercising I seem to come down really fast. I do quite high intensity training. But fed up of going high after feel like I am always chasing my tail.

Feb 4, 2014

Phil Maskell 194 posts

Topic: General Discussion / gym and insulin qty

runsweet is quite good to see that other diabetics cope, but it is not as well used as here in all honesty.

Plus I think you need to find your own way with exercise, I have big problems as I do 10 - 15 hours cycling, I have gels and sports drinks in every jersey pocket and a special top tube bag for energy bars with slower release carbs as well as pure sugar.

The main problem with CV exercise is your muscles crave sugar to produce power, they send a signal to the liver to kick out glycogen as a fast response, without the pancreas creating insulin this sugar can't get out of the blood, so if you start exercise with little or no insulin on board your BG can shoot through the roof. The problem is too much and you have a hypo during, hence the massive amounts of sugar I carry as a precaution on the bike. For hours after exercise, even up 36 hours if you've done alot the muscles will be repairing and replenishing gylcogen which comes from the sugar in your blood some you may need to lower BI and just be careful with QA (this is trial and error as everytime you exercise is different).

Hope some of that waffle makes sense and helps.

Phil

Feb 9, 2014 Peg Leg Chewit 5 posts	Topic: General Discussion / Snacks I've been type 1 for over 15 years and through bad control and high bg, I've only ever had 3 hypos. I have just done the dafne course and my bloods are between 5 and 8 most of the time and it's a great feeling, but now I am paranoid that I'm going to start having hypos. I carry dextrose tablets and a cerealbar everywhere and have lucozade stashed all over the house and in the car...

Feb 9, 2014 brendashore 1 post	Topic: Questions for HCPs / The 2 hour check I attended a Dafne meeting last November and heard mention that the 2 hour after meal blood check is no longer used. Was going to ask more but as usual at these meetings got sidetracked by different subjects all being discussed at the same time. Thought the Dafne rule was to sometimes do a blood check 2 hours after eating and make sure BG is not over 10mm. Did I hear right. Thanks. Bren.

Feb 8, 2014 Peter 109 posts	Topic: General Discussion / MDI - Basal/Bolus - Meals There is nothing in the DAFNE course which says you have to have 3 meals a day. You're taught how to handle the situation where you have fewer (or more for that matter). It's a pity you can't get on course to find out all the details.

Feb 8, 2014 Peter 109 posts	Topic: General Discussion / different bg reading The other factor which may have an impact is whether you squeeze the finger to promote faster/sufficient blood flow. The meter manufacturers advise against doing this but, in my case, without doing so I'd have insufficient blood to perform a test much of the time and so I ignore that advice. However, I guess, that if you were inconsistent in how you obtained the sample then that could have played a part in the range of figures. The biggest reason, as others have said, is likely to be the unreliability of the meters.

Feb 8, 2014 Vickyp 137 posts	Topic: Carbohydrate Counting / Carbs - Rounding Off If my BGs are below target then I round down, if on/above target I round up to nearest 5, again round as a total rather than individually.

Feb 7, 2014 Rich h 1 post	Topic: Site Development / diary configaration Hi all Is there any way to change the diary so it looks more like the paper version?

Feb 7, 2014 Glynis 3 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Sorry Simon, but all I seem to be able to do is open DAFNE app, then add new diary entry, then type in Blood Glucose, then have to press Done, then type in Carbs then press Done again, then type in Insulin Dose and then type Done again and only then can I press Save. On the Android app I just entered all the info in one go and then pressed Save. Looking for help on this one as it takes a while to put each entry in individually, surely there must be an easier way

Feb 7, 2014 Glynis 3 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Sorry Simon, but all I seem to be able to do is open DAFNE app, then add new diary entry, then type in Blood Glucose, then have to press Done, then type in Carbs then press Done again, then type in Insulin Dose and then type Done again and only then can I press Save. On the Android app I just entered all the info in one go and then pressed Save. Looking for help on this one as it takes a while to put each entry in individually, surely there must be an easier way

Feb 7, 2014 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Carbs - Rounding Off I would also round the above example to 50g........... I would only round up the final count however as opposed to rounding up each separate carb item.....

Feb 7, 2014 novorapidboi26 1,819 posts	Topic: General Discussion / Stem Cell Cure This is the whole problem about diabetic cures........... It will never be a cure until that exact auto immune response is rectified. And that requires genetic manipulation of some sort.......which is difficult and faces other moral challenges etc.... So at best this article describes a treatment for diabetes, which is great, really great, as I think we will get a fully functioning treatment that will keep our blood sugars steady using our own bodies blood glucose measurement a long time before any cure as I described above.....

Feb 7, 2014 Warwick 425 posts	Topic: General Discussion / Stem Cell Cure More progress being made: http://www.theguardian.com/society/2014/feb/06/scientists-closer-stem-cell-cure-type-1-diabetes The problem as I see it though is that the mice were made diabetic, they weren't naturally diabetic. So if this goes on to help human diabetics, then our auto-immune systems will probably just kill off the new beta cells. It needs another step to turn off the auto-immune factor that kills off the cells in the first place.

Feb 6, 2014 alturn 78 posts	Topic: Carbohydrate Counting / Carbs - Rounding Off I normally round to nearest 5 up or down depending on last BG reading, what I plan to later, how I feel and meal time (different ratio for each meal). A simpler option is to decide as a decision has to made, an adjustment can be made at next meal - there is no right or wrong answer. Normally I don't think it will make a significant difference. Normally I would round 48g to 50g

Feb 6, 2014 mum2westiesGill 502 posts	Topic: Carbohydrate Counting / Carbs - Rounding Off Hi, Just a little refresher for me please Were you taught to round off carbs to the nearest 5? How would you round off carbs for something which says on the packet 42.3g per pie? Also if you had a meal which was: sandwich - 36g soup - 12g total = 48g how would you round this off to the nearest 5?

Feb 5, 2014 Simon 578 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi Glynis - you can put all the information in when you add a new entry, are you not seeing this?

Feb 5, 2014 novorapidboi26 1,819 posts	Topic: General Discussion / My Recent BGs - comments wanted please Ahh, I see now about the corrections..... As far as a split BI dose goes, its really because its always in the back of my mind that your highs could be down to your BI dose running out and/or you needing more/less in the AM/PM part of the day. Yes, a 50/50 split would be the best to start off on, but the whole idea of a split is to accommodate for a different ratio of needs over the day and night, so you may need more overnight than you do during the day, so it might end up a 60/40 or 70/30.... you do have a good understanding of your own blood sugars and the possible fixes you can try though, which is good seeing as you haven't done DAFNE.....well done....

Feb 5, 2014 Phil Maskell 194 posts	Topic: General Discussion / gym and insulin qty Warwick, another factor I have found to add to the list is stress. I can have higher BG after a day at work, but plummet when I get on the bike cos whatever the body is doing to raise BG during stress is relieved during exercise on the bike, double whammy a hypo or carbs needed if caught.

Feb 5, 2014 Warwick 425 posts	Topic: General Discussion / New to dafne Hello, Are you using the same doses for Levemir as you were for Lantus? It is quite common to need to increase doses of Levemir to get the same effect as Lantus - sometimes by up to 25%. So if for example, you were on 20 units of Lantus daily, and you have switched to 2 x 10-unit doses of Levemir per day, then you may need to be on as much as 12 or 13 units per Levemir dose. As Phil says though, test your overnight levels, and if you do increase the dose, then only do it by 10% at a time, and leave for 2-3 days before any further increases.

Feb 5, 2014 Warwick 425 posts	Topic: General Discussion / gym and insulin qty I am reading the Daiabetic Athlete's Handbook by Sheri R. Colberg at the moment which is very good and highly recommended. Here is what she lists as affecting blood glucose responses to exercise: Energy system used (exercise duration and intensity) Blood sugars at start of activity. Training status (i.e., new versus usual activity) Prior exercise (same day or day before) Types of insulin you use Time you last ate Temperature and other environmental conditions Recent or current illness Phase of menstrual cycle Type of exercise Time of day of exercise Previous episode of hypoglycemia Timing of last insulin dose Other glucose-lowering medications that you take Type of food that you ate Level of hydration Pregnancy So lots of things to consider when exercising. It is still worth it though, even when we get it wrong :-)

Feb 5, 2014 Warwick 425 posts	Topic: General Discussion / gym and insulin qty Changing the t of day that you are exercising can help with this. Exercising before breakfast means that you don't have any QA lingering to worry about, and can also help with dawn phenomenon. I find that I can go for an hour-long run before breakfast and return with BGs similar to what I started with. Cycling to work after breakfast gives me no trouble, but cycling home 5 hours after lunch is a different issue, where my BGs tend to plunge unless I eat about 30 grams of carbs beforehand. It is really hard to keep BGs in the right place during exercise though, and frequent testing does seem to be the best way. I did a long-distance triathlon last weekend, and pre-swim was 14.5 (I like to be about 13 beforehand as the swim in open water is the worst place to have a hypo), around 9.5 at transition 1 (swim to bike), but had gone to 24.5 at transition 2 (bike to run). I still don't know what shot me that high. It had never happened in training. Possibly the meter was at fault - I had it in a bag on my back which was in direct sunlight and the temperature was over 30 degrees so it might have been giving high readings as a result. I injected 4 units of insulin, and half an hour later was down to 7 while running, and then had to keep on eating to avoid a hypo for the rest of the run. I was also battling the early stages of a cold and that had been sending my BGs higher recently too, so maybe that was part of the issue too. I think when it comes down to it though, it becomes a matter of trial and error, and the more you exercise, the better you get to know your body's BG response. 90% of the time, I know how much carb I need before my evening cycle commute. 10 % of the time, I'll get home with high BGs, or occasionally a hypo, and given how many variables there are that affect blood glucose levels, I think that is as good as I am going to get it.

Feb 5, 2014 aprilp 4 posts	Topic: General Discussion / gym and insulin qty I have so much respect for any diabetic who does such huge amounts of exercise as you do, Phil. I find it mind boggling, although I used to run 10 miles in training when I was younger. I hope Neil that you will continue like me to do what we can to stay fit, but I think I feel diabetes as more of a handicap when exercising than at any other time. I am sure you are right, Phil about how it varies each time.

Feb 4, 2014 Mollymynett 2 posts	Topic: General Discussion / New to dafne Thanks for your advice . I know i will get there just so many changes and I feel awful when in double figures . I will stay positive and be patient . You know what it's like maybe it's just me expecting results straight away . I spoke with my nurse today and she has mentioned something called the dawn phenomina . She has also talked about me going on the pump which I'm not sure about . So much to think about

Feb 4, 2014 alturn 78 posts	Topic: General Discussion / New to dafne Welcome, hope you find the forums useful. Try not be frustrated by your levels, it may take a while to adjust to DAFNE and split Levemir. I've just checked my units (keep them all in a spreadsheet as well as in DAFNE) and I increased my Levemir from 9am/7pm to 13am/11pm over about 4 months after DAFNE. BGs vary, had a lot in the 9-13 range recently which really dislike as feel out of control, but with DAFNE now avoiding (most of) very high levels and very low. So last HBA1C was spot-on - but next will probably be a bit higher. It's a continuous process of monitor and adjust.

Feb 4, 2014 Glynis 3 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Used to use DAFNE app on Android phone but now have been given my sons old iPhone 4 and have been using DAFNE app on it. Was very disappointed when I found out they are not the same. Gradually getting used to it but surely there must be a way to put all the entries in at once eg blood glucose, carbs and then dose? Hoping it is just me and I have missed something, if so can you advise me how to do it, if not can you fix it so that you can put all entries in and the save. Thanks G Rennie

Feb 4, 2014 neilbunting 8 posts	Topic: General Discussion / gym and insulin qty Thanks phil that does make sense. But putting in to practice is harder. Aprilp you are right it is scary working out. The thought of putting insulin in when exercising I seem to come down really fast. I do quite high intensity training. But fed up of going high after feel like I am always chasing my tail.

Feb 4, 2014 Phil Maskell 194 posts	Topic: General Discussion / gym and insulin qty runsweet is quite good to see that other diabetics cope, but it is not as well used as here in all honesty. Plus I think you need to find your own way with exercise, I have big problems as I do 10 - 15 hours cycling, I have gels and sports drinks in every jersey pocket and a special top tube bag for energy bars with slower release carbs as well as pure sugar. The main problem with CV exercise is your muscles crave sugar to produce power, they send a signal to the liver to kick out glycogen as a fast response, without the pancreas creating insulin this sugar can't get out of the blood, so if you start exercise with little or no insulin on board your BG can shoot through the roof. The problem is too much and you have a hypo during, hence the massive amounts of sugar I carry as a precaution on the bike. For hours after exercise, even up 36 hours if you've done alot the muscles will be repairing and replenishing gylcogen which comes from the sugar in your blood some you may need to lower BI and just be careful with QA (this is trial and error as everytime you exercise is different). Hope some of that waffle makes sense and helps. Phil