Recent Posts - DAFNE Online

Oct 14, 2013

youone 102 posts

Topic: General Discussion / Exercise & BG levels

Only run 10km (6miles) hope to increase that to 9miles
Good luck and all the best with the London marathon Cool

Oct 14, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Exercise & BG levels

No marathon or any running experience, but good luck and well done........ Smile

Oct 14, 2013

Rafa 99 posts

Topic: General Discussion / Exercise & BG levels

I signed up to run the London Marathon for type one diabetes research last week. Really looking forward to running for the charity. Nervous as well! Any diabetics on here run a marathon any advice/tips please? Only ever ran two half marathons before.

Oct 11, 2013

izzi1234 5 posts

Topic: General Discussion / Needles

I have never used 12 mm. speak to your doctors or diabetic nurse sure there will be an alternative

Oct 11, 2013

hannahdefries 12 posts

Topic: General Discussion / Exercise & BG levels

Ahhhh! not sure how i will manage this especially when i run at 6:20am and my alarm normally goes off at 6:10am! This will be okay when i exercise after work but for now I may just have to carry on with what I am doing. My levels today have all been perfect *touch wood*, but tomorrow could be another story! Thankyou!

Oct 11, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Insulin on board algorithms in pumps

The pump company for sure............its likely we as pump users know more than the HCP's...

It happened again for me this afternoon, correction was less than the IOB........only by a few decimals right enough....

Oct 11, 2013

davidcragg 17 posts

Topic: Carbohydrate Counting / carbs and cal iphone app

marke,

Apologies I didn't realise that existed! I could have saved myself a bit of work! lol
By all means nab anything from my list.

David

Oct 11, 2013

Jimandbillow 8 posts

Topic: Questions for HCPs / Insulin on board algorithms in pumps

Hi novorapidboi26,

Thank you for the reply and good reply on perhaps the logic behind the algorithm.

It would be good to get a reply or comment from someone who is an HCP dealing in pumps or from a pump company wouldn't it?

Thanks

Oct 11, 2013

Rafa 99 posts

Topic: Carbohydrate Counting / carbs and cal iphone app

Thanks David.

Oct 11, 2013

davidcragg 17 posts

Topic: Carbohydrate Counting / carbs and cal iphone app

Yes they've been having a few glitches with the 3.1 release too. The latest update from Carbs and Cals is as follows:

"Hi everyone - sincere apologies for all the iPhone App issues recently! We think we've fixed it now, so please switch your device completely off, then on, and start the Carbs & Cals App (with internet access). It will take a few minutes to sync (which should only happen once) and then you should be back up and running. If some of the foods are greyed out and you are asked you to do an In-App purchase, please be aware that the price of the In-App purchase is FREE, so you will be able to unlock all the foods for no additional charge."

Hope that helps,
David

Oct 11, 2013

Rafa 99 posts

Topic: Carbohydrate Counting / carbs and cal iphone app

I am on the iphone and each time i try to go into the app it comes up with the following message, We've added new food items to the Carbs & Cals app! Please be patient while your database is being updated. This may take several minutes. Then when i do get in it tells me that it wasn't synched properly.

Oct 11, 2013

Louise1988 69 posts

Topic: General Discussion / 3am tests

Sounds like a starting place, thank you so so much for your help! Very Happy

Oct 11, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / 3am tests

That would be a good place to start, you would need to just test it out and see.........theoretically you should be able to go steady overnight, and by steady that means, up and down within 1-2mmol/l, that margin of tolerance is acceptable.

once you have got the your bg holding within the 1-2mmol then you can be confident that dose is right, then you can go on to test the morning BI dose, by carb free tests throughout the day..........its usually OK to do 3 days testing but stagger the times you go carb free, so Monday breakfast carb free, Tuesday lunch carb free, Wednesday dinner carb free, this will tell you what your morning BI is doing at those 3 critical times of the day.

You may find that the breakfast, lunch and dinner periods all require different levels of BI, but unfortunately without a pump you can never accommodate that, but when injecting insulin there is rarely ever real need to get the BI that accurate, and surplus or deficit BI needs can be caught with your QA insulin.......

Book and appointment and see what your DSN says, they will be more equipped than me to advise you....... Smile

Oct 11, 2013

Louise1988 69 posts

Topic: General Discussion / 3am tests

That makes complete sense. When I've done 3am tests in the past, I have seemed to go higher, and then dropped again by morning. So in theory, if I were to do 4u at night, and then 3u in the morning, this could ensure I don't drop as much during the night, and then maintain the next day's bg levels? Have I got that right?

If so, I think I'll make an appointment to see my DSN Smile

Oct 11, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / 3am tests

One dose over 24 hours has to deal with varying BI needs over that time, basically and commonly most people need different doses for the AM and PM portions of the day.

In fact the amount of BI you need changes by the hour, the only way to achieve accurate dosing for BI is on the pump.

By splitting your dose you will be giving one dose before bed to hold you steady till morning, and then another dose at breakfast/waking to hold you steady till the bedtime.

This means that if you go low overnight due to too much basal, you can reduce your dose without that reduction affecting your daytime blood sugar.

Currently this is how you are doing it.........for example the 7 your own currently could be fine to hold you steady till morning, but you may need more or less than that 7 to hold you steady during the day........

Another benefit is its much more flexible for things like exercise and alcohol.......

If you were going hill walking for example all day, you could actually reduce your morning dose to compensate for the reduction in BG you will experience due to the extra physical exertion... If drinking of a night, due to the lowering effects alcohol has on BG, you could reduce your bedtime dose in order to prevent a hypo, and even reduce the next mornings dose if the alcohol is still inn your system.......

Its the only way to go really, in my opinion, but not everyone can see the benefits in their particular circumstances..... Smile

Oct 11, 2013

Louise1988 69 posts

Topic: General Discussion / 3am tests

I haven't considered splitting. I don't know much about what the benefit of that would be Confused

Oct 11, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Insulin on board algorithms in pumps

I am on android so haven't looked, I used to use apps now but my pump takes care of everything to my satisfaction now..........

I just tested my BG there and it was 5.4 and I planned to have 22g of carbs just over half way through my insulin action, I have 1.5 units remaining.

BG: 5.4
Carbs: 22
Food Bolus: 2.7 {8:1 ratio}
Correction: -0.1
IOB: 1.5

So the pump suggested 2.6 , which is food bolus - minus the correction, so yeah, I can confirm that happens, but why?

If the correction was more than the IOB, then there has been a miscalculation and there is not enough insulin to get you back on target. So the pump would offer the correction and also consider what is still on board.

The reason it doesn't remove IOB from a correction less than the IOB is likely because the pump is assuming the IOB is still present to process the remaining carbs on board.

So for my scenario above, the pump made the assumption that the 1.5 IOB was still there working on the breakfast carbs, and so all of that 1.5 is still required. Theoretically this 1.5 would still be required even if I had ran to work and was low when I tested. And so it uses the negative correction instead to drop down the final bolus.

Reading this back sounds quite confusing...........lol.... Very Happy

I think extra activity uses glucose stores from your muscles directly, and so the carbs you had eaten previously are still there, the drop in BG is down to the muscles absorbing back from the blood stream.

I think that is the logic behind the algorithm.....

Oct 11, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / 3am tests

There wasn't much change from 21:03 to 03:00 then, which is a good sign, small drop from 03:00 to 07:00 though.....

I would just repeat what you done for a day or two more and compare each nights results......

Your only small amounts of Levemir, but it can be split fairly easily, have you considered splitting?

Oct 11, 2013

Louise1988 69 posts

Topic: General Discussion / 3am tests

I'm actually on Levemir. Yesterday, I had 3 dextrose 3pm and 4pm, in a bid to get my bg levels up a bit during the evening. I can't seem to get my bg levels up to the higher end of DAFNE. I forgot to mention that last night I actually had 5cp's, rather than 4, and gave myself 4 units of NovoRapid.

I was 10.3 at 3am this morning, and 7.7 at 7am...

Oct 11, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / 3am tests

I can see your on a single dose of background, which would suggest Lantus. Is this correct? EDIT: I now see your on Levemir

You seem to be on the lower end of the DAFNE targets before bed (I would be happy between 4-7 at this time), and so you have been giving yourself either some dextrose tablets or last night, some chocolate. These carbs working overnight could be effecting your waking readings, even if they are small amounts [dextrose tabs and DARK chocolate]

The best thing to do is try and aim for a higher reading before bed, you could try chopping of a unit a dinner time to achieve this maybe, then test before bed and have no carbs/hypo resolve. This will then give you an accurate picture of what is happening overnight by looking at your pre bed and waking results.

This should be done for 2-3 days consecutively before you make any dose change.....its good practice even with Levemir

Once you can see a steady overnight pattern, then you can tackle lows in the day time, which may mean dropping your ratios to below 1:1, like 0.5:1, or looking at splitting your BI dose, so that the night and day time BI needs are managed separately.....

What were you this morning?

Very Happy

Oct 11, 2013

Louise1988 69 posts

Topic: General Discussion / 3am tests

I'm not really sure what to do with my basal rate, keep it to the lower rate or 7units, or go back to the original 8? The reason I thought to lower this basal, was to try to stop myself from getting so low during the day. However, I'm finding that I am dropping quickly. Any opinions?

Oct 11, 2013

Vickyp 137 posts

Topic: General Discussion / Basal Testing - nighttime

if doing night tests I always take monitor to bed, that way I don't have to get up and go downstairs! 3am is a guide, I have often done them at 230am or 330am!

Oct 10, 2013

Warwick 425 posts

Topic: General Discussion / Exercise & BG levels

Having a week or so off exercise can drive BGs up. I took a couple of weeks off exercise in June and instead of doing about 10 hours of exercise per week, I only did one 20 minute run over the two week period and my BGs went so high that I had to increase my basal insulin by quite a large amount to compensate.

Exercise helps the absorption of insulin, but for exercise of less than half an hour, taking extra QA more than what you are taking is unlikely to change your post-exercise BGs without risking hypos an hour or so after the exercise.

I'd recommend testing about 45 minutes before exercise. If you are high, you can then take QA to correct, and by the time you finish your exercise, most of the QA will be used up which should give you a good idea of how much you need to take.

Oct 10, 2013

DianeW 115 posts

Topic: General Discussion / Needles

I've just found out that Novo Nordisk are discontinuing the 12mm needle from November. Now I realise that I may be in the minority in using them, but I have poor eyesight and find the 12 is fine to use, whereas the 8mm I struggle with. Anyone know what I could do, or another manufacturer of needles??

Oct 14, 2013 youone 102 posts	Topic: General Discussion / Exercise & BG levels Only run 10km (6miles) hope to increase that to 9miles Good luck and all the best with the London marathon

Oct 14, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Exercise & BG levels No marathon or any running experience, but good luck and well done........

Oct 14, 2013 Rafa 99 posts	Topic: General Discussion / Exercise & BG levels I signed up to run the London Marathon for type one diabetes research last week. Really looking forward to running for the charity. Nervous as well! Any diabetics on here run a marathon any advice/tips please? Only ever ran two half marathons before.

Oct 11, 2013 izzi1234 5 posts	Topic: General Discussion / Needles I have never used 12 mm. speak to your doctors or diabetic nurse sure there will be an alternative

Oct 11, 2013 hannahdefries 12 posts	Topic: General Discussion / Exercise & BG levels Ahhhh! not sure how i will manage this especially when i run at 6:20am and my alarm normally goes off at 6:10am! This will be okay when i exercise after work but for now I may just have to carry on with what I am doing. My levels today have all been perfect touch wood, but tomorrow could be another story! Thankyou!

Oct 11, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps The pump company for sure............its likely we as pump users know more than the HCP's... It happened again for me this afternoon, correction was less than the IOB........only by a few decimals right enough....

Oct 11, 2013 davidcragg 17 posts	Topic: Carbohydrate Counting / carbs and cal iphone app marke, Apologies I didn't realise that existed! I could have saved myself a bit of work! lol By all means nab anything from my list. David

Oct 11, 2013 Jimandbillow 8 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps Hi novorapidboi26, Thank you for the reply and good reply on perhaps the logic behind the algorithm. It would be good to get a reply or comment from someone who is an HCP dealing in pumps or from a pump company wouldn't it? Thanks

Oct 11, 2013 Rafa 99 posts	Topic: Carbohydrate Counting / carbs and cal iphone app Thanks David.

Oct 11, 2013 davidcragg 17 posts	Topic: Carbohydrate Counting / carbs and cal iphone app Yes they've been having a few glitches with the 3.1 release too. The latest update from Carbs and Cals is as follows: "Hi everyone - sincere apologies for all the iPhone App issues recently! We think we've fixed it now, so please switch your device completely off, then on, and start the Carbs & Cals App (with internet access). It will take a few minutes to sync (which should only happen once) and then you should be back up and running. If some of the foods are greyed out and you are asked you to do an In-App purchase, please be aware that the price of the In-App purchase is FREE, so you will be able to unlock all the foods for no additional charge." Hope that helps, David

Oct 11, 2013 Rafa 99 posts	Topic: Carbohydrate Counting / carbs and cal iphone app I am on the iphone and each time i try to go into the app it comes up with the following message, We've added new food items to the Carbs & Cals app! Please be patient while your database is being updated. This may take several minutes. Then when i do get in it tells me that it wasn't synched properly.

Oct 11, 2013 Louise1988 69 posts	Topic: General Discussion / 3am tests Sounds like a starting place, thank you so so much for your help!

Oct 11, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / 3am tests That would be a good place to start, you would need to just test it out and see.........theoretically you should be able to go steady overnight, and by steady that means, up and down within 1-2mmol/l, that margin of tolerance is acceptable. once you have got the your bg holding within the 1-2mmol then you can be confident that dose is right, then you can go on to test the morning BI dose, by carb free tests throughout the day..........its usually OK to do 3 days testing but stagger the times you go carb free, so Monday breakfast carb free, Tuesday lunch carb free, Wednesday dinner carb free, this will tell you what your morning BI is doing at those 3 critical times of the day. You may find that the breakfast, lunch and dinner periods all require different levels of BI, but unfortunately without a pump you can never accommodate that, but when injecting insulin there is rarely ever real need to get the BI that accurate, and surplus or deficit BI needs can be caught with your QA insulin....... Book and appointment and see what your DSN says, they will be more equipped than me to advise you.......

Oct 11, 2013 Louise1988 69 posts	Topic: General Discussion / 3am tests That makes complete sense. When I've done 3am tests in the past, I have seemed to go higher, and then dropped again by morning. So in theory, if I were to do 4u at night, and then 3u in the morning, this could ensure I don't drop as much during the night, and then maintain the next day's bg levels? Have I got that right? If so, I think I'll make an appointment to see my DSN

Oct 11, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / 3am tests One dose over 24 hours has to deal with varying BI needs over that time, basically and commonly most people need different doses for the AM and PM portions of the day. In fact the amount of BI you need changes by the hour, the only way to achieve accurate dosing for BI is on the pump. By splitting your dose you will be giving one dose before bed to hold you steady till morning, and then another dose at breakfast/waking to hold you steady till the bedtime. This means that if you go low overnight due to too much basal, you can reduce your dose without that reduction affecting your daytime blood sugar. Currently this is how you are doing it.........for example the 7 your own currently could be fine to hold you steady till morning, but you may need more or less than that 7 to hold you steady during the day........ Another benefit is its much more flexible for things like exercise and alcohol....... If you were going hill walking for example all day, you could actually reduce your morning dose to compensate for the reduction in BG you will experience due to the extra physical exertion... If drinking of a night, due to the lowering effects alcohol has on BG, you could reduce your bedtime dose in order to prevent a hypo, and even reduce the next mornings dose if the alcohol is still inn your system....... Its the only way to go really, in my opinion, but not everyone can see the benefits in their particular circumstances.....

Oct 11, 2013 Louise1988 69 posts	Topic: General Discussion / 3am tests I haven't considered splitting. I don't know much about what the benefit of that would be

Oct 11, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps I am on android so haven't looked, I used to use apps now but my pump takes care of everything to my satisfaction now.......... I just tested my BG there and it was 5.4 and I planned to have 22g of carbs just over half way through my insulin action, I have 1.5 units remaining. BG: 5.4 Carbs: 22 Food Bolus: 2.7 {8:1 ratio} Correction: -0.1 IOB: 1.5 So the pump suggested 2.6 , which is food bolus - minus the correction, so yeah, I can confirm that happens, but why? If the correction was more than the IOB, then there has been a miscalculation and there is not enough insulin to get you back on target. So the pump would offer the correction and also consider what is still on board. The reason it doesn't remove IOB from a correction less than the IOB is likely because the pump is assuming the IOB is still present to process the remaining carbs on board. So for my scenario above, the pump made the assumption that the 1.5 IOB was still there working on the breakfast carbs, and so all of that 1.5 is still required. Theoretically this 1.5 would still be required even if I had ran to work and was low when I tested. And so it uses the negative correction instead to drop down the final bolus. Reading this back sounds quite confusing...........lol.... I think extra activity uses glucose stores from your muscles directly, and so the carbs you had eaten previously are still there, the drop in BG is down to the muscles absorbing back from the blood stream. I think that is the logic behind the algorithm.....

Oct 11, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / 3am tests There wasn't much change from 21:03 to 03:00 then, which is a good sign, small drop from 03:00 to 07:00 though..... I would just repeat what you done for a day or two more and compare each nights results...... Your only small amounts of Levemir, but it can be split fairly easily, have you considered splitting?

Oct 11, 2013 Louise1988 69 posts	Topic: General Discussion / 3am tests I'm actually on Levemir. Yesterday, I had 3 dextrose 3pm and 4pm, in a bid to get my bg levels up a bit during the evening. I can't seem to get my bg levels up to the higher end of DAFNE. I forgot to mention that last night I actually had 5cp's, rather than 4, and gave myself 4 units of NovoRapid. I was 10.3 at 3am this morning, and 7.7 at 7am...

Oct 11, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / 3am tests I can see your on a single dose of background, which would suggest Lantus. Is this correct? EDIT: I now see your on Levemir You seem to be on the lower end of the DAFNE targets before bed (I would be happy between 4-7 at this time), and so you have been giving yourself either some dextrose tablets or last night, some chocolate. These carbs working overnight could be effecting your waking readings, even if they are small amounts [dextrose tabs and DARK chocolate] The best thing to do is try and aim for a higher reading before bed, you could try chopping of a unit a dinner time to achieve this maybe, then test before bed and have no carbs/hypo resolve. This will then give you an accurate picture of what is happening overnight by looking at your pre bed and waking results. This should be done for 2-3 days consecutively before you make any dose change.....its good practice even with Levemir Once you can see a steady overnight pattern, then you can tackle lows in the day time, which may mean dropping your ratios to below 1:1, like 0.5:1, or looking at splitting your BI dose, so that the night and day time BI needs are managed separately..... What were you this morning?

Oct 11, 2013 Louise1988 69 posts	Topic: General Discussion / 3am tests I'm not really sure what to do with my basal rate, keep it to the lower rate or 7units, or go back to the original 8? The reason I thought to lower this basal, was to try to stop myself from getting so low during the day. However, I'm finding that I am dropping quickly. Any opinions?

Oct 11, 2013 Vickyp 137 posts	Topic: General Discussion / Basal Testing - nighttime if doing night tests I always take monitor to bed, that way I don't have to get up and go downstairs! 3am is a guide, I have often done them at 230am or 330am!

Oct 10, 2013 Warwick 425 posts	Topic: General Discussion / Exercise & BG levels Having a week or so off exercise can drive BGs up. I took a couple of weeks off exercise in June and instead of doing about 10 hours of exercise per week, I only did one 20 minute run over the two week period and my BGs went so high that I had to increase my basal insulin by quite a large amount to compensate. Exercise helps the absorption of insulin, but for exercise of less than half an hour, taking extra QA more than what you are taking is unlikely to change your post-exercise BGs without risking hypos an hour or so after the exercise. I'd recommend testing about 45 minutes before exercise. If you are high, you can then take QA to correct, and by the time you finish your exercise, most of the QA will be used up which should give you a good idea of how much you need to take.

Oct 10, 2013 DianeW 115 posts	Topic: General Discussion / Needles I've just found out that Novo Nordisk are discontinuing the 12mm needle from November. Now I realise that I may be in the minority in using them, but I have poor eyesight and find the 12 is fine to use, whereas the 8mm I struggle with. Anyone know what I could do, or another manufacturer of needles??