Recent Posts - DAFNE Online

Oct 11, 2013

novorapidboi26 1,819 posts

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 423 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 10, 2013

hannahdefries 12 posts

Topic: General Discussion / Exercise & BG levels

Im still very unsure of where I am going wrong with this, I was away for 1 week so didn;t have much exercise at all and was having to 'guess' my cp's as was on holiday so my BG were a little crazy at times. I can go to sleep on a 5.8 and then i wake on around 12.. Yet other mornings i will wake on 5.5 for example! My levels 9 times out of 10 are high before exercise so i am still taking 3 or 4 units before i run, then i test when im back and often around 10-14, I then correct with my breakfast and am normally okay around lunch time.

Oct 10, 2013

Garry 328 posts

Topic: General Discussion / Milking fingers causes low BG readings

Yes I'm sure that your meter information is correct as anything that takes up volume - as marke suggests - in a small sample is going to 'dilute' that sample and give a lower result.

When you finger ends are tender though and look like pin cushions there is no way that I would deepen the stab.

Yes, I encourage blood out of my fingers always. With this consistant approach I get reproducibility of results.
Recognising that BG meters do not give absolute mmol/L values and that so many factors affect the meter result I am satisfied to have reliable, repeatable numbers.
I use an Abbott Optium Xceed meter, the blood sample is only a tiny one - 0.6 Î¼L and I found results varied even between barely wetting the strip and giving it a large dollop of blood. Small blood samples gave lower results than large blood samples.
Unwashed hands gave remarkably different results from clean, dry hands.
So I just try and reproduce a consistent same size sample all the time from washed and dried hands.
With fingers feeling the way mine do - thatâ€™s a small blood sample from a minimum stab depth.
Regards
Garry

Oct 9, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Milking fingers causes low BG readings

if you prick your finger and there just isn't enough, a little encouragement it better than another stabbing.........lol

Oct 9, 2013

marke 681 posts

Topic: General Discussion / Milking fingers causes low BG readings

my understanding and it could be wrong, is that if you squeeze the blood out you could also squeeze out subcutaneous matter that affects the reading. This is why they say don't milk...
That said I too do it, its one of those things that the medical profession think patients don't do, that in reality they do all the time Laughing

Oct 9, 2013

JayBee 587 posts

Topic: General Discussion / Milking fingers causes low BG readings

I've also heard that it generally skews the BG result.

I've outright ignored this though. Blood is blood as far as I'm concerned.

Oct 9, 2013

Alan 49 284 posts

Topic: General Discussion / Milking fingers causes low BG readings

I can't see how massaging your finger can decrease the blood-sugar readiing.

Perhaps an HCP could answer that.

Oct 9, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Basal Testing - nighttime

The 3am time is just a guide to be honest. It represents a time where the blood stream will have minimum influence from other hormones, specifically those which occur in the morning when your body starts to wake up, so those hormones associated with the dawn phenomenon.

So if you were testing your blood sugar at this time it would be to establish whether or not your blood sugar has been held steady overnight, before the dawn phenomenon actually starts, which is important information when deciding whether or not to increase your overnight basal dose.

For general basal testing its actually most effective to test your blood sugar every hour..........so if you have confirmed that you are experiencing the dawn phenomenon but still want to check if your basal dose is correct, then testing before bed and at 3am would give a good indication. Any time after that wouldn't be accurate as your blood sugar may be rising due to events not in your control.......

That's was a bit long winded, sorry, ultimately it may not matter if you tested at 3am or 3:43. Everyone's hormonal release can start at different times you see, some earlier than 3am, some later, depends on the body clock and when you get up in the morning....

What was your pre bed and 3 am test results last night ?

Oct 9, 2013

mum2westiesGill 502 posts

Topic: General Discussion / Basal Testing - nighttime

Should this be done at exactly 3:00am or can it be up to so many minutes either side?

I did one last night when I woke up to go downstairs which was 3:43am.

Oct 9, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Milking fingers causes low BG readings

Lol....I think there's more than enough blood in there.....

Increase the lancet depth setting....

That's if you actually think that milking it makes a significant difference....

I don't.... Smile

Oct 9, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Milking fingers causes low BG readings

Lol....I think there's more than enough blood in there.....

Increase the lancet depth setting....

That's if you actually think that milking it makes a significant difference....

I don't.... Smile

Oct 9, 2013

Louise1988 69 posts

Topic: General Discussion / Milking fingers causes low BG readings

I have to milk my fingers, I don't have enough blood to let it come out on it's own!

Oct 9, 2013

Jimandbillow 8 posts

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

Thanks for the reply novorapidboi26. I agree about the scenario being fairly uncommon, but possible if you were to do some light/unexpected exercise or unknowingly overestimate your insulin etc between the 2 meals. I am just not sure why the pump wouldn't take the IOB into account for every dose instead of just when a greater correction dose is needed.

Have you tried rapid calc app for iphones? I think this has better algorithms set within it.

Oct 8, 2013

izzi1234 5 posts

Topic: General Discussion / Diet Drinks

diet coke is all that is available near me .

I think diet lemonade should be sold in pubs and restaurants.

I dont mind diet coke but its got a lot of caffeine in it

Oct 8, 2013

novorapidboi26 1,819 posts

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

If no correction is suggested when you test mid meal, this means that the IOB is sufficient..........

Maybe if the difference between the correction is less than 1 it might just suggest the food insulin only.......

I need to set up the above scenario for myself.......its very rare for me to be lower than I thought mid meal, unless there is alcohol in my system......

Oct 8, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Milking fingers causes low BG readings

I have heard people on the diabetes support forum say its best to let it come out on its own.......

personally I don't take much notice, it has never seemed to cause me problems.........the meters are hardly that accurate anyway......... Very Happy

Oct 8, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / afternoon hypos

usually if your background insulin is a single dose and its doing an important job like holding off the DP, then you should consider reducing your lunch ratio, or as you say taking a unit off your lunch dose would be worth a shot...... Very Happy

you say in your comments you don't get hypo warnings anymore, for that reason alone I would personally drop the BI so as to increase your levels throughout the whole day........

have you discussed options to regain your hypo awareness with you diabetic team...............?

Also, considering a split dose of BI is much more flexible, especially when varying levels of activity are concerned.......

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 423 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 10, 2013 hannahdefries 12 posts	Topic: General Discussion / Exercise & BG levels Im still very unsure of where I am going wrong with this, I was away for 1 week so didn;t have much exercise at all and was having to 'guess' my cp's as was on holiday so my BG were a little crazy at times. I can go to sleep on a 5.8 and then i wake on around 12.. Yet other mornings i will wake on 5.5 for example! My levels 9 times out of 10 are high before exercise so i am still taking 3 or 4 units before i run, then i test when im back and often around 10-14, I then correct with my breakfast and am normally okay around lunch time.

Oct 10, 2013 Garry 328 posts	Topic: General Discussion / Milking fingers causes low BG readings Yes I'm sure that your meter information is correct as anything that takes up volume - as marke suggests - in a small sample is going to 'dilute' that sample and give a lower result. When you finger ends are tender though and look like pin cushions there is no way that I would deepen the stab. Yes, I encourage blood out of my fingers always. With this consistant approach I get reproducibility of results. Recognising that BG meters do not give absolute mmol/L values and that so many factors affect the meter result I am satisfied to have reliable, repeatable numbers. I use an Abbott Optium Xceed meter, the blood sample is only a tiny one - 0.6 Î¼L and I found results varied even between barely wetting the strip and giving it a large dollop of blood. Small blood samples gave lower results than large blood samples. Unwashed hands gave remarkably different results from clean, dry hands. So I just try and reproduce a consistent same size sample all the time from washed and dried hands. With fingers feeling the way mine do - thatâ€™s a small blood sample from a minimum stab depth. Regards Garry

Oct 9, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Milking fingers causes low BG readings if you prick your finger and there just isn't enough, a little encouragement it better than another stabbing.........lol

Oct 9, 2013 marke 681 posts	Topic: General Discussion / Milking fingers causes low BG readings my understanding and it could be wrong, is that if you squeeze the blood out you could also squeeze out subcutaneous matter that affects the reading. This is why they say don't milk... That said I too do it, its one of those things that the medical profession think patients don't do, that in reality they do all the time

Oct 9, 2013 JayBee 587 posts	Topic: General Discussion / Milking fingers causes low BG readings I've also heard that it generally skews the BG result. I've outright ignored this though. Blood is blood as far as I'm concerned.

Oct 9, 2013 Alan 49 284 posts	Topic: General Discussion / Milking fingers causes low BG readings I can't see how massaging your finger can decrease the blood-sugar readiing. Perhaps an HCP could answer that.

Oct 9, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Basal Testing - nighttime The 3am time is just a guide to be honest. It represents a time where the blood stream will have minimum influence from other hormones, specifically those which occur in the morning when your body starts to wake up, so those hormones associated with the dawn phenomenon. So if you were testing your blood sugar at this time it would be to establish whether or not your blood sugar has been held steady overnight, before the dawn phenomenon actually starts, which is important information when deciding whether or not to increase your overnight basal dose. For general basal testing its actually most effective to test your blood sugar every hour..........so if you have confirmed that you are experiencing the dawn phenomenon but still want to check if your basal dose is correct, then testing before bed and at 3am would give a good indication. Any time after that wouldn't be accurate as your blood sugar may be rising due to events not in your control....... That's was a bit long winded, sorry, ultimately it may not matter if you tested at 3am or 3:43. Everyone's hormonal release can start at different times you see, some earlier than 3am, some later, depends on the body clock and when you get up in the morning.... What was your pre bed and 3 am test results last night ?

Oct 9, 2013 mum2westiesGill 502 posts	Topic: General Discussion / Basal Testing - nighttime Should this be done at exactly 3:00am or can it be up to so many minutes either side? I did one last night when I woke up to go downstairs which was 3:43am.

Oct 9, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Milking fingers causes low BG readings Lol....I think there's more than enough blood in there..... Increase the lancet depth setting.... That's if you actually think that milking it makes a significant difference.... I don't....

Oct 9, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Milking fingers causes low BG readings Lol....I think there's more than enough blood in there..... Increase the lancet depth setting.... That's if you actually think that milking it makes a significant difference.... I don't....

Oct 9, 2013 Louise1988 69 posts	Topic: General Discussion / Milking fingers causes low BG readings I have to milk my fingers, I don't have enough blood to let it come out on it's own!

Oct 9, 2013 Jimandbillow 8 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps Thanks for the reply novorapidboi26. I agree about the scenario being fairly uncommon, but possible if you were to do some light/unexpected exercise or unknowingly overestimate your insulin etc between the 2 meals. I am just not sure why the pump wouldn't take the IOB into account for every dose instead of just when a greater correction dose is needed. Have you tried rapid calc app for iphones? I think this has better algorithms set within it.

Oct 8, 2013 izzi1234 5 posts	Topic: General Discussion / Diet Drinks diet coke is all that is available near me . I think diet lemonade should be sold in pubs and restaurants. I dont mind diet coke but its got a lot of caffeine in it

Oct 8, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps If no correction is suggested when you test mid meal, this means that the IOB is sufficient.......... Maybe if the difference between the correction is less than 1 it might just suggest the food insulin only....... I need to set up the above scenario for myself.......its very rare for me to be lower than I thought mid meal, unless there is alcohol in my system......

Oct 8, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Milking fingers causes low BG readings I have heard people on the diabetes support forum say its best to let it come out on its own....... personally I don't take much notice, it has never seemed to cause me problems.........the meters are hardly that accurate anyway.........

Oct 8, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / afternoon hypos usually if your background insulin is a single dose and its doing an important job like holding off the DP, then you should consider reducing your lunch ratio, or as you say taking a unit off your lunch dose would be worth a shot...... you say in your comments you don't get hypo warnings anymore, for that reason alone I would personally drop the BI so as to increase your levels throughout the whole day........ have you discussed options to regain your hypo awareness with you diabetic team...............? Also, considering a split dose of BI is much more flexible, especially when varying levels of activity are concerned.......