Recent Posts - DAFNE Online

Oct 8, 2013

john m 15 posts

Topic: General Discussion / afternoon hypos

keep having hypos in the afternoon only mon-fri well im in work sat /sun is ok maybe because im less active at weekends decreasing my bl could give me high bg reading in the morning because i suffer with dawn phenomenom or could i do 1 unit less at lunch not sure what to do ?

Oct 8, 2013

Alan 49 284 posts

Topic: General Discussion / Milking fingers causes low BG readings

The User Manual that came with my Mendor Discreet BG meter says that when testing BGs, milking the finger to get the blood 'may cause low test results'.

I've never heard this before - is this true?

Oct 8, 2013

Jimandbillow 8 posts

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

Thanks for the responses guys....

Davey38 - your comment 'Active Insulin means there has been a correction' is only applicable to the roche pump as roche only count correction insulin as active insulin. Medtronic and every other company count any insulin taken as active insulin.

novorapidboi26 - Medtronic will only subtract the active insulin from the correction part of a dose if the correction is greater than the IOB. So if no correction is needed the pump will not subract the IOB from the bolus suggestion, which personally I think is wrong as it could lead to a hypo in the scenario explained above.

Oct 8, 2013

novorapidboi26 1,819 posts

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

I am also on a Medtronic pump, the paradigm 754........

your pump should only recommend you take the full 3.0 units if the correction of the 7.0mmol equals that of the remaining insulin....I think..........

I would love to confirm but I have no more insulin left and I am 4.2......

Does your pump not subtract the active insulin and then add a correction (which can also be negative)...?

Oct 8, 2013

Davey54 8 posts

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

Hi Jim, I use a ACCU-CHEK COMBO.
Active Insulin means there has been a correction, so that's gone don't worry. The 6 units of insulin you had is at it's peak 2 hours after. Therefore, if I was you I wouldn't have any insulin with the 30g carbs, to do so causes what's called STACKING and will probably cause an hypo. Remember that no insulin with the 30g will increase your BG level, better that than an hypo. It will be corrected the next time you test and take on carbs.
Ultimately you have to do what you're comfortable with. GOOD LUCK!

Oct 8, 2013

Louise1988 69 posts

Topic: General Discussion / 3am tests

Hi Garry, thanks for your reply. I'm currently on just 8u of levemir, which I take at 9pm. I'm wondering whether I need to lower this, as I keep getting hypos during the day, so I'm trying to see how much of an effect my basal rate has on the rest of the day. My morning rates aren't too bad, around 5-6. I'm only on tiny doses as it is, and just want to get my levels up. Will post in a few days and let you know.

Oct 8, 2013

Garry 328 posts

Topic: General Discussion / 3am tests

Carb free dinner is not necessary Louise1988.
Take your dinner as normal with the matching QA. BI dose as normal, at normal time.
You are only checking that your BI is right. We all need an established background insulin level to keep us ticking over, especially when comparatively inactive. So I hope you find that your before bed, 3 am and before breakfast BGs are ideally within 1 mmol/L â€“ donâ€™t fret if they are not though. No changes really necessary if they are pretty even. You do need plenty of days results to compare with one another though as lots of other things get in the way of our understanding the body - it is a dynamic â€˜fickleâ€™ machine.
You may wish to post again in a week or so when you have data. Please let us know your particular BI and typical dose/s. Currently, I split Lantus 27u at 06:30 and 27u 18:00 to 19:00. But Iâ€™m sure someone here will be able to advise you better, if using your type of BI.
Regards
Garry

Oct 8, 2013

Jimandbillow 8 posts

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

Hi...

I have a question about bolus advice when there is active insulin involved. I use a Medtronic pump.

Here's a scenario...

My carb ratio is 1u:10g, my correction factor is 1u:3mmol/L, BG target 6.5mmol/L

My BG is 6.5 and I eat 60g food and take 6u of insulin. In the next 2 hours I do a little exercise but nothing too dramatic. I then decide to have 30g (3u insulin) of food which is 2 hours after the 6u I took. I test my BG and they are 7.0mmol/L. Clearly I have insulin still working (approx 2.3 units). My pump will still suggest that I take the full 3u even though it will show that there is insulin on board. Why? Should it not take my lower than expected BG levels into account and suggest something like a 0.9 U dose?

It appears that most calculators use an algorithm similar to this but I don't see the reasoning behind this as in this scenario that is not unusual, I will clearly have a hypo if the full dose is taken.

Thanks

Oct 8, 2013

Jimandbillow 8 posts

Topic: General Discussion / ketones

A meter that measures ketones if far better and more accurate than urine sticks. There are 2 to try. Glucomen lx plus or the abbott freestyle optium.

Oct 8, 2013

Louise1988 69 posts

Topic: General Discussion / Diet Drinks

I'd love to start a campaign to get more diet drinks in pubs and restaurants! I can't drink coke, as I have an intolerance to it, so all I drink when I'm out, is water, which is incredibly boring. My local pub did order in diet lemonade, but they say it was a mistake and won't be ordering any more in Sad

Oct 8, 2013

john day 54 posts

Topic: DAFNE Online Mobile / How to upload diary from app to website

I am running the app on a Nexus 7 and, as new to Android, still getting to grips with how to drive the thing generally !

In particular , as per BMuffs query, I have not been able to work out how to delete or amend an erroneous dafne entry . I have one saved currently and it indicates error upon upload attempt and appears to prevent other, later entries being uploaded also.

Hopefully there is a simple solution!

Oct 8, 2013

Louise1988 69 posts

Topic: General Discussion / 3am tests

I need to test my basal rates, which involves a 3am test (eek). I never eat after about 8pm, so I would have no qa insulin working at 3am. Do I still need to have a carb free dinner, to test this accurately?

Oct 8, 2013

Matt Hewitt 8 posts

Topic: General Discussion / Diabetic jokes

My wife recently found out she suffers from both diabetes and hay fever.

I have tried to cheer her up by sending gifts, you know; flowers, chocolates.

Oct 7, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Think my Novorapid is too slow!

That is a valid risk and one that needs to be factored in of course....if you had a habit of not finishing a meal then you could consider smaller portions....as for fire alarm situations....its good practice to have hypo resolve to hand at all times....

Its all about trial and error and weighing up the risks personal to you....

In this situation having 19 and 20s in my opinion wouldn't be good enough....I feel really bad at those levels....but dome may be OK and wouldn't see a significant effect on long term blood sugars.... Don't forget about complications that come with yo yoing BG...

;)

Oct 7, 2013

youone 102 posts

Topic: Questions for HCPs / Think my Novorapid is too slow!

When you inject before having a meal you risk putting yourself in a position where for what ever reason you can't complete your meal.
This is 1 topic I disagreed with Dafne since Dafne teaches us to inject after eating.
My view changed when I injected before I had started to eat my lunch, when the fire alarm went off, for real, complete get your self out the building quick.
I had injected 6 units of AQ humolog.
I can tell you the next 15 mins looking for and explaining to the fire marshal that I needed carbs is something that reminds me to eat then inject.
Shocked

Oct 7, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Think my Novorapid is too slow!

When our dose adjusting, then the pre meal test is the most important one, but once that's all done its good to go after the mid meal numbers.....

for me these were causing problems, really tired in the afternoons and also pushing up my HbA1c.....

In Sheilas case its definitely worth tackling with numbers that high.....

If your on target by the next meal even when your getting the highs 1 hour to 2 hours after injecting then its all about timing...........you need to get the peak effectiveness of the insulin, which is quoted to be 1-2 hours after injecting, to match up with the peak of the digestion, everyone digests at different speeds, same with the insulin action........so you need to get the insulin in a lot quicker than 'at the time of eating' or 'just before you eat', you need to experiment with it, get it in 15 minutes, 20 minutes, 30 minutes, sometimes more before eating...

the results will e good...... Very Happy

Oct 7, 2013

youone 102 posts

Topic: Questions for HCPs / Think my Novorapid is too slow!

sheila said:
Hi everyone - thank you so much for your interest and speedy replies! The injecting into muscle sounds intriguing, but isn't it a bit sore? And wouldn't I need longer needles (I have 6mm at the moment)? It definitely sounds like something I'd look into, though, thanks for the suggestion. My BG seems to rise to as high as 19 or 20 an hour after I've eaten, and that's when it's at between 6 and 7 before I eat. This can't be right, surely? I wondered whether I should change my ratios, but it seems to be more to do with when it's rising rather than the amounts? I'm now also seriously considering taking my bolus dose early, though this might not be achievable ea fi
time I eat, as sometimes it's more spontaneous than others! Thanks for all your suggestions.

Hi
The important BG is the 1 after 4 to 5 hours after your QA dose this is the BG you correct from.
The only time you would correct after an 1 hour period is when its below the starting BG number the correction then would be with a QA carb.
If you find the number to high and it worry's you don't test at this stage unless you feel hot and sweaty which points to you been to low.
The injection into muscle worry's me, over time even a single injection would cause sores which take a long time to heal.
I've seen many people who injected into the arm with very sore and not good looking brusing
But this is new to me,I never over 40 yrs injected directly into muscle.
I'm glad i'm now on the omnipod 2 MDI sounds like a medieval torture.

Oct 7, 2013

youone 102 posts

Topic: General Discussion / Background insulin (BI)

Glad it helped SueA
The numbers I showed worked up to a point and are only a guide.
The best thing any type 1 can do is exercise even a walk helps you reduce your insulin amounts
Good luck with you hitting both your BG and weight targets
Type1 MDI 42 yes
Omnipod2 2months

Oct 7, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / eye scan

I have had background retinopathy for five years, and it was my last appointment that flagged up maculopathy in one of my eyes.......

A trip to the hospital eye doctor confirmed in fact it had not progressed further in........

I think after having diabetes for a long time, maybe 10 years plus, its perfectly normal to have background reitnopathy. As long as blood sugars are stable and not high and low, and your BP is under control, the leaks can heal themselves without causing problems......

the letter does need changed though.........

Oct 7, 2013

SueA 9 posts

Topic: General Discussion / Background insulin (BI)

I just read this topic for the first time and have found it really helpful. Smile

Since Dafne I have put on weight and at present I am trying to reverse this. Brian's post has explained why I have had to put up my BI and the figures confirm that I am on the right amount. It will also help with adjustments as I loose weight.
Thank you
SueA

Oct 6, 2013

marke 681 posts

Topic: Carbohydrate Counting / Dominoes

There is a link to the Dominos carb data in our carb content list here

Oct 6, 2013

marke 681 posts

Topic: Carbohydrate Counting / carbs and cal iphone app

I should probably point out that this site also has a carb content list here, which any additions would also be most welcome Laughing

Oct 6, 2013

Louise1988 69 posts

Topic: Carbohydrate Counting / Dominoes

It depends what toppings you go for...pepperoni for example is 2cp's per slice. Carbs 'n' cals seems to be pretty comprehensive when it comes to takeaway food.

Oct 6, 2013

Jonbaldwin1 1 post

Topic: Carbohydrate Counting / Dominoes

Hi does anyone know how many cps are in a large dominoes pizza?

Oct 6, 2013

Alan 49 284 posts

Topic: General Discussion / Mendor Discreet meter

I received in the post a Mendor Discreet blood glucose meter yesterday. It came with a letter from a company called Merck Serono, thanking me for applying for it. I don't remember applying for it, but I suppose I might have ticked a box on a website or something.

Anyway, I followed the User Guide and set it up. When I tried to use it, the test-strip appeared at the side if the meter, I inserted a lancet in the side of the mete (this bit isn't mentioned in the Guide) and primed it, as shown in the Guide, but I couldn't get the finger-pricker to work.

Has anybody managed to get it to work?

Oct 8, 2013 john m 15 posts	Topic: General Discussion / afternoon hypos keep having hypos in the afternoon only mon-fri well im in work sat /sun is ok maybe because im less active at weekends decreasing my bl could give me high bg reading in the morning because i suffer with dawn phenomenom or could i do 1 unit less at lunch not sure what to do ?

Oct 8, 2013 Alan 49 284 posts	Topic: General Discussion / Milking fingers causes low BG readings The User Manual that came with my Mendor Discreet BG meter says that when testing BGs, milking the finger to get the blood 'may cause low test results'. I've never heard this before - is this true?

Oct 8, 2013 Jimandbillow 8 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps Thanks for the responses guys.... Davey38 - your comment 'Active Insulin means there has been a correction' is only applicable to the roche pump as roche only count correction insulin as active insulin. Medtronic and every other company count any insulin taken as active insulin. novorapidboi26 - Medtronic will only subtract the active insulin from the correction part of a dose if the correction is greater than the IOB. So if no correction is needed the pump will not subract the IOB from the bolus suggestion, which personally I think is wrong as it could lead to a hypo in the scenario explained above.

Oct 8, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps I am also on a Medtronic pump, the paradigm 754........ your pump should only recommend you take the full 3.0 units if the correction of the 7.0mmol equals that of the remaining insulin....I think.......... I would love to confirm but I have no more insulin left and I am 4.2...... Does your pump not subtract the active insulin and then add a correction (which can also be negative)...?

Oct 8, 2013 Davey54 8 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps Hi Jim, I use a ACCU-CHEK COMBO. Active Insulin means there has been a correction, so that's gone don't worry. The 6 units of insulin you had is at it's peak 2 hours after. Therefore, if I was you I wouldn't have any insulin with the 30g carbs, to do so causes what's called STACKING and will probably cause an hypo. Remember that no insulin with the 30g will increase your BG level, better that than an hypo. It will be corrected the next time you test and take on carbs. Ultimately you have to do what you're comfortable with. GOOD LUCK!

Oct 8, 2013 Louise1988 69 posts	Topic: General Discussion / 3am tests Hi Garry, thanks for your reply. I'm currently on just 8u of levemir, which I take at 9pm. I'm wondering whether I need to lower this, as I keep getting hypos during the day, so I'm trying to see how much of an effect my basal rate has on the rest of the day. My morning rates aren't too bad, around 5-6. I'm only on tiny doses as it is, and just want to get my levels up. Will post in a few days and let you know.

Oct 8, 2013 Garry 328 posts	Topic: General Discussion / 3am tests Carb free dinner is not necessary Louise1988. Take your dinner as normal with the matching QA. BI dose as normal, at normal time. You are only checking that your BI is right. We all need an established background insulin level to keep us ticking over, especially when comparatively inactive. So I hope you find that your before bed, 3 am and before breakfast BGs are ideally within 1 mmol/L â€“ donâ€™t fret if they are not though. No changes really necessary if they are pretty even. You do need plenty of days results to compare with one another though as lots of other things get in the way of our understanding the body - it is a dynamic â€˜fickleâ€™ machine. You may wish to post again in a week or so when you have data. Please let us know your particular BI and typical dose/s. Currently, I split Lantus 27u at 06:30 and 27u 18:00 to 19:00. But Iâ€™m sure someone here will be able to advise you better, if using your type of BI. Regards Garry

Oct 8, 2013 Jimandbillow 8 posts	Topic: Questions for HCPs / Insulin on board algorithms in pumps Hi... I have a question about bolus advice when there is active insulin involved. I use a Medtronic pump. Here's a scenario... My carb ratio is 1u:10g, my correction factor is 1u:3mmol/L, BG target 6.5mmol/L My BG is 6.5 and I eat 60g food and take 6u of insulin. In the next 2 hours I do a little exercise but nothing too dramatic. I then decide to have 30g (3u insulin) of food which is 2 hours after the 6u I took. I test my BG and they are 7.0mmol/L. Clearly I have insulin still working (approx 2.3 units). My pump will still suggest that I take the full 3u even though it will show that there is insulin on board. Why? Should it not take my lower than expected BG levels into account and suggest something like a 0.9 U dose? It appears that most calculators use an algorithm similar to this but I don't see the reasoning behind this as in this scenario that is not unusual, I will clearly have a hypo if the full dose is taken. Thanks

Oct 8, 2013 Jimandbillow 8 posts	Topic: General Discussion / ketones A meter that measures ketones if far better and more accurate than urine sticks. There are 2 to try. Glucomen lx plus or the abbott freestyle optium.

Oct 8, 2013 Louise1988 69 posts	Topic: General Discussion / Diet Drinks I'd love to start a campaign to get more diet drinks in pubs and restaurants! I can't drink coke, as I have an intolerance to it, so all I drink when I'm out, is water, which is incredibly boring. My local pub did order in diet lemonade, but they say it was a mistake and won't be ordering any more in

Oct 8, 2013 john day 54 posts	Topic: DAFNE Online Mobile / How to upload diary from app to website I am running the app on a Nexus 7 and, as new to Android, still getting to grips with how to drive the thing generally ! In particular , as per BMuffs query, I have not been able to work out how to delete or amend an erroneous dafne entry . I have one saved currently and it indicates error upon upload attempt and appears to prevent other, later entries being uploaded also. Hopefully there is a simple solution!

Oct 8, 2013 Louise1988 69 posts	Topic: General Discussion / 3am tests I need to test my basal rates, which involves a 3am test (eek). I never eat after about 8pm, so I would have no qa insulin working at 3am. Do I still need to have a carb free dinner, to test this accurately?

Oct 8, 2013 Matt Hewitt 8 posts	Topic: General Discussion / Diabetic jokes My wife recently found out she suffers from both diabetes and hay fever. I have tried to cheer her up by sending gifts, you know; flowers, chocolates.

Oct 7, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! That is a valid risk and one that needs to be factored in of course....if you had a habit of not finishing a meal then you could consider smaller portions....as for fire alarm situations....its good practice to have hypo resolve to hand at all times.... Its all about trial and error and weighing up the risks personal to you.... In this situation having 19 and 20s in my opinion wouldn't be good enough....I feel really bad at those levels....but dome may be OK and wouldn't see a significant effect on long term blood sugars.... Don't forget about complications that come with yo yoing BG... ;)

Oct 7, 2013 youone 102 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! When you inject before having a meal you risk putting yourself in a position where for what ever reason you can't complete your meal. This is 1 topic I disagreed with Dafne since Dafne teaches us to inject after eating. My view changed when I injected before I had started to eat my lunch, when the fire alarm went off, for real, complete get your self out the building quick. I had injected 6 units of AQ humolog. I can tell you the next 15 mins looking for and explaining to the fire marshal that I needed carbs is something that reminds me to eat then inject.

Oct 7, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! When our dose adjusting, then the pre meal test is the most important one, but once that's all done its good to go after the mid meal numbers..... for me these were causing problems, really tired in the afternoons and also pushing up my HbA1c..... In Sheilas case its definitely worth tackling with numbers that high..... If your on target by the next meal even when your getting the highs 1 hour to 2 hours after injecting then its all about timing...........you need to get the peak effectiveness of the insulin, which is quoted to be 1-2 hours after injecting, to match up with the peak of the digestion, everyone digests at different speeds, same with the insulin action........so you need to get the insulin in a lot quicker than 'at the time of eating' or 'just before you eat', you need to experiment with it, get it in 15 minutes, 20 minutes, 30 minutes, sometimes more before eating... the results will e good......

Oct 7, 2013 youone 102 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! sheila said: Hi everyone - thank you so much for your interest and speedy replies! The injecting into muscle sounds intriguing, but isn't it a bit sore? And wouldn't I need longer needles (I have 6mm at the moment)? It definitely sounds like something I'd look into, though, thanks for the suggestion. My BG seems to rise to as high as 19 or 20 an hour after I've eaten, and that's when it's at between 6 and 7 before I eat. This can't be right, surely? I wondered whether I should change my ratios, but it seems to be more to do with when it's rising rather than the amounts? I'm now also seriously considering taking my bolus dose early, though this might not be achievable ea fi time I eat, as sometimes it's more spontaneous than others! Thanks for all your suggestions. Hi The important BG is the 1 after 4 to 5 hours after your QA dose this is the BG you correct from. The only time you would correct after an 1 hour period is when its below the starting BG number the correction then would be with a QA carb. If you find the number to high and it worry's you don't test at this stage unless you feel hot and sweaty which points to you been to low. The injection into muscle worry's me, over time even a single injection would cause sores which take a long time to heal. I've seen many people who injected into the arm with very sore and not good looking brusing But this is new to me,I never over 40 yrs injected directly into muscle. I'm glad i'm now on the omnipod 2 MDI sounds like a medieval torture.

Oct 7, 2013 youone 102 posts	Topic: General Discussion / Background insulin (BI) Glad it helped SueA The numbers I showed worked up to a point and are only a guide. The best thing any type 1 can do is exercise even a walk helps you reduce your insulin amounts Good luck with you hitting both your BG and weight targets Type1 MDI 42 yes Omnipod2 2months

Oct 7, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / eye scan I have had background retinopathy for five years, and it was my last appointment that flagged up maculopathy in one of my eyes....... A trip to the hospital eye doctor confirmed in fact it had not progressed further in........ I think after having diabetes for a long time, maybe 10 years plus, its perfectly normal to have background reitnopathy. As long as blood sugars are stable and not high and low, and your BP is under control, the leaks can heal themselves without causing problems...... the letter does need changed though.........

Oct 7, 2013 SueA 9 posts	Topic: General Discussion / Background insulin (BI) I just read this topic for the first time and have found it really helpful. Since Dafne I have put on weight and at present I am trying to reverse this. Brian's post has explained why I have had to put up my BI and the figures confirm that I am on the right amount. It will also help with adjustments as I loose weight. Thank you SueA

Oct 6, 2013 marke 681 posts	Topic: Carbohydrate Counting / Dominoes There is a link to the Dominos carb data in our carb content list here

Oct 6, 2013 marke 681 posts	Topic: Carbohydrate Counting / carbs and cal iphone app I should probably point out that this site also has a carb content list here, which any additions would also be most welcome

Oct 6, 2013 Louise1988 69 posts	Topic: Carbohydrate Counting / Dominoes It depends what toppings you go for...pepperoni for example is 2cp's per slice. Carbs 'n' cals seems to be pretty comprehensive when it comes to takeaway food.

Oct 6, 2013 Jonbaldwin1 1 post	Topic: Carbohydrate Counting / Dominoes Hi does anyone know how many cps are in a large dominoes pizza?

Oct 6, 2013 Alan 49 284 posts	Topic: General Discussion / Mendor Discreet meter I received in the post a Mendor Discreet blood glucose meter yesterday. It came with a letter from a company called Merck Serono, thanking me for applying for it. I don't remember applying for it, but I suppose I might have ticked a box on a website or something. Anyway, I followed the User Guide and set it up. When I tried to use it, the test-strip appeared at the side if the meter, I inserted a lancet in the side of the mete (this bit isn't mentioned in the Guide) and primed it, as shown in the Guide, but I couldn't get the finger-pricker to work. Has anybody managed to get it to work?