Recent Posts - DAFNE Online

Oct 3, 2013

izzi1234 5 posts

Thanks for the replies im hoping its just back ground retinopathathy.

Think the letter which is obviously a template should be worded better. I have only been type 1 for 5 years so is a bit worrying im only 26.

Oct 3, 2013

Auffea 2 posts

Topic: General Discussion / eye scan

I had a letter like that last year saying that I had "background retinopathy" I was so worried that i asked the diabetes specialist at my local hospital who explained that most of the population has background retinopathy and that it doesn't mean that you are in imminent danger of losing your eyesight. He said just keep your blood glucose down within target and everything should be alright. I have had diabetes now for 15 years and that was the first time I'd heard of background retinopathy.

Oct 3, 2013

Warwick 430 posts

Topic: General Discussion / eye scan

It may of course be something other than diabetic retinopathy. Hopefully your letter will tell you what it is.

Oct 3, 2013

Warwick 430 posts

Topic: General Discussion / eye scan

Sounds like Diabetic Retinopathy to me:

http://en.wikipedia.org/wiki/Diabetic_retinopathy

The management section of this article may be helpful.

Definitely talk to someone - opthalmologist or doctor about this. If you aren't happy with the response you get, then get a second opinion. Part of a medical professional's job is to answer your questions and help your management, and if they aren't doing that effectively, then you are well within your rights to find that one does.

Oct 2, 2013

izzi1234 5 posts

Topic: General Discussion / eye scan

I have recently had an eye scan and been sent a letter saying that diabetes is affecting my eyes. no treatment required.

I rung my doctors as it says to ring them for more info but they just left a voicemail saying basically nothing other than that its affecting my eyes and will go for another scan in a year.

has any one had this before can it go? its left me a bit worried

thanks

Oct 1, 2013

Warwick 430 posts

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

Hello,

I don't find it sore at all injecting into my bicep. I think it may have hurt a bit injecting into my calf, but I stopped doing that. Everyone is different though, so it would be a case of experimentation.

I use 4 mm needles whether injecting into fat or muscle, but I have very little fat between the skin and muscle of the bicep. An 8 mm needle may be required if more body fat is carried.

If your BGLs are back in a normal zone 3-4 hours after eating, then increasing your QA dose would be a bad idea as it will likely lead to hypos. You would want to look at injecting earlier before meals so that the peak action of the QA matches the peaking of the BGs after eating, or trying the muscle injections.

Oct 1, 2013

sheila 2 posts

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

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? Sad

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 each time I eat, as sometimes it's more spontaneous than others! Thanks for all your suggestions.

Oct 1, 2013

jlyall 8 posts

Topic: Carbohydrate Counting / carbs in turnip

a good helping of mashed turnip instead of potatoes and a bit of butter
possibly count it the next time and see what happens

Oct 1, 2013

Eatonmywords 2 posts

Topic: Questions for HCPs / Ketones at Night

Thanks novorapidboi26 - I think that my BI is holding me steady once I have got rid of the ketones I am back in target and it holds me there. I wondered about increasing my dinnertime ratio in the hope that it would help hold the ketones off. I am on soluble (Humulin S) QA so it hangs around for up to 8 hours.

Oct 1, 2013

novorapidboi26 1,816 posts

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

Experimenting with the timing as Garry suggested would be my personal choice. Allowing the insulin to get in and going strong would be advantageous to your quick digestion. I injected, and still do bolus with pump, 30 minutes before I eat, in order to get the mid meal spike down as low as possible, so 1.5 to 2 hours later. It works a treat. So definitely worth experimenting with.

Warwick suggestion is good too, if your up for that....

How much of a rise in BG have you observed.....?

Oct 1, 2013

novorapidboi26 1,816 posts

Topic: Questions for HCPs / Ketones at Night

how many ketones are you registering? Is it blood ketones?

Ketones usually present them selves when there is lack of glucose energy getting in to the cells and so fat is burned to satisfy that glucose requirement. You seem to be having carbs every few hours with insulin, so you would expect ketone levels to be lower during this time, which is during the day, the time your ketone levels are lower....

I cant really say if its normal for ketones to come and go. I know once they are there they have to processed with insulin just as glucose does....

If the ketone levels are low, so + or ++, then I would recommend doing a BI check overnight. Only if you feel up to it. You would be up every 2 hours anyway, so it would be an excellent opportunity to see what your BI is doing overnight.

Ultimately you aren't getting enough insulin during the night, which is causing the ketones, so getting your BI to do the heavy lifting rather than breaking sleep and giving QA to compensate would be much more appealing....

Very Happy

Oct 1, 2013

novorapidboi26 1,816 posts

Topic: Carbohydrate Counting / carbs in turnip

was there a lot of turnip?

either way, a few more test with it should confirm if you need insulin........the amount of which will likely be unique to you.... Smile

Oct 1, 2013

novorapidboi26 1,816 posts

Topic: General Discussion / working nights

I agree with Wawrick, taking it at the same time would be the preferred option...

There is no reason why this wont be possible, unless your shift starts at 10 pm. An hour either side of 10 pm wont matter though.......

Enjoy the night shift........

I was on 2 injections a day when I done night shift, it killed me........

Oct 1, 2013

Eatonmywords 2 posts

Topic: Questions for HCPs / Ketones at Night

I discovered two skin infection sites on 27th. The GP nurse prescribed antibiotics to fight the infection. Alongside hot compresses this seems to have worked quite well. I am checking Ketones as I also have a cold. But I am finding that I am clear of Ketones during the day, but they reappear before I go to bed meaning I am having to check 2 hourly through the night (according to the sick day rules).

Is it normal for Ketones to come and go like this? Could I make a change to my INSULIN regime during the day to counteract the Ketones at night?

Sep 30, 2013

Rafa 99 posts

Topic: Questions for HCPs / Weekly readings

Went away to America for ten days and my morning readings went mad. Nearly all between 14-15. I was eating out every night so might have BEEN calculating cps wrong even though i had my notes, carbs and cals with me. Hoping that i am back now i will be able to settle down over the coming days and am BG won't be as high. Before i went my educator advised me to take my evening BI with my dinner at 7.30-8pm due to the am readings and see how it goes. I had been taking my BI at bedtime (10pm-11pm). This was just before i went away. Will give it three days and see how the am read. If not i am thinking my BI in the evening may need to go up.

Sep 30, 2013

Warwick 430 posts

Topic: General Discussion / working nights

Hi Dean,

I'd suggest keeping it the same, and doing regular tests. If you find yourself going high or low consistently then you can raise or lower your BI, but it probably won't affect you too much.

Some people take Lantus in the morning, some at night. I take it twice a day - with breakfast and with tea as I find it doesn't last the full 24 hours for me, so taking it around the same time as you already do will probably work fine for you.

Cheers,
Warwick.

Sep 29, 2013

Dean123 7 posts

Topic: General Discussion / working nights

hi i have just been told that i am working nights for 3 weeks for 12 hour shifts , how do i go on with my lantus i usely take it at 10pm night, any tips or info would be very welcome . thanks dean

Sep 28, 2013

youone 102 posts

Topic: General Discussion / Skin drug with spin-off benefits for Type 1

I agree, very interesting and another move forward Very Happy

Sep 28, 2013

Warwick 430 posts

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

Something I have had great success with recently after hearing about it from Gary Scheiner (author of Think Like a Pancreas) is injecting insulin directly into muscle rather than fat. It gets absorbed twice as quickly. I'm on Humalog which takes about 3 hours to fully absorb, and 90 minutes to peak, but injecting into muscle means it is all used within 90 minutes with a peak at about 45 minutes.

I have only used it so far for when I am high and want to get back down into the normal range quickly, but my HbA1c has gone from 7.2 last year, to 6.1 6 months ago, and 6.2 last week. I inject into my bicep, but I was told that quads and calf muscle could also be used. I haven't had such a good result from either of those (and it can be difficult to inject there if wearing trousers, so I've stuck exclusively to the bicep muscle.

It is also good when I know I am high, but will be exercising within two hours, as I can inject into muscle to bring my down to a good range, and know that all QA will be consumed before I exercise reducing the risk of a hypo during the exercise.

In your case, you could proceed cautiously, and split your dose into two equal injections - one in your normal area of injection, and one into the muscle. Then based on your results, you could increase one and decrease the other depending on what works for you.

Cheers,
Warwick.

Sep 26, 2013

Garry 328 posts

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

Although not a HCP please consider my perspective:
If you were not Diabetic and had a full set of fully functioning Islets of Langerhans containing their insulin secreting Beta cells...your blood sugar would still rise after eating. These cells need sense the rising blood sugar for them to secrete insulin.
So don't worry about it. High BGs after eating are normal and we need focus on getting the levels right prior to our next meal.
We are all individuals. We all have different digestion rates for particular types of foods. Some people find they don't need count some types of carbohydrate...and others of us find it absolutely necessary to tot up all carbohydrate.
I'm afraid that over the years I have regularly seen 14s, 15s and 16s after meals. I take Humalog QA and cope with my uptake rate by taking this insulin 15 to 40 minutes before eating. Bit of a pain when you guess the CHO wrong...but easily coped with by a second, compensation dose immediately after the meal.
If you made detailed notes and can recover sufficient data from the diary figures of your 8 years since DAFNE you may be able to pick out some of the meals that have a marked effect on your BGs. Some of them may surprise you.
I always find eating out a problem. Many a Chef adds sugar to his main course sauce to give it a shine...how do we know that and compensate with the requisite amount of insulin? I now always tell restaurant staff that I am Diabetic and ask them to let the Chef know no added sugar when ordering any meal now.
After 34 years I still muck it up though. Lots of things get in the way of our understanding the complicated thing that is the human body. Don't worry...just do your best.
Regards
Garry

Sep 26, 2013

AnneinWelwyn... 1 post

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

Hello Sheila. I'm a brand-new graduate, so don't feel particularly qualified to advise you (yet) as I'm still just getting my head around the principles involved, but we were told that Novorapid starts to work within 5 minutes and carries on working for 2 to 3 hours. I too notice a high level about an hour after a dose of Novorapid at breakfast (reading taken pre-driving) but it's always down again before lunch, so I haven't worried about it. Hope that's helpful?
Regards, Anne.

Sep 25, 2013

sheila 2 posts

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

Hi, I did a DAFNE course in 2005, and have been 'doing DAFNE' ever since, except I've been lapsing for the past few years and my HBA1c has been steadily increasing. Obviously this has to do with my non-adherence to DAFNE principles (which are great in theory, but most of the time it's difficult to keep motivated and, to be honest, thinking about avoiding horrible complications is not really such a great motivator as it tends to just leave me feeling a bit depressed). However, there is another issue that I have, and that I've had since I was first diagnosed with Type 1 (I was 30 at the time). This is that I think I digest food quickly, and that the rapid acting insulin that I take (Novorapid) is too slow and doesn't match my digestive process. My blood sugar seems to rise to very high levels for about an hour after taking the Novorapid, and I've always been told that my blood sugar will rise and that this is unavoidable. I'm pretty sensitive to insulin and hypos and am on 1:1 ratios - I think that if I increased my ratios I'd get more hypos. I've been trying to find literature about this, but the closest I got was an article about the timing of the injections. Is there any information out there about the timings of digestion and rapid acting insulin? And how high should blood sugar rise after eating, even after taking rapid acting insulin?

Thank you.

Oct 3, 2013 izzi1234 5 posts	Topic: General Discussion / eye scan Thanks for the replies im hoping its just back ground retinopathathy. Think the letter which is obviously a template should be worded better. I have only been type 1 for 5 years so is a bit worrying im only 26.

Oct 3, 2013 Auffea 2 posts	Topic: General Discussion / eye scan I had a letter like that last year saying that I had "background retinopathy" I was so worried that i asked the diabetes specialist at my local hospital who explained that most of the population has background retinopathy and that it doesn't mean that you are in imminent danger of losing your eyesight. He said just keep your blood glucose down within target and everything should be alright. I have had diabetes now for 15 years and that was the first time I'd heard of background retinopathy.

Oct 3, 2013 Warwick 430 posts	Topic: General Discussion / eye scan It may of course be something other than diabetic retinopathy. Hopefully your letter will tell you what it is.

Oct 3, 2013 Warwick 430 posts	Topic: General Discussion / eye scan Sounds like Diabetic Retinopathy to me: http://en.wikipedia.org/wiki/Diabetic_retinopathy The management section of this article may be helpful. Definitely talk to someone - opthalmologist or doctor about this. If you aren't happy with the response you get, then get a second opinion. Part of a medical professional's job is to answer your questions and help your management, and if they aren't doing that effectively, then you are well within your rights to find that one does.

Oct 2, 2013 izzi1234 5 posts	Topic: General Discussion / eye scan I have recently had an eye scan and been sent a letter saying that diabetes is affecting my eyes. no treatment required. I rung my doctors as it says to ring them for more info but they just left a voicemail saying basically nothing other than that its affecting my eyes and will go for another scan in a year. has any one had this before can it go? its left me a bit worried thanks

Oct 1, 2013 Warwick 430 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! Hello, I don't find it sore at all injecting into my bicep. I think it may have hurt a bit injecting into my calf, but I stopped doing that. Everyone is different though, so it would be a case of experimentation. I use 4 mm needles whether injecting into fat or muscle, but I have very little fat between the skin and muscle of the bicep. An 8 mm needle may be required if more body fat is carried. If your BGLs are back in a normal zone 3-4 hours after eating, then increasing your QA dose would be a bad idea as it will likely lead to hypos. You would want to look at injecting earlier before meals so that the peak action of the QA matches the peaking of the BGs after eating, or trying the muscle injections.

Oct 1, 2013 sheila 2 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! 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 each time I eat, as sometimes it's more spontaneous than others! Thanks for all your suggestions.

Oct 1, 2013 jlyall 8 posts	Topic: Carbohydrate Counting / carbs in turnip a good helping of mashed turnip instead of potatoes and a bit of butter possibly count it the next time and see what happens

Oct 1, 2013 Eatonmywords 2 posts	Topic: Questions for HCPs / Ketones at Night Thanks novorapidboi26 - I think that my BI is holding me steady once I have got rid of the ketones I am back in target and it holds me there. I wondered about increasing my dinnertime ratio in the hope that it would help hold the ketones off. I am on soluble (Humulin S) QA so it hangs around for up to 8 hours.

Oct 1, 2013 novorapidboi26 1,816 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! Experimenting with the timing as Garry suggested would be my personal choice. Allowing the insulin to get in and going strong would be advantageous to your quick digestion. I injected, and still do bolus with pump, 30 minutes before I eat, in order to get the mid meal spike down as low as possible, so 1.5 to 2 hours later. It works a treat. So definitely worth experimenting with. Warwick suggestion is good too, if your up for that.... How much of a rise in BG have you observed.....?

Oct 1, 2013 novorapidboi26 1,816 posts	Topic: Questions for HCPs / Ketones at Night how many ketones are you registering? Is it blood ketones? Ketones usually present them selves when there is lack of glucose energy getting in to the cells and so fat is burned to satisfy that glucose requirement. You seem to be having carbs every few hours with insulin, so you would expect ketone levels to be lower during this time, which is during the day, the time your ketone levels are lower.... I cant really say if its normal for ketones to come and go. I know once they are there they have to processed with insulin just as glucose does.... If the ketone levels are low, so + or ++, then I would recommend doing a BI check overnight. Only if you feel up to it. You would be up every 2 hours anyway, so it would be an excellent opportunity to see what your BI is doing overnight. Ultimately you aren't getting enough insulin during the night, which is causing the ketones, so getting your BI to do the heavy lifting rather than breaking sleep and giving QA to compensate would be much more appealing....

Oct 1, 2013 novorapidboi26 1,816 posts	Topic: Carbohydrate Counting / carbs in turnip was there a lot of turnip? either way, a few more test with it should confirm if you need insulin........the amount of which will likely be unique to you....

Oct 1, 2013 novorapidboi26 1,816 posts	Topic: General Discussion / working nights I agree with Wawrick, taking it at the same time would be the preferred option... There is no reason why this wont be possible, unless your shift starts at 10 pm. An hour either side of 10 pm wont matter though....... Enjoy the night shift........ I was on 2 injections a day when I done night shift, it killed me........

Oct 1, 2013 Eatonmywords 2 posts	Topic: Questions for HCPs / Ketones at Night I discovered two skin infection sites on 27th. The GP nurse prescribed antibiotics to fight the infection. Alongside hot compresses this seems to have worked quite well. I am checking Ketones as I also have a cold. But I am finding that I am clear of Ketones during the day, but they reappear before I go to bed meaning I am having to check 2 hourly through the night (according to the sick day rules). Is it normal for Ketones to come and go like this? Could I make a change to my INSULIN regime during the day to counteract the Ketones at night?

Sep 30, 2013 Rafa 99 posts	Topic: Questions for HCPs / Weekly readings Went away to America for ten days and my morning readings went mad. Nearly all between 14-15. I was eating out every night so might have BEEN calculating cps wrong even though i had my notes, carbs and cals with me. Hoping that i am back now i will be able to settle down over the coming days and am BG won't be as high. Before i went my educator advised me to take my evening BI with my dinner at 7.30-8pm due to the am readings and see how it goes. I had been taking my BI at bedtime (10pm-11pm). This was just before i went away. Will give it three days and see how the am read. If not i am thinking my BI in the evening may need to go up.

Sep 30, 2013 Warwick 430 posts	Topic: General Discussion / working nights Hi Dean, I'd suggest keeping it the same, and doing regular tests. If you find yourself going high or low consistently then you can raise or lower your BI, but it probably won't affect you too much. Some people take Lantus in the morning, some at night. I take it twice a day - with breakfast and with tea as I find it doesn't last the full 24 hours for me, so taking it around the same time as you already do will probably work fine for you. Cheers, Warwick.

Sep 29, 2013 Dean123 7 posts	Topic: General Discussion / working nights hi i have just been told that i am working nights for 3 weeks for 12 hour shifts , how do i go on with my lantus i usely take it at 10pm night, any tips or info would be very welcome . thanks dean

Sep 28, 2013 youone 102 posts	Topic: General Discussion / Skin drug with spin-off benefits for Type 1 I agree, very interesting and another move forward

Sep 28, 2013 Warwick 430 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! Something I have had great success with recently after hearing about it from Gary Scheiner (author of Think Like a Pancreas) is injecting insulin directly into muscle rather than fat. It gets absorbed twice as quickly. I'm on Humalog which takes about 3 hours to fully absorb, and 90 minutes to peak, but injecting into muscle means it is all used within 90 minutes with a peak at about 45 minutes. I have only used it so far for when I am high and want to get back down into the normal range quickly, but my HbA1c has gone from 7.2 last year, to 6.1 6 months ago, and 6.2 last week. I inject into my bicep, but I was told that quads and calf muscle could also be used. I haven't had such a good result from either of those (and it can be difficult to inject there if wearing trousers, so I've stuck exclusively to the bicep muscle. It is also good when I know I am high, but will be exercising within two hours, as I can inject into muscle to bring my down to a good range, and know that all QA will be consumed before I exercise reducing the risk of a hypo during the exercise. In your case, you could proceed cautiously, and split your dose into two equal injections - one in your normal area of injection, and one into the muscle. Then based on your results, you could increase one and decrease the other depending on what works for you. Cheers, Warwick.

Sep 26, 2013 Garry 328 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! Although not a HCP please consider my perspective: If you were not Diabetic and had a full set of fully functioning Islets of Langerhans containing their insulin secreting Beta cells...your blood sugar would still rise after eating. These cells need sense the rising blood sugar for them to secrete insulin. So don't worry about it. High BGs after eating are normal and we need focus on getting the levels right prior to our next meal. We are all individuals. We all have different digestion rates for particular types of foods. Some people find they don't need count some types of carbohydrate...and others of us find it absolutely necessary to tot up all carbohydrate. I'm afraid that over the years I have regularly seen 14s, 15s and 16s after meals. I take Humalog QA and cope with my uptake rate by taking this insulin 15 to 40 minutes before eating. Bit of a pain when you guess the CHO wrong...but easily coped with by a second, compensation dose immediately after the meal. If you made detailed notes and can recover sufficient data from the diary figures of your 8 years since DAFNE you may be able to pick out some of the meals that have a marked effect on your BGs. Some of them may surprise you. I always find eating out a problem. Many a Chef adds sugar to his main course sauce to give it a shine...how do we know that and compensate with the requisite amount of insulin? I now always tell restaurant staff that I am Diabetic and ask them to let the Chef know no added sugar when ordering any meal now. After 34 years I still muck it up though. Lots of things get in the way of our understanding the complicated thing that is the human body. Don't worry...just do your best. Regards Garry

Sep 26, 2013 AnneinWelwyn... 1 post	Topic: Questions for HCPs / Think my Novorapid is too slow! Hello Sheila. I'm a brand-new graduate, so don't feel particularly qualified to advise you (yet) as I'm still just getting my head around the principles involved, but we were told that Novorapid starts to work within 5 minutes and carries on working for 2 to 3 hours. I too notice a high level about an hour after a dose of Novorapid at breakfast (reading taken pre-driving) but it's always down again before lunch, so I haven't worried about it. Hope that's helpful? Regards, Anne.

Sep 25, 2013 sheila 2 posts	Topic: Questions for HCPs / Think my Novorapid is too slow! Hi, I did a DAFNE course in 2005, and have been 'doing DAFNE' ever since, except I've been lapsing for the past few years and my HBA1c has been steadily increasing. Obviously this has to do with my non-adherence to DAFNE principles (which are great in theory, but most of the time it's difficult to keep motivated and, to be honest, thinking about avoiding horrible complications is not really such a great motivator as it tends to just leave me feeling a bit depressed). However, there is another issue that I have, and that I've had since I was first diagnosed with Type 1 (I was 30 at the time). This is that I think I digest food quickly, and that the rapid acting insulin that I take (Novorapid) is too slow and doesn't match my digestive process. My blood sugar seems to rise to very high levels for about an hour after taking the Novorapid, and I've always been told that my blood sugar will rise and that this is unavoidable. I'm pretty sensitive to insulin and hypos and am on 1:1 ratios - I think that if I increased my ratios I'd get more hypos. I've been trying to find literature about this, but the closest I got was an article about the timing of the injections. Is there any information out there about the timings of digestion and rapid acting insulin? And how high should blood sugar rise after eating, even after taking rapid acting insulin? Thank you.