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I have the pocket version but have the android app which is much better, especially when out and about!

Sep 19, 2013

hannahdefries 12 posts

So i should leave everything dosage wise as it is for now, But make sure i test straight after my exercise?
Shall i carry on having QA before exercise too?

Sep 19, 2013

Warwick 423 posts

Well, if you get this part of your insulin dosage right, then you may be able to drop your BI a bit too and avoid some of those hypos.

I've shared my diary with you so you can look and see that you are in no way abnormal. I might even win the prize for most hypos. :-)

I get to see my endo tomorrow morning and I don't think that she will be happy. :-)

Sep 19, 2013

hannahdefries 12 posts

So I need to test again as soon as I am back from my run or swim? Drives me insane not being able to get it right. I recently dropped my morning bi from 16 to 14 bcos of all those hypos

Sep 19, 2013

Warwick 423 posts

Good stuff. Hope you come right soon. Definitely get an Optium Freestyle (Formerly known as Optium Exceed). Even if you have to buy one, it is worth having for these kind of cases. I've got two in case one of them dies.

Cheers,
Warwick.

Sep 19, 2013

Warwick 423 posts

Scary. Your diary looks a lot like mine. :-) Lots of hypos after exercise. :-)

OK, so sounds like things went well today which is great news. I suggest that you keep an eye out for hypos later on today though as exercise tends to lead to hypos for up to 24 hours after exercise.

2.6 miles in 25 minutes is aerobic exercise (actually anything longer than 15 minutes is aerobic exercise), and it is unusual for BGLs to rise during and after aerobic exercise without taking in excess carb, but everybody is different and it sounds like that is what is happening in your case.

I like that you have listed your exercise types in the comments. That is very helpful. Can I suggest that for future exercise sessions, you test just before your exercise as you currently are doing (before any food intake), and then again as soon as you finish? Just select the type as "After Exercise". At the moment it is a bit hard to tell - e.g. Sunday 15/9 you have exercise start at 10.03 and then no test until an hour and half later at 11.33 and I'm pretty sure it didn't take you 90 minutes to run 3 miles. :-) Then I can see if the rise has happened during the exercise or between the exercise ending and the next meal.

Hope that all makes sense.

Warwick.

Sep 19, 2013

davidcragg 17 posts

I can recommend the Carbs and Cals phone app too (it's available for iPhone, Android and Blackberry phones).
I've used both the iPhone and Android versions.

Just remember to download all the pictures to your phone so that you can use it when you don't have a phone signal!
You can do that by going to the setup screen and selecting the "Download all images" button, but I suggest you do that on a wifi connection as there is a lot to transfer.

regards,
David

Sep 19, 2013

davidcragg 17 posts

Yes, it's interesting that when I was on the course I looked through the process and didn't think much about it. Just "Ok, I follow this flowchart when I'm unwell".

Now I'm actually following the sick day rules you suddenly realise how crude the Ketostix measurement is. Useable, but crude.
Sick day rules switch at 3mmol/L but the colour chart on the Ketostix goes 1.5mmol/L and then 4mmol/L.

I will certainly ask about the meter when I'm next in clinic as currently I use the bgstar meter which doesn't have that feature.

thanks,
David

Sep 19, 2013

hannahdefries 12 posts

BG Diary

Sep 19, 2013

hannahdefries 12 posts

Amy i downloaded the book to my phone on App store and it is soooooo convenient.. well recommended!
Obviously if you have the phone to do so! x

Sep 19, 2013

hannahdefries 12 posts

Fab. thanks so much
I have just shared my diary with you
When i woke this morning i was 11.. I took 4 QA (scared this was too much but hey ho).. I ran 2.6 miles in around 25 minutes at 6:20am, I had my BI which is levemir at 7:30 and i have now just had my breakfast and my BG was 4.8!!
I do exercise quite often and have been doing this more since i finished DAFNE mid august.
I have 2QA - 1CP , so 2:1 ratio.
I have always had high levels after exercising.

Sep 19, 2013

Garry 328 posts

If you would like 'live' ketone levels you may wish considering another meter.
I use an Abbott Optium Xceed meter for which you are able to be prescribed Ketone test strips in addition to the normal Blood Glucose testing strips.
Urinanalyis test strips are OK but only give you results of what has already happened...not much use when you are wanting early warning of things going awry when ill.
This meter and Ketone test strips give you a much tighter range for Ketone analysis too...down to 0.1 and although I havn't researched the accuracy of these low value results, I gain confidence from them as they seem to reflect how I am feeling at the time of illness.

Regards
Garry

Sep 19, 2013

AmySouter 1 post

I've just completed a week of Dafne and am trying to get a grip on counting CPs etc. The scales are out at home all the time, and sometimes i manage to get everything worked out in time to eat my food while its still hot... ! I think a Carbs and Cals book might make things speedier - has anyone tried the pocket version, or is the full size version more complete?

Sep 19, 2013

davidcragg 17 posts

Thanks Warwick.

I went to the GP yesterday to rule out anything too nasty. Seems to be "something" viral, waiting on some blood results but told to get back to them if things get worse. Spent about 4 hours after that worrying that I was going to be admitted to hospital (won't go into details Very Happy

), but thankfully got through it and managed to have my evening meal and get some sleep Smile

I'm getting more confident at putting in the bigger doses of insulin when ketones are present and it seems to be working.
What I have learned this week is that if it wasn't for the DAFNE course I would certainly have ended up in hospital so this is been a good opportunity to put theory into practice - this is my first time being ill since dx.

thanks again,
David

Sep 19, 2013

Anele46 109 posts

Warwick said:
Hi Hannah,

Welcome to the wonderful world of diabetes and exercise. It is rewarding when it works, but can be frustrating to get right too.

It would be helpful to get some more information from you about your exercise and insulin regimes. Is it possible to get you to share your diary with me? Click on the "Users" link on the orange Menu bar at the top of this page, type ws130583 in the "Find a User" search bar to the right, click on "Warwick", and then click on "Share my diary with this user".

You could also share the last 15 days of your diary with this forum, which gives everyone the chance to see what is going on.

Can you please let me know the following?

1) What QA do you take?

2) What basal insulin do you take?

3) When do you take them?

4) Are you doing hard, quick runs, or gentle slow jogs?

5) On the days that you don't exercise, do your blood glucose levels rise anyway even without exercise or do they stay fairly stable?

6) Have you recently started exercising, or have you been doing this for a while?

7) Is this a new thing that your BGLs rise after exercise or is this fairly normal for you?

Once we know that, it all becomes a little easier to make helpful suggestions.

Cheers,
Warwick.

Thanks David, was hoping you could assist Hannah from your previous posts regarding exercise Smile

Cheers,
Anele.

Sep 19, 2013

Warwick 423 posts

davidcragg said:

1. Is it sensible to have a few carb free meals to see if this is purely a shift in BI? Am I ill and just don't realise it - if that makes sense?

From everything you have said, it certainly sounds like you are sick. BGLs go sky-high when we are sick. I had pneumonia a couple of year back, and my BGs were constantly high and difficult to control. The DAFNE handbook link to the right of this page will have a section on sick day rules. Follow that as best as you can, but I'd strongly suggest talking to a doctor ASAP too in case you have something serious. I was sick for over a week before the doctor realised that it wasn't viral, but bacterial. A course of antibiotics quickly cleared things up.

2. I know I could most probably of handling this better, checking for ketones earlier etc, it would be good to hear what people think I should be doing now, any thoughts?

Follow the sick day rules and see a doctor is the best advice I can give.

3. Can someone explain the process around ketones, how does taking 7u remove the ketones but doesn't drop the bgs?
I understand ketones can occur from the body breaking down fat to produce energy but the actual process of sorting it all out afterwards is what I'm unsure about. Is the insulin responsible for clearing up ketones or does the body deal with that in other ways and the insulin just allows the body to stop going to fat sources?

I believe that your last statement is correct. When insulin brings the BGLs down, the body stops going to fat sources for energy and therefore stops producing ketones.

When you are sick, your body becomes much more resistant to insulin (similar to a type 2 diabetic), so you need more (sometimes quite a lot more) insulin for the body to bring the BGLs down.

Hope you get well soon.

Warwick.

Sorry for the ramble and thanks for taking the time to read
David

Sep 19, 2013

Warwick 423 posts

Topic: DAFNE Graduate Group (DGG) / Join Now !!

Is this applicable to Australian users, or just UK ones?

Thanks,
Warwick.

Sep 19, 2013

Warwick 423 posts

Hi Hannah,

Welcome to the wonderful world of diabetes and exercise. It is rewarding when it works, but can be frustrating to get right too.

It would be helpful to get some more information from you about your exercise and insulin regimes. Is it possible to get you to share your diary with me? Click on the "Users" link on the orange Menu bar at the top of this page, type ws130583 in the "Find a User" search bar to the right, click on "Warwick", and then click on "Share my diary with this user".

You could also share the last 15 days of your diary with this forum, which gives everyone the chance to see what is going on.

Can you please let me know the following?

1) What QA do you take?

2) What basal insulin do you take?

3) When do you take them?

4) Are you doing hard, quick runs, or gentle slow jogs?

5) On the days that you don't exercise, do your blood glucose levels rise anyway even without exercise or do they stay fairly stable?

6) Have you recently started exercising, or have you been doing this for a while?

7) Is this a new thing that your BGLs rise after exercise or is this fairly normal for you?

Once we know that, it all becomes a little easier to make helpful suggestions.

Cheers,
Warwick.

Sep 18, 2013

Anele46 109 posts

hannahdefries said:
Thanks for all your help, So even if i test before exercise and i am running at 5 for example, I should still maybe have some QA before exercise?

Hi Hannah, I'm not sure to be honest as I'm not a HCP but going from one of your earlier posts you said you were 4.6 before your run which rose to 14 so going by that I would say you should take some. I reckon your best bet is to err on the side of caution and take 1 or 2 units before and make sure you have carbs during, before and if you can take your meter with you so you can test during or if you feel low. Keeping a record of how much exercise, carbs and QA and BI will give you an idea on how your body reacts to the types of exercise. Obviously this will not always be set in stone as diabetes can still be unpredictable. Also something to keep in mind or might help is to think about how 1 unit of QA affects your BG? How much does it tend to lower it by might help you decide how much you need too. Like I say I would recommend you seek some advice from your DSN, GP or consultant.

Sorry I can't give you a definitive clear answer as everyone's BGs react differently with exercise QA and carbs.

Hope you get the regime for you worked out Smile

Good luck x

Sep 17, 2013

hannahdefries 12 posts

Thanks for all your help, So even if i test before exercise and i am running at 5 for example, I should still maybe have some QA before exercise?

Sep 17, 2013

davidcragg 17 posts

Topic: DAFNE Graduate Group (DGG) / Join Now !!

Can anyone tell me if a newsletter or announcement has occured since July 26th 2013?

Since sending in my application by email on that date I've had no acknowledgement or correspondance, so it is hard to know if my application has been processed and not much is going on or if my application has got lost along the way and I'm missing out on things.

thanks
David

Sep 17, 2013

davidcragg 17 posts

My numbers recently have been absolutely rubbish, pretty much double digits all the way Sad

Yesterday I decided it was time to do something about it and increased by BI in the morning from 5u to 6u. Not a major change, but a start.

I wasn't feeling very well, felt very tired and always on the edge of thinking I would throw up, but spent a good part of the morning sleeping. I took this as just being because my numbers were high.

I woke up in time to get ready and go to the doctors to have my annual bloodwork done (hadn't planned to do it today, just opportune given I was off work) where for the first time in years I thought I was going to be sick and pass out - thankfully not!

Once I got home and tested before lunch I saw that my bgs where finally coming down, although not in range, it was progress. Had lunch and a small corrective dose and before I knew it...

...more sleeping! I tested at 17:38 and somehow my bgs had risen to 15.2mmol/L so I had a further 4u - yes more than I'd have on a normal day as that would take me to 3.2mmol/L but I knew it wouldn't make that much of an impact based on my previous corrective doses.

More sleep and I woke at 19:37 realising I should be checking for ketones.
For the first time I've used the ketostixs it came back positive, in colour terms closer to the 4mmol/L than the 1.5mmol/L.

I confess to retesting just before dinner because it's the first time since being hospitalised with DKA I've had a postive ketone result and it was taking my brain a little while to come to terms with that.

So no surprises (I guess) when the ketone result was the same at 1958 but my bgs at 15.3mmol/L were.
Dinner was 33.6g of carbs, so 3u for the dinner and 7u based on 20% normal TDD. Two hours later ketones had pretty much gone but my bg was still 15.6mmol/L which was a surprise again (to me at least).

Because the ketones had gone I took a 3u corrective dose and 1u for 1CPs worth of salted peanuts and by bedtime I was 8.6mmol/L.
I decided not to correct this any further but take my BI as normal.

I woke to 9.4mmol/L, feeling absolutely shattered but at least no ketones present. Had the same breakfast as the previous day and 1u of correction. More sleep. At 10:14 I was back at 13.4mmol/L so another correction and more sleep.

Now it's lunchtime and I'm 9.6mmol/L, having 4CPs for lunch and a 1u correction.

So I guess I've not quite managed to follow the rules exactly, but I'm trying.
The weird bit is that I don't feel ill, just tired and ordinarily I'd put that down to the constant highs, but this is super sleepy tired. The feeling sick of yesterday has gone but my numbers still don't seem to want to play ball.

So, a couple of questions if I may:

1. Is it sensible to have a few carb free meals to see if this is purely a shift in BI? Am I ill and just don't realise it - if that makes sense?

2. I know I could most probably of handling this better, checking for ketones earlier etc, it would be good to hear what people think I should be doing now, any thoughts?

3. Can someone explain the process around ketones, how does taking 7u remove the ketones but doesn't drop the bgs?
I understand ketones can occur from the body breaking down fat to produce energy but the actual process of sorting it all out afterwards is what I'm unsure about. Is the insulin responsible for clearing up ketones or does the body deal with that in other ways and the insulin just allows the body to stop going to fat sources?

Sorry for the ramble and thanks for taking the time to read
David

Sep 17, 2013

Anele46 109 posts