Recent Posts - DAFNE Online

Sep 26, 2013

Garry 328 posts

Topic: Questions ? / 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 ? / 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 ? / 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.

Sep 23, 2013

jlyall 8 posts

Topic: Carbohydrate Counting / carbs in turnip

thanks novo rapid
had it yesterday and reading was high after it
didn't cover it

Sep 23, 2013

novorapidboi26 1,818 posts

Topic: Carbohydrate Counting / carbs in turnip

turnips are actually high in the GI index, which means they will be processed in to glucose reasonably quickly, however they have a low glycaemic load, which account for carbs per serving, so as with most things, you will likely need to just test them out and make a decision from there......

Sep 23, 2013

novorapidboi26 1,818 posts

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

interesting, thanks..........

anything that can help the newly diagnosed is a bonus, and obviously research and development of such drugs increases understanding..... Very Happy

Sep 23, 2013

JamesW 24 posts

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

Saw this on the BBC site so thought I would post up a link

http://www.bbc.co.uk/news/health-24177519

Sep 23, 2013

jlyall 8 posts

Topic: Carbohydrate Counting / carbs in turnip

should the carbs in turnip be counted with your meal

Sep 21, 2013

derekh1965 99 posts

Topic: General Discussion / Ilumiworld

Hi

Don't know if anyone is aware of this site http://www.ilumiworld.com/

They sell gluten/allergy free foods which are very easy to cook, just microwave for 2 minutes. Can be stored in the food cupboard. Taste lovely and are a good price with free delivery.

They always have promotions

Regards
Derek

Sep 20, 2013

Iddkmd 1 post

Topic: General Discussion / receeding gums

Hi kittycat
I am a recent dafne graduate but also a dentist. Diabetes does have an effect on the health of your gums. The problem is down to our susceptibility to infections. We also experience complications with damage to our capacity to heal. These factors make us more susceptible to a condition known as Periodontal(Gum) disease. The tissues affected are the gums and the underlying bone. As the name suggests the condition is an infection and involving the bacterial invasion of the afore mentioned gums. This is why your dentist suggested corsodyl mouthwash as it is an antibacterial mouthwash that will reduce the bacteria present.
We cannot really do anymore to reduce our susceptibility to gum disease other than improve our blood glucose control through the dafne programme.
The only other steps to take are those open to non-diabetics which is collectively known as oral hygiene. The best person to advise on this is your dentist/ dental hygienist/ dental therapist. There are specialist Periodontists but they are usually private.

All that being said the problem of gum recession is usually down to over brushing. The best way to improve against that would be to try an electric toothbrush as it cleans well enough without scrubbing the gum away.

It is hard to be precise about anything without clinical examination but I hope the information has been helpful.

There should be plenty advice at your dentist just don't be afraid to ask.

Good luck

Sep 20, 2013

novorapidboi26 1,818 posts

Topic: Carbohydrate Counting / Carbs and cals book

i have the pocket and app and both have proved very useful when dining out......

Sep 20, 2013

Garry 328 posts

Topic: General Discussion / ketones

Most DAFNE HCPs have access to free meters doled out by the manufacturers. Sweetheart your DAFNE team and I'm sure that they will be able to help.
Once you have one and are satisfied with the performance, phone Abbott on 0500467466 and tell them you are interested in an Optium Freestyle meter for use with both BGs and Ketones. They will normally send one out free....and thus you have 2 meters - 1 in use and 1 standby.
Talk to them at the same time asking about download capabilities of the meter and they will likely supply you with a USB download lead and software to suit your meter.
I have always found Abbott Laboratories a very helpful business. They always used to send out batteries for the meter too, when your low battery warning light comes on, but have stopped doing it as they say they are not now allowed by Royal Mail to send out batteries in the post!
Regards
Garry

Sep 20, 2013

hannahdefries 12 posts

Topic: General Discussion / Exercise & BG levels

I shall try & we shall see
Thanks for all your help Surprised

)

Sep 20, 2013

Warwick 434 posts

Topic: General Discussion / Exercise & BG levels

Leave everything as is for now. Test straight after exercise in addition to all the good things you are currently doing. And yes, it looks like having QA before exercise is working for you, so continue with that.

I'm sure that you already carry jellybeans or the like on your runs, so continue with that in case you take too much QA, but experiment a little until you get it right. By the look of it, you are pretty close to that, and if you are running the same route each time, then you'll be able to work out how much insulin is appropriate depending on your starting BG levels.

Sep 19, 2013

Vickyp 135 posts

Topic: Carbohydrate Counting / Carbs and cals book

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

Topic: General Discussion / Exercise & BG levels

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 434 posts

Topic: General Discussion / Exercise & BG levels

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

Topic: General Discussion / Exercise & BG levels

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 434 posts

Topic: General Discussion / ketones

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 434 posts

Topic: General Discussion / Exercise & BG levels

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 14 posts

Topic: Carbohydrate Counting / Carbs and cals book

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 14 posts

Topic: General Discussion / ketones

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 26, 2013 Garry 328 posts	Topic: Questions ? / 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 ? / 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 ? / 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.

Sep 23, 2013 jlyall 8 posts	Topic: Carbohydrate Counting / carbs in turnip thanks novo rapid had it yesterday and reading was high after it didn't cover it

Sep 23, 2013 novorapidboi26 1,818 posts	Topic: Carbohydrate Counting / carbs in turnip turnips are actually high in the GI index, which means they will be processed in to glucose reasonably quickly, however they have a low glycaemic load, which account for carbs per serving, so as with most things, you will likely need to just test them out and make a decision from there......

Sep 23, 2013 novorapidboi26 1,818 posts	Topic: General Discussion / Skin drug with spin-off benefits for Type 1 interesting, thanks.......... anything that can help the newly diagnosed is a bonus, and obviously research and development of such drugs increases understanding.....

Sep 23, 2013 JamesW 24 posts	Topic: General Discussion / Skin drug with spin-off benefits for Type 1 Saw this on the BBC site so thought I would post up a link http://www.bbc.co.uk/news/health-24177519

Sep 23, 2013 jlyall 8 posts	Topic: Carbohydrate Counting / carbs in turnip should the carbs in turnip be counted with your meal

Sep 21, 2013 derekh1965 99 posts	Topic: General Discussion / Ilumiworld Hi Don't know if anyone is aware of this site http://www.ilumiworld.com/ They sell gluten/allergy free foods which are very easy to cook, just microwave for 2 minutes. Can be stored in the food cupboard. Taste lovely and are a good price with free delivery. They always have promotions Regards Derek

Sep 20, 2013 Iddkmd 1 post	Topic: General Discussion / receeding gums Hi kittycat I am a recent dafne graduate but also a dentist. Diabetes does have an effect on the health of your gums. The problem is down to our susceptibility to infections. We also experience complications with damage to our capacity to heal. These factors make us more susceptible to a condition known as Periodontal(Gum) disease. The tissues affected are the gums and the underlying bone. As the name suggests the condition is an infection and involving the bacterial invasion of the afore mentioned gums. This is why your dentist suggested corsodyl mouthwash as it is an antibacterial mouthwash that will reduce the bacteria present. We cannot really do anymore to reduce our susceptibility to gum disease other than improve our blood glucose control through the dafne programme. The only other steps to take are those open to non-diabetics which is collectively known as oral hygiene. The best person to advise on this is your dentist/ dental hygienist/ dental therapist. There are specialist Periodontists but they are usually private. All that being said the problem of gum recession is usually down to over brushing. The best way to improve against that would be to try an electric toothbrush as it cleans well enough without scrubbing the gum away. It is hard to be precise about anything without clinical examination but I hope the information has been helpful. There should be plenty advice at your dentist just don't be afraid to ask. Good luck

Sep 20, 2013 novorapidboi26 1,818 posts	Topic: Carbohydrate Counting / Carbs and cals book i have the pocket and app and both have proved very useful when dining out......

Sep 20, 2013 Garry 328 posts	Topic: General Discussion / ketones Most DAFNE HCPs have access to free meters doled out by the manufacturers. Sweetheart your DAFNE team and I'm sure that they will be able to help. Once you have one and are satisfied with the performance, phone Abbott on 0500467466 and tell them you are interested in an Optium Freestyle meter for use with both BGs and Ketones. They will normally send one out free....and thus you have 2 meters - 1 in use and 1 standby. Talk to them at the same time asking about download capabilities of the meter and they will likely supply you with a USB download lead and software to suit your meter. I have always found Abbott Laboratories a very helpful business. They always used to send out batteries for the meter too, when your low battery warning light comes on, but have stopped doing it as they say they are not now allowed by Royal Mail to send out batteries in the post! Regards Garry

Sep 20, 2013 hannahdefries 12 posts	Topic: General Discussion / Exercise & BG levels I shall try & we shall see Thanks for all your help )

Sep 20, 2013 Warwick 434 posts	Topic: General Discussion / Exercise & BG levels Leave everything as is for now. Test straight after exercise in addition to all the good things you are currently doing. And yes, it looks like having QA before exercise is working for you, so continue with that. I'm sure that you already carry jellybeans or the like on your runs, so continue with that in case you take too much QA, but experiment a little until you get it right. By the look of it, you are pretty close to that, and if you are running the same route each time, then you'll be able to work out how much insulin is appropriate depending on your starting BG levels.

Sep 19, 2013 Vickyp 135 posts	Topic: Carbohydrate Counting / Carbs and cals book 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	Topic: General Discussion / Exercise & BG levels 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 434 posts	Topic: General Discussion / Exercise & BG levels 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	Topic: General Discussion / Exercise & BG levels 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 434 posts	Topic: General Discussion / ketones 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 434 posts	Topic: General Discussion / Exercise & BG levels 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 14 posts	Topic: Carbohydrate Counting / Carbs and cals book 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 14 posts	Topic: General Discussion / ketones 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