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Jul 9, 2013
novorapidboi26 1,819 posts

Topic: Questions for HCPs / No carb day .. Nearly

So by 18:39 yesterday you were on target, great, nearly 2 hours later, still within range, brilliant......you should try and get another reading at 22:00, as its likely before bed, but mainly as it will tell you if your AM BI dose is lasting up till then.........

Do the same tonight and tomorrow.........if all is well then you can tick off dinner to bedtime as OK......

You might find that between lunch and dinner you need more less BI, and the same from breakfast to lunch........because injecting isn't completely flexible you might need to compensate for any surplus or deficit of BI with some QA.....

Well done so far......
 
Jul 9, 2013
MaryJC 10 posts

Topic: Questions for HCPs / No carb day .. Nearly

Hiya
Yesterday had quite a good low carb day, for me it was anyway. I had 3units QA at breakfast and needed no more until this mornings breakfast. Would like any comments on diary. I'm trying to get the hang of working out basal. I'm now taking at regular times and trying to have some no carb meals.

Mary x
 
Jul 9, 2013
Warwick 423 posts

Topic: General Discussion / Lantus - times

Split 13u @ 7 a.m, 13u @ ~ 10 p.m.
 
Jul 9, 2013
Warwick 423 posts

Topic: Questions for HCPs / Hyperglycaemia in early hours of the morning

Hi Tom,

I split my Lantus in January, but my reasons for doing that is that the Lantus wasn't lasting the full 24 hours, so BGs were going up between dinner and bedtime. Since splitting, no further trouble there This is not for the reason that you are thinking of splitting yours though.

Has upping your Lantus increased hypos during the daytime? If not, then you should be able to increase your Lantus dose. I don't think there is a need to split unless you see it running out early, as I did.

Has your diet changed at all? You mention increasing your training intensity. Have you increased your portion sizes at the same time? There are some foods that I can go to bed with readings of around 6, and wake at 3 am with readings of 17. Foods like lentils, beans, chick peas etc all do this to me. My only way to get around it is to take extra QA at bed time after one of these meals, even if my BGs are perfect at bedtime. It is all a bit of trial and error.

Dawn phenomenon doesn't affect me at all, in fact quite the reverse - my breakfast ratio is only 1/3 whereas all other meals are 1/2, so I can't help you with any of my experience there, but here are some practical tips to help when the BGs are high.

1) Check for ketones if your BGs are over 17.

2) Injecting directly into muscle will halve the time it takes to absorb the insulin. If I have a really high reading and I want to get my BGs down fast, then I inject straight into my bicep, and within 90 minutes, all of the QA is absorbed (Humalog) rather than waiting for 3-4 hours. For best results, rub the injection site after injecting and flex the muscle a couple of times. I only need a 4mm needle for this, but some people need an 8 mm one. The amount of QA needed when doing this is exactly the same as when injecting into fatty tissue, e.g if you need 3 units of QA to drop a BG that is 9 mmol/L high, then you still inject 3 units into the muscle. The only thing that changes is the rate of absorption.

3) If you can test BGs for a few nights at different times, you can see when your BGs start to elevate. If it is within a few hours of heading to bed, then taking some QA at bedtime (injected normally into fatty tissue rather than into muscle) could help delay the rise.

4) If you can afford a weeks monitoring with a CGM (Continuous Glucose Monitor) (Not cheap unfortunately), then you can see your trends over a week, see when the BGs start to rise or drop and then work your injection regime into that.

Hope that helps,
Warwick.

 
Jul 8, 2013
john day 54 posts

Topic: DAFNE Online Mobile / Online App runs on Tablet?

As a long time user of the main DO site I am at last looking to buy a 7" tablet and would like to use the DO mobile app on it.

Will the app run on the mini Ipad or on the nexus 7? From a quick peek, most comments in this forum seem to be re smartphone hosting.

I do not have a smartphone so obliged for advice on this.

Thanks JD
 
Jul 8, 2013
novorapidboi26 1,819 posts

Topic: Questions for HCPs / Hyperglycaemia in early hours of the morning

If you think about it as your body needing xunits per hour....each hour between bed and the next morning potentially needs a different rate of background. ...

BAsically its not a fixed amount you need even though your giving yourself a fixed amount.....

WHen I was injecting I had 38 overnight and 22 during the day....so the am and pm could be completely different....

THAT'S why the pump is so effective as you can program a rate in for every hour if you wanted....
 
Jul 8, 2013
eelong 3 posts

Topic: Questions for HCPs / Hyperglycaemia in early hours of the morning

I've recently boosted my lantus up to around 14-15 units (from around 11 units) and I take this just before bed (typically around 2230).

My question with regards to splitting my lantus is this:
Surely if 15 units during the night isn't enough.....then 7-8 units twice a day wont be enough either. I'd just be going to bed on 7-8 units of lantus rather than 15.....I don't see how that would help?
 
Jul 8, 2013
SA2010 69 posts

Topic: General Discussion / Lantus - times

Split: 3u @ 11am, 7u @ 11pm
 
Jul 8, 2013
mum2westiesGill 502 posts

Topic: General Discussion / Lantus - times

What time do you take your Lantus?
 
Jul 8, 2013
chrisinbrum 41 posts

Topic: Questions for HCPs / Hyperglycaemia in early hours of the morning

Although I don't train/exercise like you, I've struggled with the same high morning BG and extra QA (humalog) at bed time or during the night to correct high BG then often has no effect. Even doses as high as 6 or 8 units do nothing, and I've ruled out hypos being involved.

I'm on a split dose BI (levemir) and although this helped a bit, it wasn't great. I think for me the morning levemir wasn't lasting until bed so I was starting to creep up then and found it hard or impossible to correct, so ended up with high morning BG.

I've brought my bedtime dose of levemir forward to tea time now, so I have more of a 12ish hour gap, but not an even dose split: 7units at breakfast, 12 units at dinner. This seems to work better for me most of the time, although if i eat and therefore have any QA after about 7 or 8 in the evening my bedtime and then morning BG can get very unpredictable again so I try to avoid any evening snacking!

So I'd recommend levemir and possibly a split dose, if your DSN thinks that would be suitable for you.
 
Jul 8, 2013
Garry 328 posts

Topic: General Discussion / Cycling and exercise

Good read. Thanks Warwick.
Regards
Garry
 
Jul 8, 2013
Warwick 423 posts

Topic: General Discussion / Cycling and exercise

An inspirational article:

http://www.guardian.co.uk/lifeandstyle/2013/jul/07/type-1-diabetes-cycling-team-novo-nordisk
 
Jul 8, 2013
novorapidboi26 1,819 posts

Topic: Questions for HCPs / Hyperglycaemia in early hours of the morning

Hi,

You should basically review you overnight BI requirements.....

When you increase your dose, remember to do 3 am tests, more if you like, so you can paint a picture of whats happening over night.....

It could be you need more BI, or it could be the Dawn Phenomenon, or could be you bouncing back from a hypo.........

you can quickly rule out the hypo by taking some overnight results........the dawn phenomenon doesn't really ever go away, everyone gets it, its just some see a much more noticeable effect.......there are means to tackle it though.....

For some one as active as yourself the only way to go is on a split BI dose, preferably Levemir..........have you considered Levemir.....?

Do you not suffer from regular hypos due to the activity and the inflexibility of the Lantus......?

The HGH, which I have limited knowledge on probably isn't having this effect. From reading about it, it builds muscle, increases energy, so in fact the insulin requirements and effectiveness will likely increase, which may make you hypo rather than high......but as I say, don't know much about it.....
 
Jul 8, 2013
eelong 3 posts

Topic: Questions for HCPs / Hyperglycaemia in early hours of the morning

Age: 22
Type 1 diabetes for ~4 years
Insulin: Lantus & Novorapid
Activity level: high - regular exerciser, sports participation and active job (Personal Trainer by profession for last two months)

I am struggling with elevated blood sugar in the mornings. I generally have good control over my blood sugars (all my HbA1C tests have been between 6.5 and 7.5) but my readings before breakfast are always high. In the last two months I have increased my training intensity as I have begun a resistance training programme; and things seem to be getting a bit worse.

I am finding myself waking up a lot more frequently between 02:00am and 04:00am needing to go to the toilet due to high blood sugar. Sometimes when I wake up in these early hours of the morning needing to pee, I will do an injection to try and bring me back down by the time breakfast comes around - but my blood sugar doesn't seem to change, and sometimes i end up even higher by breakfast time! I've been gradually increasing my lantus does to try and counter high blood sugar during the night but this hasn't seemed to have done anything yet. I have done a little bit of research about elevated blood sugar in the morning and I think I am struggling with either the Dawn Effect or the Somogyi Effect.

I know that the biggest HGH secretion comes during deep sleep and that HGH has a countering effect on the action of insulin. So would higher levels of HGH (induced by all this resistance exercise I'm now doing) be the cause of my elevation in blood sugar in the mornings?

Shall I just keep increasing my lantus (and reducing my novorapid doses during the day) to try and lower the nighttime blood sugar levels?
Or would splitting my lantus doses help?

Any thoughts/advice would be greatly appreciated!

Thanks
Tom
 
Jul 6, 2013
youone 102 posts

Topic: General Discussion / Higher CP value meal - Should higher than normal QA doses be split?

SA2010 said:
That is very good.

I would be happy with 2nd QA dose being no more than an hour after the first - I would still be ok with my personal 5 hour rule for measuring BG not before 5 hours elapsed after a QA dose.

I will try and do that - With this I can go to a Pizza Express again and eat a whole Pizza !

Thanks



Hi
I think the last time I was at pizza express a full 12 inch was 150g of carbs according to the manager, in fact he said all their pizzas are 150g
In this case you could try two options
1 x 8 + 7 1 hour later
Or
1 x 10 + ? If like me you decide to have a Pud
Hope you have a good meal
Regards
Brian
Type 1 42 yrs
 
Jul 6, 2013
SimonC 78 posts

Topic: DAFNE Online Mobile / iPhone app redesign

Simon said:
SimonC - you can now print the charts on their own - see the small 3-bar icon at the top right hand corner of each chart.



Simon - with the added bonus of selecting a file type to download! many thanks
 
Jul 6, 2013
Simon 578 posts

Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc...

Understood Smile
 
Jul 6, 2013
SA2010 69 posts

Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc...

words - again ! sorry.

I do not mean feed as in RSS.

I do mean email because I do not often look at RSS feeds but I do always read emails
 
Jul 6, 2013
Simon 578 posts

Topic: DAFNE Online Mobile / iPhone app redesign

SimonC - you can now print the charts on their own - see the small 3-bar icon at the top right hand corner of each chart.
 
Jul 6, 2013
Simon 578 posts

Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc...

Ah I see - when you say feed do you mean an email or an RSS-like feed which you can subscribe to?
 
Jul 6, 2013
SA2010 69 posts

Topic: General Discussion / Higher CP value meal - Should higher than normal QA doses be split?

That is very good.

I would be happy with 2nd QA dose being no more than an hour after the first - I would still be ok with my personal 5 hour rule for measuring BG not before 5 hours elapsed after a QA dose.

I will try and do that - With this I can go to a Pizza Express again and eat a whole Pizza !

Thanks
 
Jul 6, 2013
SA2010 69 posts

Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc...

Thanks Simon but that defeats the object of knowing what has happened without actually remembering to go to the site

For months I do not login to Dafne Online and whenever I login I find relevant and useful stuff

I would prefer a feed that comes to me rather than me having to go and look for it. But doing what you suggest could be phase 1 of what I am after. Phase 2 would be introducing the setting for each user to indicate if the updates list/summary/detail should be emailed or not and if weekly or daily and remembering when last feed was made.
 
Jul 6, 2013
Simon 578 posts

Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc...

Maybe rather than an email we could do a section with 'recent updates' - expanding the current recent posts bit?

// Tech speak starts

Most records on the site have an updated_at field so we could do something with that?

// Tech speak ends
 
Jul 6, 2013
Simon 578 posts

Topic: DAFNE Online Mobile / iPhone app redesign

Keep the ideas/feedback coming!
 
Jul 6, 2013
Simon 578 posts

Topic: DAFNE Online Mobile / iPhone app redesign

Hi Youone,

It sounds like you work in app/web design? If you'd like to help out then we're always open to offers ;) Good idea though, I'd already thought about changing the home tab to have more information on. Regarding the calculation - the app already does this (see auto-calc in the settings) - is this what you mean or have I interpreted it wrongly?

SimonC/Garry - thanks for the feedback, some good ideas. I'll also take a look at the graphs on the site and see what we can do to make printing easier.

Simon