Recent Posts - DAFNE Online

Jul 6, 2013

youone 102 posts

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

Hi
I note your remarks.
I had a MacDonald's meal on Saturday which was 20cp
By BG was 8.2 before meal at 6pm
I took 10mmol at the start of meal and another at 7pm
I peaked 90mins later at 11.4
At 11pm I was 7.4
In the ,morning at 5.30am I was 7.2
In this case no correction was needed because it stated on their site the meal was 20cp
So I could match close With the QA.
I think large carb meals are OK if you've got a ture CP amount to match too

Type1 42 yrs

Jul 6, 2013

youone 102 posts

Topic: Questions for HCPs / exercise

novorapidboi26 said:
ive been doing intense cardio for 30 minutes 4 days a week after dinner............blood sugars are brilliant, the odd hypo of course, but makes your supper taste better.........

Hi
That's omg good I'm only at 2 km runs at the moment, taking it easy on the knees.
I've seen a cut in my insulin by 2/3 with better BG ,still been carful I've never been this low at 5 to 6 for a long period as I'm now.
But your right I've never enjoyed food as much as I do now. Very Happy

Jul 6, 2013

youone 102 posts

Topic: Questions for HCPs / Figures muddle me!!!

Hi
I would put behind you any BG results until you start taking your BI insulin at the same time
In my previous post I said start with lunch since its mid day

If your BI insulin is correct you should be able to go 4 to 5 hours without taking carbs.
Notice the time period I've quoted. This matches the period between taking your QA and its effectiveness.
This makes sense since any carbs taken need matching with QA
Remember the rule
QA is taken to control any carbs taken
BI is to control the back background level or your body.
Of course other things effect both but that's for another time.

Jul 6, 2013

MaryJC 10 posts

Topic: Questions for HCPs / Figures muddle me!!!

Thank you for trying to help me. I am posting my diary for last 10 days as i realise 1days reading is not enough to go on. Any input gratefully received
I have started trawling through all previous posts to see what I can learn from everyone on here

Mary

Jul 6, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / exercise

ive been doing intense cardio for 30 minutes 4 days a week after dinner............blood sugars are brilliant, the odd hypo of course, but makes your supper taste better......... Smile

Jul 6, 2013

SA2010 69 posts

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

Thanks youone for that. I have now read through the related topic "Dealing with large carb meals" and see that you and Warwick split the dose. I will now try to restrict the CPs in my meals so that I do not exceed 10u of QA or split. I also agree with comments made on that thread about getting misleading measure of BG if done after 2 hours of QA Novorapid dose - I do not measure again unless 5 hours elapsed unless I am feeling hypo coming on or sometimes a spike in BG 1-2 hours after some meals.

If I split I would do the second dose based on the initial BG pre meal measurement and the CPs for the meal rather than measure again again - leaving a correction to the measurement 5 hours after the meal. But this would lead to a potential problem for me - as to get any real accurate BG measurement I find i have to wait for 5 hours to pass after a QA dose. It is bad enough at the moment having to stay awake till 1am to do that. So I don't know... Probably better option is to keep my evening meals at 11 CPs max (I am on a QA:CP ratio for evening meal of 0.9:1)

Jul 6, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Figures muddle me!!!

you only need to test with one meal, you can then get 2-3 days worth of results over the same meal time and then make a decision on what you need to do with the BI dose.....

no doubt there are some who can manage a whole day, I know I couldn't.....

I sometimes don't even wait 2-3 days.........I would miss lunch on the Monday, then dinner on the Tuesday ,then lunch on Wednesday, dinner on Thursday......

its obviously quite easy to do overnight tests as you wont be eating anyway......

Most would tackle the overnight first because of this, and because its quite important to get your morning reading right, so as to set you up for the day......

That's what you should do , and its obvious you need to from the results you posted.......you overnight results show a large drop, this is down to too much BI, would be good to get a similar result again to confirm, but you will be reducing in my opinion.......

Jul 6, 2013

MaryJC 10 posts

Topic: Questions for HCPs / Figures muddle me!!!

Thank you for replies.
Sorry to be a dunce but when you say no carbs for testing BI does this mean all day or just for one meal. I could probably manage that but would be very hard for me to go all day.
Feeling fed up with it all so very down this week. Ready to give it all up. Sad

As for injecting Bl at same time, I've never seen this anywhere but it certainly makes sense now I've seen it in print. Thank you for that. I have been injecting at any ol time of the day whenever I remembered. So from this morning I shall try 10am / 10 pm
Something puzzling me from last night is....
Went to bed high. 22.5 mmol
At 3:30am reading was 5.4 mmol.
With nothing to eat or drink in between my reading is now 10 mmol.
I always imagined that BG wouldn't rise if you had no food? Am I misunderstanding.

Jul 6, 2013

youone 102 posts

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

Hi
I've posted on this subject , briefly I found that when I took more than 10u of QA my body didn't seem to use it, I never looked at the detail why.
I moved to splitting any large CP meal by 3. The last being the correction if needed, my BG would level off at My target after 4 to 5 hours after the last injection, but what was more important to me, I didn't' have lows or highs the following day.
Before Dafne I had large CP meals but only a few. After Dafne I'm having up to 20 + CP meals all the time with good target hits, also since I started running again the control is even better with my insulin amounts only a 1/3 of what there where before Dafne
So for me splitting the QA works.

Type 1 42 yrs

Jul 5, 2013

SA2010 69 posts

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

Thanks for the feedback mark.

I guess I was a bit naiive thinking it just needed you to think that it would be useful. I have changed the topic text to give an indication of what this is about. Before it was cryptic and really just aimed for you.

With the change I would guarantee more participation from members and that s a good thing for everyone

Thanks

Simon

Jul 5, 2013

marke 681 posts

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

Hi, generally when suggestions are made we see what support they receive. We are just two people doing the site in our spare time with finite resources, therefore if you don't get a response its not necessarily that its not feasible, merely that we are waiting to see what the demand is for a feature, If it is something we think we should do there will still be a delay for us to actually implement it.

In theory your idea sounds simple, however its not, not all changes to the site are date tracked and so pooling them together for an email is not that straight forward. Also the emails could potentially be quite large in some cases causing issues with delivery. This would create a lot more admin for us. So at them moment its unlikely to happen unless their is more demand for it.

Jul 5, 2013

SimonC 78 posts

Topic: DAFNE Online Mobile / iPhone app redesign

Hi - an ipad version would be good, as some may only have an ipad, and not a an iphone, and so may be missing out on a great app. I have both and being able to update using the pad would be useful.

I would also like to see graphs - as you can on here, of the trends - I would also like to be able to print off the graphs from the website - I just tried, and whilst I held the mouse pointer over the graph, and then right clicked, I got the option to print, and it did print out the graph - but it also printed off the whole web page, which is a waste of paper. If possible I would like the ability just to print off a graph - with the header of what the graph is. I know this is slightly off topic and I apologise.

Simon

Jul 5, 2013

youone 102 posts

Topic: Questions for HCPs / Figures muddle me!!!

1 important note for BI when on a two split.
Try and inject at the same time every day,
"Why"
Day 1 inject at 6 am then at 6 pm
Day 2 inject at 9 am then 6 pm

This very basic example shows the effect of not having a set time
Day 2 would be out of your target because you have a period of no BI 3 hrs this would throw all your normal ratios out giving highs, which in turn when you correct later you'll find your BG lower than expected since you have a over lap of BI.
Dafne gives you flexibility with your QA but I'm sorry to say the BI is less forgiving.
Type 1 42 yrs

Jul 5, 2013

youone 102 posts

Topic: Questions for HCPs / insulin

cargeo111 carol b said:
Thanks Brian i am totally confused with my blood levels the now !!!!

Hi yes it can be confusing,
1 method is to only focus on 1 meal at a time,
Don't forget that what you do before a meal always has an effect on the BG
when your happy with what your doing you can expand out and cover a whole day.
Lunch is a good start,
A bit like a large calculation you split it down into its small parts
Hope this helps with the carb free meal
Regards
Brian
Type1 42 yrs

Jul 5, 2013

cargeo111 ca... 12 posts

Topic: Questions for HCPs / insulin

Thanks Brian i am totally confused with my blood levels the now !!!!

Jul 5, 2013

Jenny Spollen 13 posts

Topic: General Discussion / Just another day with Medtronic

Just a warning for anyone using a Medtronic insulin pump. They have recently issued a recall for a large volume of faulty reservoirs which have a lovely tendency to under-deliver your dose. Would have liked to say I was surprised but......

Anyhow check here to see if yours are in the extensive recall list:
http://medtronic-diabetes.info/_Checker.html?cc=ie&lc=en

Jul 4, 2013

youone 102 posts

Topic: Questions for HCPs / exercise

Hi to all
I've just really got back into exercise which is totally down to Dafne and the group of people who where on the course,
Its too soon to add any comments since I've only been running 6 weeks but I've seen a change in the control of my BG,
I'll watch with interest the comments people like yourselves are posting Cool

Type 1 42 yrs

Jul 4, 2013

youone 102 posts

Topic: DAFNE Online Mobile / iPhone app redesign

IPhone or other O/S need to make it simple, I find in the designs and problem solving solutions I do must be simple or people are put off, some of us are happy using these apps,but I always thing of the people who aren't,,its these people who really need the help.
1 thing I would like to see on a app is soon as you open the 1st page it tells you your last BG,the amount of CP and QA you had taken so after you take your BG you have the option to put in the CP your going to eat,it gives a calculation based on your ratio the amount of QA needed,this would help people who find it confusing when calculating their QA

I've seen similar to above on some apps, but only after you've found your way in,which to some people takes to long,hence its not used.

Jul 4, 2013

SA2010 69 posts

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

Hi

I presume this is not feasible !

Jul 4, 2013

youone 102 posts

Topic: Questions for HCPs / insulin

cargeo111 carol b said:
Hi i want to make sure my back ground insulin is holding me steady will i have carbohydrate free meals all day ?

I would use either your lunch or dinner meal as a carb free meal,I wouldn't do more than 1 meal at a time
The method I would use is this
Day 1 use the lunch meal, making sure its more than two hours after and 4 hours before your dose of BI
Note BG at the start if its higher than 13 leave until another day,
Try and act as normal as possible, I mean normal activities don't just sit and do nothing,
Its pointless having a BI level that's not suitable to your normal day activities.
This will give a guide for your morning BI,its only a guide.
Then try the evening meal which is more difficult, you have a lot more to watch since it will effect your morning BG
If you have a partner explain to them what your doing and why,also what to do if something happens.
Have some fun and get them involved by them having the same meal,I find a very large bacon and tomato omelette fills the hungry space.
Make sure you test and note in which direction your BG is moving
Regards
Brian
Type1 42 yrs

Jul 4, 2013

SA2010 69 posts

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

I have mentioned before that maybe QA:CP ratios break down at certain levels of CPs. Or may be when the QA dose is high (relative to the normal dose) it acts much faster than the CPs ??

I have just had an unexpected drop in BG to 3.7 mmol/l just over an hour after dinner. The only differences about this meal and QA dose from my norm were:

* Time since previous meal and QA dose was 5 hours exactly (I normally have more than 5 hour break - to be 100% sure no residual QA still in action)

* The QA dose was over 10u. My normal QA dose for dinner is between 7u and 9u most of the time.

I cannot this time say it was the cycling in the afternoon - because I had such activity on the previous 2 days and the issue did not arise then,

I am wondering now that a QA dose of 10.5u (10u+0.5u correction) for me has dropped the BG faster than the 11 CPs I had for dinner. Previous evening's meal was 9.5 CPs wih QA of 8.5u. Similar meal - difference was today there was 1 CP of Quince Paste/Jelly and 1.5 CPs of Oatcakes compared to 1 CP of Blueberry pancake yesterday. Rest of the meal the same as yesterday.

Please have a look at the diary and tell me what you think

BI = Lantus, QA = Novorapid

Thanks

Edit: Added bedtime BG to diary. 14.7 mmol/l Repeated the test and it was 15.1 in the other hand !!!!

My theory now is that the 10.5u QA at 19:00 went woosh and got all used up within the first 2 hours leaving the CPs with no QA left. There is no other explanation. Fault in Novorapid action? Known issue? Can happen??

Despite DAFNE rules I have applied some QA correction at bedtime. Only 1u - surely DAFNE rules on correction on spike after hypo needs to have some limits.

Jul 4, 2013

SA2010 69 posts

Topic: General Discussion / Lantus Prefilled Pen

I had a Solostar Lantus Pen jam in February 2011. Talked to Sanofi and they asked for me to send it back to them. I did not ask to be informed of the outcome so do not know what they discovered. But that was more than 2 years ago so they should have fixed the source of that issue by now

My reminder for reordering is set at 450 units left (ie pen and a half) so I allow myself one spare pen at all times. Probably needs to be more.

Whilst on holiday I had a novorapid pen fill cartridge fall on the floor (ceramic floor tiles) and the glass cracked and started to leak. I stopped using it - worrying about the dose or minute glass bits - so I was one penfill down and no spares till back in the uk.

Jul 4, 2013

SA2010 69 posts

Topic: General Discussion / Another reason to avoid hospitals

Just to add to this from experiences - I think it goes beyond diabetes.

I was in a daze for days whilst in hospital and it was due to the Tramadol they put on after an operation. It was only when my son who happens to be a Doctor said that it is not right and cannot just due to my op that we decided to check all medications and then asked for the Tramadol to be stopped that I came back to life.

So the experts do not always know what they are doing and at weekends the pain team were not visiting the wards - so the risks go higher then

Smon

Jul 4, 2013

cargeo111 ca... 12 posts

Topic: Questions for HCPs / insulin

Hi i want to make sure my back ground insulin is holding me steady will i have carbohydrate free meals all day ?

Jul 4, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / insulin

11.2 before breakfast definitely needs a correction.........

say your target is 5.5mmol/l and your correction factor is 2.5mmol for every unit......

you want to come down 5.7mmol, therefore 5.7/2.5 = 2.3 units of correction, so 2 units......

which ties in with youones calculation that you needed 2 more units.....

make sure your correcting properly before you make any dose changing bg records......

Jul 6, 2013 youone 102 posts	Topic: General Discussion / Higher CP value meal - Should higher than normal QA doses be split? Hi I note your remarks. I had a MacDonald's meal on Saturday which was 20cp By BG was 8.2 before meal at 6pm I took 10mmol at the start of meal and another at 7pm I peaked 90mins later at 11.4 At 11pm I was 7.4 In the ,morning at 5.30am I was 7.2 In this case no correction was needed because it stated on their site the meal was 20cp So I could match close With the QA. I think large carb meals are OK if you've got a ture CP amount to match too Type1 42 yrs

Jul 6, 2013 youone 102 posts	Topic: Questions for HCPs / exercise novorapidboi26 said: ive been doing intense cardio for 30 minutes 4 days a week after dinner............blood sugars are brilliant, the odd hypo of course, but makes your supper taste better......... Hi That's omg good I'm only at 2 km runs at the moment, taking it easy on the knees. I've seen a cut in my insulin by 2/3 with better BG ,still been carful I've never been this low at 5 to 6 for a long period as I'm now. But your right I've never enjoyed food as much as I do now.

Jul 6, 2013 youone 102 posts	Topic: Questions for HCPs / Figures muddle me!!! Hi I would put behind you any BG results until you start taking your BI insulin at the same time In my previous post I said start with lunch since its mid day If your BI insulin is correct you should be able to go 4 to 5 hours without taking carbs. Notice the time period I've quoted. This matches the period between taking your QA and its effectiveness. This makes sense since any carbs taken need matching with QA Remember the rule QA is taken to control any carbs taken BI is to control the back background level or your body. Of course other things effect both but that's for another time.

Jul 6, 2013 MaryJC 10 posts	Topic: Questions for HCPs / Figures muddle me!!! Thank you for trying to help me. I am posting my diary for last 10 days as i realise 1days reading is not enough to go on. Any input gratefully received I have started trawling through all previous posts to see what I can learn from everyone on here Mary

Jul 6, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / exercise ive been doing intense cardio for 30 minutes 4 days a week after dinner............blood sugars are brilliant, the odd hypo of course, but makes your supper taste better.........

Jul 6, 2013 SA2010 69 posts	Topic: General Discussion / Higher CP value meal - Should higher than normal QA doses be split? Thanks youone for that. I have now read through the related topic "Dealing with large carb meals" and see that you and Warwick split the dose. I will now try to restrict the CPs in my meals so that I do not exceed 10u of QA or split. I also agree with comments made on that thread about getting misleading measure of BG if done after 2 hours of QA Novorapid dose - I do not measure again unless 5 hours elapsed unless I am feeling hypo coming on or sometimes a spike in BG 1-2 hours after some meals. If I split I would do the second dose based on the initial BG pre meal measurement and the CPs for the meal rather than measure again again - leaving a correction to the measurement 5 hours after the meal. But this would lead to a potential problem for me - as to get any real accurate BG measurement I find i have to wait for 5 hours to pass after a QA dose. It is bad enough at the moment having to stay awake till 1am to do that. So I don't know... Probably better option is to keep my evening meals at 11 CPs max (I am on a QA:CP ratio for evening meal of 0.9:1)

Jul 6, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Figures muddle me!!! you only need to test with one meal, you can then get 2-3 days worth of results over the same meal time and then make a decision on what you need to do with the BI dose..... no doubt there are some who can manage a whole day, I know I couldn't..... I sometimes don't even wait 2-3 days.........I would miss lunch on the Monday, then dinner on the Tuesday ,then lunch on Wednesday, dinner on Thursday...... its obviously quite easy to do overnight tests as you wont be eating anyway...... Most would tackle the overnight first because of this, and because its quite important to get your morning reading right, so as to set you up for the day...... That's what you should do , and its obvious you need to from the results you posted.......you overnight results show a large drop, this is down to too much BI, would be good to get a similar result again to confirm, but you will be reducing in my opinion.......

Jul 6, 2013 MaryJC 10 posts	Topic: Questions for HCPs / Figures muddle me!!! Thank you for replies. Sorry to be a dunce but when you say no carbs for testing BI does this mean all day or just for one meal. I could probably manage that but would be very hard for me to go all day. Feeling fed up with it all so very down this week. Ready to give it all up. As for injecting Bl at same time, I've never seen this anywhere but it certainly makes sense now I've seen it in print. Thank you for that. I have been injecting at any ol time of the day whenever I remembered. So from this morning I shall try 10am / 10 pm Something puzzling me from last night is.... Went to bed high. 22.5 mmol At 3:30am reading was 5.4 mmol. With nothing to eat or drink in between my reading is now 10 mmol. I always imagined that BG wouldn't rise if you had no food? Am I misunderstanding.

Jul 6, 2013 youone 102 posts	Topic: General Discussion / Higher CP value meal - Should higher than normal QA doses be split? Hi I've posted on this subject , briefly I found that when I took more than 10u of QA my body didn't seem to use it, I never looked at the detail why. I moved to splitting any large CP meal by 3. The last being the correction if needed, my BG would level off at My target after 4 to 5 hours after the last injection, but what was more important to me, I didn't' have lows or highs the following day. Before Dafne I had large CP meals but only a few. After Dafne I'm having up to 20 + CP meals all the time with good target hits, also since I started running again the control is even better with my insulin amounts only a 1/3 of what there where before Dafne So for me splitting the QA works. Type 1 42 yrs

Jul 5, 2013 SA2010 69 posts	Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc... Thanks for the feedback mark. I guess I was a bit naiive thinking it just needed you to think that it would be useful. I have changed the topic text to give an indication of what this is about. Before it was cryptic and really just aimed for you. With the change I would guarantee more participation from members and that s a good thing for everyone Thanks Simon

Jul 5, 2013 marke 681 posts	Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc... Hi, generally when suggestions are made we see what support they receive. We are just two people doing the site in our spare time with finite resources, therefore if you don't get a response its not necessarily that its not feasible, merely that we are waiting to see what the demand is for a feature, If it is something we think we should do there will still be a delay for us to actually implement it. In theory your idea sounds simple, however its not, not all changes to the site are date tracked and so pooling them together for an email is not that straight forward. Also the emails could potentially be quite large in some cases causing issues with delivery. This would create a lot more admin for us. So at them moment its unlikely to happen unless their is more demand for it.

Jul 5, 2013 SimonC 78 posts	Topic: DAFNE Online Mobile / iPhone app redesign Hi - an ipad version would be good, as some may only have an ipad, and not a an iphone, and so may be missing out on a great app. I have both and being able to update using the pad would be useful. I would also like to see graphs - as you can on here, of the trends - I would also like to be able to print off the graphs from the website - I just tried, and whilst I held the mouse pointer over the graph, and then right clicked, I got the option to print, and it did print out the graph - but it also printed off the whole web page, which is a waste of paper. If possible I would like the ability just to print off a graph - with the header of what the graph is. I know this is slightly off topic and I apologise. Simon

Jul 5, 2013 youone 102 posts	Topic: Questions for HCPs / Figures muddle me!!! 1 important note for BI when on a two split. Try and inject at the same time every day, "Why" Day 1 inject at 6 am then at 6 pm Day 2 inject at 9 am then 6 pm This very basic example shows the effect of not having a set time Day 2 would be out of your target because you have a period of no BI 3 hrs this would throw all your normal ratios out giving highs, which in turn when you correct later you'll find your BG lower than expected since you have a over lap of BI. Dafne gives you flexibility with your QA but I'm sorry to say the BI is less forgiving. Type 1 42 yrs

Jul 5, 2013 youone 102 posts	Topic: Questions for HCPs / insulin cargeo111 carol b said: Thanks Brian i am totally confused with my blood levels the now !!!! Hi yes it can be confusing, 1 method is to only focus on 1 meal at a time, Don't forget that what you do before a meal always has an effect on the BG when your happy with what your doing you can expand out and cover a whole day. Lunch is a good start, A bit like a large calculation you split it down into its small parts Hope this helps with the carb free meal Regards Brian Type1 42 yrs

Jul 5, 2013 cargeo111 ca... 12 posts	Topic: Questions for HCPs / insulin Thanks Brian i am totally confused with my blood levels the now !!!!

Jul 5, 2013 Jenny Spollen 13 posts	Topic: General Discussion / Just another day with Medtronic Just a warning for anyone using a Medtronic insulin pump. They have recently issued a recall for a large volume of faulty reservoirs which have a lovely tendency to under-deliver your dose. Would have liked to say I was surprised but...... Anyhow check here to see if yours are in the extensive recall list: http://medtronic-diabetes.info/_Checker.html?cc=ie&lc=en

Jul 4, 2013 youone 102 posts	Topic: Questions for HCPs / exercise Hi to all I've just really got back into exercise which is totally down to Dafne and the group of people who where on the course, Its too soon to add any comments since I've only been running 6 weeks but I've seen a change in the control of my BG, I'll watch with interest the comments people like yourselves are posting Type 1 42 yrs

Jul 4, 2013 youone 102 posts	Topic: DAFNE Online Mobile / iPhone app redesign IPhone or other O/S need to make it simple, I find in the designs and problem solving solutions I do must be simple or people are put off, some of us are happy using these apps,but I always thing of the people who aren't,,its these people who really need the help. 1 thing I would like to see on a app is soon as you open the 1st page it tells you your last BG,the amount of CP and QA you had taken so after you take your BG you have the option to put in the CP your going to eat,it gives a calculation based on your ratio the amount of QA needed,this would help people who find it confusing when calculating their QA I've seen similar to above on some apps, but only after you've found your way in,which to some people takes to long,hence its not used.

Jul 4, 2013 SA2010 69 posts	Topic: Site Development / Regular email with synopsis of all changes: posts, news, handbook updates etc... Hi I presume this is not feasible !

Jul 4, 2013 youone 102 posts	Topic: Questions for HCPs / insulin cargeo111 carol b said: Hi i want to make sure my back ground insulin is holding me steady will i have carbohydrate free meals all day ? I would use either your lunch or dinner meal as a carb free meal,I wouldn't do more than 1 meal at a time The method I would use is this Day 1 use the lunch meal, making sure its more than two hours after and 4 hours before your dose of BI Note BG at the start if its higher than 13 leave until another day, Try and act as normal as possible, I mean normal activities don't just sit and do nothing, Its pointless having a BI level that's not suitable to your normal day activities. This will give a guide for your morning BI,its only a guide. Then try the evening meal which is more difficult, you have a lot more to watch since it will effect your morning BG If you have a partner explain to them what your doing and why,also what to do if something happens. Have some fun and get them involved by them having the same meal,I find a very large bacon and tomato omelette fills the hungry space. Make sure you test and note in which direction your BG is moving Regards Brian Type1 42 yrs

Jul 4, 2013 SA2010 69 posts	Topic: General Discussion / Higher CP value meal - Should higher than normal QA doses be split? I have mentioned before that maybe QA:CP ratios break down at certain levels of CPs. Or may be when the QA dose is high (relative to the normal dose) it acts much faster than the CPs ?? I have just had an unexpected drop in BG to 3.7 mmol/l just over an hour after dinner. The only differences about this meal and QA dose from my norm were: * Time since previous meal and QA dose was 5 hours exactly (I normally have more than 5 hour break - to be 100% sure no residual QA still in action) * The QA dose was over 10u. My normal QA dose for dinner is between 7u and 9u most of the time. I cannot this time say it was the cycling in the afternoon - because I had such activity on the previous 2 days and the issue did not arise then, I am wondering now that a QA dose of 10.5u (10u+0.5u correction) for me has dropped the BG faster than the 11 CPs I had for dinner. Previous evening's meal was 9.5 CPs wih QA of 8.5u. Similar meal - difference was today there was 1 CP of Quince Paste/Jelly and 1.5 CPs of Oatcakes compared to 1 CP of Blueberry pancake yesterday. Rest of the meal the same as yesterday. Please have a look at the diary and tell me what you think BI = Lantus, QA = Novorapid Thanks Edit: Added bedtime BG to diary. 14.7 mmol/l Repeated the test and it was 15.1 in the other hand !!!! My theory now is that the 10.5u QA at 19:00 went woosh and got all used up within the first 2 hours leaving the CPs with no QA left. There is no other explanation. Fault in Novorapid action? Known issue? Can happen?? Despite DAFNE rules I have applied some QA correction at bedtime. Only 1u - surely DAFNE rules on correction on spike after hypo needs to have some limits.

Jul 4, 2013 SA2010 69 posts	Topic: General Discussion / Lantus Prefilled Pen I had a Solostar Lantus Pen jam in February 2011. Talked to Sanofi and they asked for me to send it back to them. I did not ask to be informed of the outcome so do not know what they discovered. But that was more than 2 years ago so they should have fixed the source of that issue by now My reminder for reordering is set at 450 units left (ie pen and a half) so I allow myself one spare pen at all times. Probably needs to be more. Whilst on holiday I had a novorapid pen fill cartridge fall on the floor (ceramic floor tiles) and the glass cracked and started to leak. I stopped using it - worrying about the dose or minute glass bits - so I was one penfill down and no spares till back in the uk.

Jul 4, 2013 SA2010 69 posts	Topic: General Discussion / Another reason to avoid hospitals Just to add to this from experiences - I think it goes beyond diabetes. I was in a daze for days whilst in hospital and it was due to the Tramadol they put on after an operation. It was only when my son who happens to be a Doctor said that it is not right and cannot just due to my op that we decided to check all medications and then asked for the Tramadol to be stopped that I came back to life. So the experts do not always know what they are doing and at weekends the pain team were not visiting the wards - so the risks go higher then Smon

Jul 4, 2013 cargeo111 ca... 12 posts	Topic: Questions for HCPs / insulin Hi i want to make sure my back ground insulin is holding me steady will i have carbohydrate free meals all day ?

Jul 4, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / insulin 11.2 before breakfast definitely needs a correction......... say your target is 5.5mmol/l and your correction factor is 2.5mmol for every unit...... you want to come down 5.7mmol, therefore 5.7/2.5 = 2.3 units of correction, so 2 units...... which ties in with youones calculation that you needed 2 more units..... make sure your correcting properly before you make any dose changing bg records......