Recent Posts - DAFNE Online

Jul 11, 2013

Warwick 434 posts

Topic: Questions ? / Hyperglycaemia in early hours of the morning

I was told that injecting into muscle would be painful, but haven't found it any more painful than injecting into the abdomen, in fact often it doesn't hurt at all, whereas some injections into the abdomen reach an 8 out of 10 on the pain scale. I do only use 4mm needles though so I think it only just reaches the muscle :-)

Jul 11, 2013

Warwick 434 posts

Topic: Questions ? / No carb day .. Nearly

Can you please post what your QA and BI insulins are? It is always nice to know the profiles of the insulins.

Thanks,
Warwick.

Jul 10, 2013

Garry 328 posts

Topic: General Discussion / Lantus - times

Normally at 06:40 and around 18:00 each day.
Currently split 26u and 26u.
Regards
Garry

Jul 10, 2013

Pat N 12 posts

Topic: General Discussion / Coeliac as well as Diabetic?

I have Type 1 Diabetes and just been diagnosed as Celiac as well. (What a nightmare).
I am now just waiting at the time of this posting for the the specialist and Dietician appointments.

I didnâ€™t think I had a Gluten problem; it was only picked up at my Diabetes review because I mentioned I was losing weight and sent to have a blood test, and then the camera job.

Has anyone any advice to help me adapt to this drastic life change.

How do you cope with eating out, Holidays, food shopping etc, you know just the normal things in life if you know what I mean.

Iâ€™m just glad that I was lucky enough to have previously been sent on the DAFNE course that will help me understand what this new tasteless food diet is doing to my blood sugars.

I know its not just all about me (insert subtle joke) but please wish me luck. Sad

Jul 10, 2013

Pat N 12 posts

Topic: General Discussion / Lantus - times

25u @ 23.00hrs. it works for me

Jul 9, 2013

MaryJC 10 posts

Topic: Questions ? / No carb day .. Nearly

thankyou x

Jul 9, 2013

marke 655 posts

Topic: Questions ? / Hyperglycaemia in early hours of the morning

A few things. Firstly, it is generally believed by the experts that run DAFNE that rebound from night time hypo's is a myth. They believe that if you wake with high BG's its either Dawn P or something you did the evening before. Secondly if it is Dawn P you would not normally expect it at 2am, it is a hormonal process to ready your body for starting the day thus you would expect it from 4am-ish onwards. This is obviously not set in stone since we are ALL different but its not generally the case. One option to consider is switching to Levemir and having a split dose, obviously you should do this in consultation with your Diabetes Team not off you own back.
You might also try reading 'Your Diabetes Science Experiment' as mentioned in other forum posts. This is a book written by Diabetic who is also a power-lifter so she understands and explains the effects of different types of exercise on your body.
Good luck if you want to try injecting into muscle, ouch, I would guess its painful and not a recommended method for injecting insulin...

Jul 9, 2013

Simon 574 posts

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

iPad all the way for me, but I am bought into the ecosystem with pad, phone and laptop. They all work together seamlessly and quite intuitively. Also iOS 7 is bringing a fresh and exciting set of features for the iPad and phone.

Jul 9, 2013

novorapidboi26 1,818 posts

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

I don't mind apple, had an iPhone and iPad.....there's not much customisation to be had on them though and getting files to and from could be easier......for me apple are all about image/brand/reliability.....which is good, but after I while I needed something different......an opportunity to play about with settings not normally open to the everyday user.....

For this reason I got my nexus and Samsung galaxy s4 on android 4.2.2......both these devices have equal specs if not better in most hardware areas......

The deal breaker for me is the ability to play HD .mkv files no problem.....my main use with the nexus......

It seems you are happy with apple for now.....ios7 looks really exciting.....missing out on that for me will be disappointing

Jul 9, 2013

john day 54 posts

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

That's good news, thanks to you Novorapid & simon for the confirmation .. so just need to pick one or the other.

From what I have read, Mini seems to win on screen and app selection, Nexus on ports, NFC, battery life and price but has no native flash.

I have an ipod Nano so probably stay in the apple family.

Any comments from Apple IOS and Android supporters?

Jul 9, 2013

Simon 574 posts

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

Hi John,

It should work fine on the iPad mini - we're also looking to do an iPad specific version in the not too distant future.

Simon

Jul 9, 2013

novorapidboi26 1,818 posts

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

I have the Nexus 7 and it runs fine........... Smile

Jul 9, 2013

novorapidboi26 1,818 posts

Topic: Questions ? / 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 ? / 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 434 posts

Topic: General Discussion / Lantus - times

Split 13u @ 7 a.m, 13u @ ~ 10 p.m.

Jul 9, 2013

Warwick 434 posts

Topic: Questions ? / 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 1,818 posts

Topic: Questions ? / 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 ? / 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 ? / 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 434 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 1,818 posts

Topic: Questions ? / 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 11, 2013 Warwick 434 posts	Topic: Questions ? / Hyperglycaemia in early hours of the morning I was told that injecting into muscle would be painful, but haven't found it any more painful than injecting into the abdomen, in fact often it doesn't hurt at all, whereas some injections into the abdomen reach an 8 out of 10 on the pain scale. I do only use 4mm needles though so I think it only just reaches the muscle :-)

Jul 11, 2013 Warwick 434 posts	Topic: Questions ? / No carb day .. Nearly Can you please post what your QA and BI insulins are? It is always nice to know the profiles of the insulins. Thanks, Warwick.

Jul 10, 2013 Garry 328 posts	Topic: General Discussion / Lantus - times Normally at 06:40 and around 18:00 each day. Currently split 26u and 26u. Regards Garry

Jul 10, 2013 Pat N 12 posts	Topic: General Discussion / Coeliac as well as Diabetic? I have Type 1 Diabetes and just been diagnosed as Celiac as well. (What a nightmare). I am now just waiting at the time of this posting for the the specialist and Dietician appointments. I didnâ€™t think I had a Gluten problem; it was only picked up at my Diabetes review because I mentioned I was losing weight and sent to have a blood test, and then the camera job. Has anyone any advice to help me adapt to this drastic life change. How do you cope with eating out, Holidays, food shopping etc, you know just the normal things in life if you know what I mean. Iâ€™m just glad that I was lucky enough to have previously been sent on the DAFNE course that will help me understand what this new tasteless food diet is doing to my blood sugars. I know its not just all about me (insert subtle joke) but please wish me luck.

Jul 10, 2013 Pat N 12 posts	Topic: General Discussion / Lantus - times 25u @ 23.00hrs. it works for me

Jul 9, 2013 MaryJC 10 posts	Topic: Questions ? / No carb day .. Nearly thankyou x

Jul 9, 2013 marke 655 posts	Topic: Questions ? / Hyperglycaemia in early hours of the morning A few things. Firstly, it is generally believed by the experts that run DAFNE that rebound from night time hypo's is a myth. They believe that if you wake with high BG's its either Dawn P or something you did the evening before. Secondly if it is Dawn P you would not normally expect it at 2am, it is a hormonal process to ready your body for starting the day thus you would expect it from 4am-ish onwards. This is obviously not set in stone since we are ALL different but its not generally the case. One option to consider is switching to Levemir and having a split dose, obviously you should do this in consultation with your Diabetes Team not off you own back. You might also try reading 'Your Diabetes Science Experiment' as mentioned in other forum posts. This is a book written by Diabetic who is also a power-lifter so she understands and explains the effects of different types of exercise on your body. Good luck if you want to try injecting into muscle, ouch, I would guess its painful and not a recommended method for injecting insulin...

Jul 9, 2013 Simon 574 posts	Topic: DAFNE Online Mobile / Online App runs on Tablet? iPad all the way for me, but I am bought into the ecosystem with pad, phone and laptop. They all work together seamlessly and quite intuitively. Also iOS 7 is bringing a fresh and exciting set of features for the iPad and phone.

Jul 9, 2013 novorapidboi26 1,818 posts	Topic: DAFNE Online Mobile / Online App runs on Tablet? I don't mind apple, had an iPhone and iPad.....there's not much customisation to be had on them though and getting files to and from could be easier......for me apple are all about image/brand/reliability.....which is good, but after I while I needed something different......an opportunity to play about with settings not normally open to the everyday user..... For this reason I got my nexus and Samsung galaxy s4 on android 4.2.2......both these devices have equal specs if not better in most hardware areas...... The deal breaker for me is the ability to play HD .mkv files no problem.....my main use with the nexus...... It seems you are happy with apple for now.....ios7 looks really exciting.....missing out on that for me will be disappointing

Jul 9, 2013 john day 54 posts	Topic: DAFNE Online Mobile / Online App runs on Tablet? That's good news, thanks to you Novorapid & simon for the confirmation .. so just need to pick one or the other. From what I have read, Mini seems to win on screen and app selection, Nexus on ports, NFC, battery life and price but has no native flash. I have an ipod Nano so probably stay in the apple family. Any comments from Apple IOS and Android supporters?

Jul 9, 2013 Simon 574 posts	Topic: DAFNE Online Mobile / Online App runs on Tablet? Hi John, It should work fine on the iPad mini - we're also looking to do an iPad specific version in the not too distant future. Simon

Jul 9, 2013 novorapidboi26 1,818 posts	Topic: DAFNE Online Mobile / Online App runs on Tablet? I have the Nexus 7 and it runs fine...........

Jul 9, 2013 novorapidboi26 1,818 posts	Topic: Questions ? / 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 ? / 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 434 posts	Topic: General Discussion / Lantus - times Split 13u @ 7 a.m, 13u @ ~ 10 p.m.

Jul 9, 2013 Warwick 434 posts	Topic: Questions ? / 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 1,818 posts	Topic: Questions ? / 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 ? / 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 ? / 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 434 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 1,818 posts	Topic: Questions ? / 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.....