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'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 686 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 4, 2013

youone 102 posts

Topic: Questions for HCPs / insulin

cargeo111 carol b said:
Thank you , i had two weetabix with milk at 10.30 took 4 units still sitting at 13.4

Hi
If you counted the 2 weetabix + the milk as 4CP and matched with 4QA that would be a ratio of 1:1
Your BG was 13.4
6 above my target of 7
Ie 2 units of QA
I would of changed the ratio to 1:1.5 giving you 6 units of QA
Which would bring you down to 6.4
Most type 1 usually have a higher ratio at breakfast
Of course this is only 1 test result,

Jul 4, 2013

cargeo111 ca... 12 posts

Topic: Questions for HCPs / insulin

after my meal i was sitting at 11.2 before should have taking 1 for correction maybe Very Happy

Jul 4, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / insulin

4 units sounds about right, and your insulin should be on the way out by now, if not completely expired.....

have the same again tomorrow, see what happens.......you may need a ratio change.....

do you inject before or after you have eaten....?

Jul 4, 2013

cargeo111 ca... 12 posts

Topic: Questions for HCPs / insulin

Thank you , i had two weetabix with milk at 10.30 took 4 units still sitting at 13.4 Crying or Very sad

Jul 4, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / insulin

you would only maybe be looking at 5g of carbs, depending on the milk amount, but no more than 10g [1unit] for it.......

but there are carbs in milk, so it should be counted, as part of a meal at least......

Jul 4, 2013

cargeo111 ca... 12 posts

Topic: Questions for HCPs / insulin

Hi do you cover milk with insulin in your cereal?

Jul 4, 2013

Garry 328 posts

Topic: Questions for HCPs / exercise

My BGs just go down after an hours swimming. Running...knees are a bit too old for that now...but energetic cycling and my bloods can rocket up - like you.
Would follow Warwick's advice. Strikes me that he is very clued up from lots of experience. But as he said, you will need experiment and find out what works for you personally.
Accurate record keeping is so important though to help you understand what works effectively.
Regards
Garry

Jul 3, 2013

Kittycat789 10 posts

Topic: Questions for HCPs / exercise

Hi Gary sorry for the delay i swim and run get high readings after both

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 686 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......

Jul 4, 2013 youone 102 posts	Topic: Questions for HCPs / insulin cargeo111 carol b said: Thank you , i had two weetabix with milk at 10.30 took 4 units still sitting at 13.4 Hi If you counted the 2 weetabix + the milk as 4CP and matched with 4QA that would be a ratio of 1:1 Your BG was 13.4 6 above my target of 7 Ie 2 units of QA I would of changed the ratio to 1:1.5 giving you 6 units of QA Which would bring you down to 6.4 Most type 1 usually have a higher ratio at breakfast Of course this is only 1 test result,

Jul 4, 2013 cargeo111 ca... 12 posts	Topic: Questions for HCPs / insulin after my meal i was sitting at 11.2 before should have taking 1 for correction maybe

Jul 4, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / insulin 4 units sounds about right, and your insulin should be on the way out by now, if not completely expired..... have the same again tomorrow, see what happens.......you may need a ratio change..... do you inject before or after you have eaten....?

Jul 4, 2013 cargeo111 ca... 12 posts	Topic: Questions for HCPs / insulin Thank you , i had two weetabix with milk at 10.30 took 4 units still sitting at 13.4

Jul 4, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / insulin you would only maybe be looking at 5g of carbs, depending on the milk amount, but no more than 10g [1unit] for it....... but there are carbs in milk, so it should be counted, as part of a meal at least......

Jul 4, 2013 cargeo111 ca... 12 posts	Topic: Questions for HCPs / insulin Hi do you cover milk with insulin in your cereal?

Jul 4, 2013 Garry 328 posts	Topic: Questions for HCPs / exercise My BGs just go down after an hours swimming. Running...knees are a bit too old for that now...but energetic cycling and my bloods can rocket up - like you. Would follow Warwick's advice. Strikes me that he is very clued up from lots of experience. But as he said, you will need experiment and find out what works for you personally. Accurate record keeping is so important though to help you understand what works effectively. Regards Garry

Jul 3, 2013 Kittycat789 10 posts	Topic: Questions for HCPs / exercise Hi Gary sorry for the delay i swim and run get high readings after both