Recent Posts - DAFNE Online

May 5, 2013

edwards002 2 posts

No lack of data! Well done!
I have not had time to analyse rigorously, so plse excuse me.
As a Type 1 diabetic of 45 years, exercise has always been a tad of a mystery. I was given an excellent suggestion on a very recent visit to my dafne centre: reduce QA bolus insulin dosage by between 30-50% if anticipating exercise.
I used to race a bike when much younger and I was staggered at how much sugar can be burnt during bike riding: 125g glucose supplement in a single shot in 20K (12.5 miles in old money) at around 36Kph (23 mph). So your fitness level, the weight of your bike, your speed and the weather conditions will all impact these kinds of numbers dramatically.
On top of this so will your general mental condition.
What do I mean?
Well, are you stressed by exams or do you find you find your levels of anxiety changing?
I have found that stress associated with activities I do not want to do (like going out or shopping (!) depress my blood sugar equally strongly just as if I were exercising.
So what am I trying to get at?
First, you will have the answers so look closely at your data and add stress factors and extra exercise-related info.
Second, my experience is derived from pump use and not MDI so please treat my observations with caution as I have not altered my basal rates during my most recent experiences.
I have only dealt with reduction of my bolus doses associated with meals.
Third, I have found that a 30% reduction is necessary for "normal" exercise like walking into town and/or mowing the lawn!
This recent change has made a dramatic effect on my perceived levels of anxiety and the numbers of hypos I have with the associated problems of hyperglycemic rebound and then later correction doses. A real see-saw and not helpful to anyone who is trying to gain control of their life.
I suspect that I will need to decrease my bolus insulin dosages by 50% if I take my bike out and seriously exercise. I would then still expect to require 60-90g of fairly fast acting carbohydrate per hour to be able to sustain my exercise level.

I hope this is helpful.

May 4, 2013

Stew B 123 posts

Topic: General Discussion / Freestyle InsuLinx Meter

I've had problems when trying to change to new / different meters, where the new meter reads higher than my trusty One Touch Ultra. I agree that most of the time variation isn't a problem, and being within one or two units is OK. My problem is the confusion when I get early hypo symptoms, do a test and find the meter is giving me a reading of 4.5 - 5.5+. It's difficult when your body says one thing and your meter another! (Also, presumably a potential problem for trying to keep to the new driving "rules"?).

Stew

May 4, 2013

SA2010 69 posts

Topic: Site Development / Date/Timestamp of posts

Hi

At the moment the date and timestamp of a post and how long ago it was posted is based on the original entry of the post.

I am thinking that perhaps it would be more appropriate to switch to the latest date/time the post has been edited rather than the original time.

Please could you think about this. As example in General Discussion I have just updated the diary and the post text for a post I put 15 hours ago. It is still showing with that date/time even though it has information that is more recent.

May 3, 2013

nitaparmar 2 posts

Topic: General Discussion / New Graduate in DAFNE

thanks for the replies guys...

will keep you posted with progress

May 3, 2013

SA2010 69 posts

Topic: General Discussion / Exercise

This is my diary for last 7 days or so. Loads of hypos - only change is daily a bit of cycling to local park or shops or bank. Seem to have delayed effect hours afterwards. Surely I should not have to reduce BI just for daily 30-50 minutes of cycling. Am I burning sugar at faster rate now. Any comments would be appreciated.

Updated Saturday: After increasing CPs from 1 to 2 before cycling the BG went sky high 2.5 hours later pre lunch. So this tells me that it probably needs to be reducing the BI - the morning dose probably especially since there is a delayed prolonged effect

Is this the right conclusion?

May 3, 2013

Apollo 45 posts

Topic: General Discussion / Freestyle InsuLinx Meter

I use a Bayer Contour USB (although it has been replaced by the contour next USB) it's great for logging, viewing trends etc but it has never suggested an insulin dose to me, this may be a new feature in the next though I've not bothered to check though as the only issues for me are is it reliable and is it compact and in this regard the next offers no change.

If you would like something to suggest a dose to you though then if you have a compatible smart phone I would get the DAFNE online app which when supplied with your ratios and your carb estimates will suggest the insulin dose you require.

May 3, 2013

Frank.M 5 posts

Topic: General Discussion / Freestyle InsuLinx Meter

Thank you for your responses. I assumed the default range of meters was between 5 - 10%. What attracted me to the InsuLix was having a suggested dose but now I'm looking at alternatives, such as the Bayer Contour USB, as I maybe coming to rely on a machine suggestion. Thank you again.

May 3, 2013

marke 646 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Hi, I can see in the logs that you ARE managing to login via the app fine, so that is not the problem....
Why do you say it doesn't do a lot ?

May 3, 2013

Simon 574 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Hi Catherine,

Are you getting an error message when trying to log in to the app? Also please note that the username and password are case sensitive.

Thanks,

Simon

May 3, 2013

catherinesouth 4 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Would love to be able to use this App on my Iphone but will not accept my user name or password. I've even gone into the settings which doesn't do a lot.
Have to say not impressed so far.

May 3, 2013

novorapidboi26 1,816 posts

Topic: General Discussion / New Graduate in DAFNE

warm welcome from me..... Wink

May 3, 2013

SA2010 69 posts

Topic: General Discussion / Exercise

That is very useful info Warwick. Thank you. Timing appears to be important. If it is soon after breakfast I would not take CPs either as my BG is probably at peak then. I will look at my diary for last week - I am cycling everyday. Spring is coming here at last. I just did not expect the delayed effect. A hypo 10 hours after the 40 minute cycling activity even with some reduction in QA after the activity.

May 3, 2013

Warwick 430 posts

Topic: General Discussion / Your Diabetes Science Experiment - Experiment 1

Agreed on the 2-hour thing. I am much more comfortable with a 3-hour window.

I tested last Thursday ( a holiday) and while not perfect, the results were encouraging. I'm lowering my BI from 13 x 2 to 10 x 2 this weekend and will see what eventuates. Also lowering my lunchtime QA from 1/2 to 1/3.

Cheers,
Warwick.

May 3, 2013

Warwick 430 posts

Topic: General Discussion / Freestyle InsuLinx Meter

I was alerted to this yesterday at my DAFNE 12-month review, although as you say, values of 50+ don't affect many of us.

I have the alternative smart meter from Aviva, and it is a replacement because the first one I had read values that were 2 units higher then my other 4 meters that I already owned. The replacement seems much better behaved. Manufacturers only have to provide a result that is with 20% of the true value. This is why you can get quite different readings within 40 seconds of taking the first reading.

I don't tend to stress much about it. All it does is give you a guide to where you are at. It does seem a little ridiculous that they read to point values when the accuracy is obviously not that good, but the reading should be within 1 or 2 units of the true result.

May 3, 2013

Warwick 430 posts

Topic: General Discussion / Exercise

Hello SA2010

I don't hypos during my 1 hour ride to work as it is too soon after breakfast, although I have occasional ones afterwards, but if I don't take carbs before my ride home, then I will hypo every time. I tend to need 3-4 CPs to keep the BGs steady on the way home.

If you have only just started cycling, then you may well find that you hypo more often until your body adjusts which can take 4-6 weeks. By that time you will have a very good idea of how exercise affects your insulin and carb needs.

May 2, 2013

SA2010 69 posts

Topic: General Discussion / Exercise

Hope it is ok to continue with this thread for my scenario today.

I am wondering how long the impact of just a 40 minute cycling activity to the local park would last.

I have had 3 occurrences of BG below 4.0 (3.3, 3.4, 3.7) since then and it was a short bike ride before lunch which was 40 minutes and i thought 1 CP of mini flapjack taken before the ride would be adequate for it - it was just over an hour before lunch. Just in case, i reduced the QA after the ride with lunch QA reduced by 1/2 (10%) and for dinner i reduced it by 1u (13%). I did not expect impact of activity to have an effect so long after.

I will try to put a diary for a few days online tomorrow.

Insulin Regimen: Novorapid QA:CP 1.3:1 (Breakfast) @07:30-08:30am, 0.6:1 (Lunch) @13:00-14:00, 0.8:1 (Dinner) @19:00-20:00.
Split Lantus 3.0 @ 11:00am, 6.0 @ 23:00
Bedtime about 1am

May 2, 2013

Apollo 45 posts

Topic: General Discussion / Freestyle InsuLinx Meter

I don't think my old one touch meter would register anything above a 30mmol/L would just say "hi". I don't know if there are some special features on you Abbott meter that mean your happy to stick with it but when I wanted to change to a bayer conrtour USB for no other reason than I liked that it was more compact than the one touch I just phoned them up and said "post me one now" and they did. Actually they sent me 3 meters!

Not to make you feel even less special though but someone posted something similar about a recall on 2 specific models that lifescan make, I don't recall the models but one touch wasn't one of them.

May 2, 2013

Frank.M 5 posts

Topic: General Discussion / Freestyle InsuLinx Meter

I use a Freestyle InsuLinx Blood Monitoring Meter that functions well enough, although why it needs a secret code (only available from Health Care Professionals) to set it up seems a little unnecessary.

Last month the manufacturer, Abbott Diabetes Care, wrote to say they have determined that at extremely high levels of 56.8 mmol/L +plus the meter will display and store in memory an inaccurate low result - not what I wanted to hear, although at 56.8 mmol/L I think being in A&E semi-comatose attached to a drip looking for the toilet would tell me something was wrong. Ok, using 56.8 mmol/L had the desired effect and I took notice.

I telephoned Abbott DC and was told the upper range was the concern and lower levels less so, maybe not to you chum but I want to know a reading of 8.5 is not 3.5 and so did a quick check. A reading of 8.3 was 7.4 only 40 seconds later.
To resolve this Abbott have a software update available on the web-site that maintains settings and historical data, what is copied I leave to the imagination.
However to update you need a computer and connecting cable, I need to find mine?? but if I cannot they offered to send me a new meter.

This morning a copy of a newspaper dropped on my desk and a finger pointed to the article 'Meter fears for diabetics' that ends in the sentence 'Manufacturers Abbott Diabetes Care will provide patients with new meters'. Ugh! and I thought I was special.

May 1, 2013

Apollo 45 posts

Topic: General Discussion / injection technequie and body deformation

I've injected in muscle more than a few times and uttered a few choice phrases as I did so.

I have tried my backside once but found it to be a real pain the arse *boom boom!* seriously though I had trouble getting the shot on straight and was left with a lump where the insulin had pooled rather than spread.

I don't think the pinching alone would have caused the deformation although I can't see it helping any especially given I take a few minutes to give myself a shot. The deformation and should I still be pinching questions were really two different points on the same general subject. I think the deformation is largely down to taking most of my shots in that area. Do my backgrounds in the thighs and QA in the belly.

Having tried to take a few shots without pinching I'm finding it a little hard, I guess a big reason is that I'm not used to it though.

May 1, 2013

marke 646 posts

Topic: General Discussion / injection technequie and body deformation

Hi, I pinch some sites and not others. The basic issue is you want to avoid injecting into muscle, firstly because it will hurt Sad

and second because the absorption profile is different to fat/subcutaneous. This is what the diagram above is trying to show, If you, as I do, inject into your rear-end there is plenty of cushioning however the abdomen is a bit different and in some of us has areas with more fat than others Laughing

Of course needles are a lot shorter nowadays as well which makes life easier. It seems unlikely that pinching has caused deformations, although anything is possible.

May 1, 2013

marke 646 posts

Topic: General Discussion / New Graduate in DAFNE

As others have said, welcome and please feel free to ask questions, there is never a shortage of opinions or people happy to help. Doing DAFNE is the start of the journey and there are still plenty of interesting places to left to go Very Happy

May 5, 2013 edwards002 2 posts	Topic: General Discussion / Exercise No lack of data! Well done! I have not had time to analyse rigorously, so plse excuse me. As a Type 1 diabetic of 45 years, exercise has always been a tad of a mystery. I was given an excellent suggestion on a very recent visit to my dafne centre: reduce QA bolus insulin dosage by between 30-50% if anticipating exercise. I used to race a bike when much younger and I was staggered at how much sugar can be burnt during bike riding: 125g glucose supplement in a single shot in 20K (12.5 miles in old money) at around 36Kph (23 mph). So your fitness level, the weight of your bike, your speed and the weather conditions will all impact these kinds of numbers dramatically. On top of this so will your general mental condition. What do I mean? Well, are you stressed by exams or do you find you find your levels of anxiety changing? I have found that stress associated with activities I do not want to do (like going out or shopping (!) depress my blood sugar equally strongly just as if I were exercising. So what am I trying to get at? First, you will have the answers so look closely at your data and add stress factors and extra exercise-related info. Second, my experience is derived from pump use and not MDI so please treat my observations with caution as I have not altered my basal rates during my most recent experiences. I have only dealt with reduction of my bolus doses associated with meals. Third, I have found that a 30% reduction is necessary for "normal" exercise like walking into town and/or mowing the lawn! This recent change has made a dramatic effect on my perceived levels of anxiety and the numbers of hypos I have with the associated problems of hyperglycemic rebound and then later correction doses. A real see-saw and not helpful to anyone who is trying to gain control of their life. I suspect that I will need to decrease my bolus insulin dosages by 50% if I take my bike out and seriously exercise. I would then still expect to require 60-90g of fairly fast acting carbohydrate per hour to be able to sustain my exercise level. I hope this is helpful.

May 4, 2013 Stew B 123 posts	Topic: General Discussion / Freestyle InsuLinx Meter I've had problems when trying to change to new / different meters, where the new meter reads higher than my trusty One Touch Ultra. I agree that most of the time variation isn't a problem, and being within one or two units is OK. My problem is the confusion when I get early hypo symptoms, do a test and find the meter is giving me a reading of 4.5 - 5.5+. It's difficult when your body says one thing and your meter another! (Also, presumably a potential problem for trying to keep to the new driving "rules"?). Stew

May 4, 2013 SA2010 69 posts	Topic: Site Development / Date/Timestamp of posts Hi At the moment the date and timestamp of a post and how long ago it was posted is based on the original entry of the post. I am thinking that perhaps it would be more appropriate to switch to the latest date/time the post has been edited rather than the original time. Please could you think about this. As example in General Discussion I have just updated the diary and the post text for a post I put 15 hours ago. It is still showing with that date/time even though it has information that is more recent.

May 3, 2013 nitaparmar 2 posts	Topic: General Discussion / New Graduate in DAFNE thanks for the replies guys... will keep you posted with progress

May 3, 2013 SA2010 69 posts	Topic: General Discussion / Exercise This is my diary for last 7 days or so. Loads of hypos - only change is daily a bit of cycling to local park or shops or bank. Seem to have delayed effect hours afterwards. Surely I should not have to reduce BI just for daily 30-50 minutes of cycling. Am I burning sugar at faster rate now. Any comments would be appreciated. Updated Saturday: After increasing CPs from 1 to 2 before cycling the BG went sky high 2.5 hours later pre lunch. So this tells me that it probably needs to be reducing the BI - the morning dose probably especially since there is a delayed prolonged effect Is this the right conclusion?

May 3, 2013 Apollo 45 posts	Topic: General Discussion / Freestyle InsuLinx Meter I use a Bayer Contour USB (although it has been replaced by the contour next USB) it's great for logging, viewing trends etc but it has never suggested an insulin dose to me, this may be a new feature in the next though I've not bothered to check though as the only issues for me are is it reliable and is it compact and in this regard the next offers no change. If you would like something to suggest a dose to you though then if you have a compatible smart phone I would get the DAFNE online app which when supplied with your ratios and your carb estimates will suggest the insulin dose you require.

May 3, 2013 Frank.M 5 posts	Topic: General Discussion / Freestyle InsuLinx Meter Thank you for your responses. I assumed the default range of meters was between 5 - 10%. What attracted me to the InsuLix was having a suggested dose but now I'm looking at alternatives, such as the Bayer Contour USB, as I maybe coming to rely on a machine suggestion. Thank you again.

May 3, 2013 marke 646 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi, I can see in the logs that you ARE managing to login via the app fine, so that is not the problem.... Why do you say it doesn't do a lot ?

May 3, 2013 Simon 574 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi Catherine, Are you getting an error message when trying to log in to the app? Also please note that the username and password are case sensitive. Thanks, Simon

May 3, 2013 catherinesouth 4 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Would love to be able to use this App on my Iphone but will not accept my user name or password. I've even gone into the settings which doesn't do a lot. Have to say not impressed so far.

May 3, 2013 novorapidboi26 1,816 posts	Topic: General Discussion / New Graduate in DAFNE warm welcome from me.....

May 3, 2013 SA2010 69 posts	Topic: General Discussion / Exercise That is very useful info Warwick. Thank you. Timing appears to be important. If it is soon after breakfast I would not take CPs either as my BG is probably at peak then. I will look at my diary for last week - I am cycling everyday. Spring is coming here at last. I just did not expect the delayed effect. A hypo 10 hours after the 40 minute cycling activity even with some reduction in QA after the activity.

May 3, 2013 Warwick 430 posts	Topic: General Discussion / Your Diabetes Science Experiment - Experiment 1 Agreed on the 2-hour thing. I am much more comfortable with a 3-hour window. I tested last Thursday ( a holiday) and while not perfect, the results were encouraging. I'm lowering my BI from 13 x 2 to 10 x 2 this weekend and will see what eventuates. Also lowering my lunchtime QA from 1/2 to 1/3. Cheers, Warwick.

May 3, 2013 Warwick 430 posts	Topic: General Discussion / Freestyle InsuLinx Meter I was alerted to this yesterday at my DAFNE 12-month review, although as you say, values of 50+ don't affect many of us. I have the alternative smart meter from Aviva, and it is a replacement because the first one I had read values that were 2 units higher then my other 4 meters that I already owned. The replacement seems much better behaved. Manufacturers only have to provide a result that is with 20% of the true value. This is why you can get quite different readings within 40 seconds of taking the first reading. I don't tend to stress much about it. All it does is give you a guide to where you are at. It does seem a little ridiculous that they read to point values when the accuracy is obviously not that good, but the reading should be within 1 or 2 units of the true result.

May 3, 2013 Warwick 430 posts	Topic: General Discussion / Exercise Hello SA2010 I don't hypos during my 1 hour ride to work as it is too soon after breakfast, although I have occasional ones afterwards, but if I don't take carbs before my ride home, then I will hypo every time. I tend to need 3-4 CPs to keep the BGs steady on the way home. If you have only just started cycling, then you may well find that you hypo more often until your body adjusts which can take 4-6 weeks. By that time you will have a very good idea of how exercise affects your insulin and carb needs.

May 2, 2013 SA2010 69 posts	Topic: General Discussion / Exercise Hope it is ok to continue with this thread for my scenario today. I am wondering how long the impact of just a 40 minute cycling activity to the local park would last. I have had 3 occurrences of BG below 4.0 (3.3, 3.4, 3.7) since then and it was a short bike ride before lunch which was 40 minutes and i thought 1 CP of mini flapjack taken before the ride would be adequate for it - it was just over an hour before lunch. Just in case, i reduced the QA after the ride with lunch QA reduced by 1/2 (10%) and for dinner i reduced it by 1u (13%). I did not expect impact of activity to have an effect so long after. I will try to put a diary for a few days online tomorrow. Insulin Regimen: Novorapid QA:CP 1.3:1 (Breakfast) @07:30-08:30am, 0.6:1 (Lunch) @13:00-14:00, 0.8:1 (Dinner) @19:00-20:00. Split Lantus 3.0 @ 11:00am, 6.0 @ 23:00 Bedtime about 1am

May 2, 2013 Apollo 45 posts	Topic: General Discussion / Freestyle InsuLinx Meter I don't think my old one touch meter would register anything above a 30mmol/L would just say "hi". I don't know if there are some special features on you Abbott meter that mean your happy to stick with it but when I wanted to change to a bayer conrtour USB for no other reason than I liked that it was more compact than the one touch I just phoned them up and said "post me one now" and they did. Actually they sent me 3 meters! Not to make you feel even less special though but someone posted something similar about a recall on 2 specific models that lifescan make, I don't recall the models but one touch wasn't one of them.

May 2, 2013 Frank.M 5 posts	Topic: General Discussion / Freestyle InsuLinx Meter I use a Freestyle InsuLinx Blood Monitoring Meter that functions well enough, although why it needs a secret code (only available from Health Care Professionals) to set it up seems a little unnecessary. Last month the manufacturer, Abbott Diabetes Care, wrote to say they have determined that at extremely high levels of 56.8 mmol/L +plus the meter will display and store in memory an inaccurate low result - not what I wanted to hear, although at 56.8 mmol/L I think being in A&E semi-comatose attached to a drip looking for the toilet would tell me something was wrong. Ok, using 56.8 mmol/L had the desired effect and I took notice. I telephoned Abbott DC and was told the upper range was the concern and lower levels less so, maybe not to you chum but I want to know a reading of 8.5 is not 3.5 and so did a quick check. A reading of 8.3 was 7.4 only 40 seconds later. To resolve this Abbott have a software update available on the web-site that maintains settings and historical data, what is copied I leave to the imagination. However to update you need a computer and connecting cable, I need to find mine?? but if I cannot they offered to send me a new meter. This morning a copy of a newspaper dropped on my desk and a finger pointed to the article 'Meter fears for diabetics' that ends in the sentence 'Manufacturers Abbott Diabetes Care will provide patients with new meters'. Ugh! and I thought I was special.

May 1, 2013 Apollo 45 posts	Topic: General Discussion / injection technequie and body deformation I've injected in muscle more than a few times and uttered a few choice phrases as I did so. I have tried my backside once but found it to be a real pain the arse boom boom! seriously though I had trouble getting the shot on straight and was left with a lump where the insulin had pooled rather than spread. I don't think the pinching alone would have caused the deformation although I can't see it helping any especially given I take a few minutes to give myself a shot. The deformation and should I still be pinching questions were really two different points on the same general subject. I think the deformation is largely down to taking most of my shots in that area. Do my backgrounds in the thighs and QA in the belly. Having tried to take a few shots without pinching I'm finding it a little hard, I guess a big reason is that I'm not used to it though.

May 1, 2013 marke 646 posts	Topic: General Discussion / injection technequie and body deformation Hi, I pinch some sites and not others. The basic issue is you want to avoid injecting into muscle, firstly because it will hurt and second because the absorption profile is different to fat/subcutaneous. This is what the diagram above is trying to show, If you, as I do, inject into your rear-end there is plenty of cushioning however the abdomen is a bit different and in some of us has areas with more fat than others Of course needles are a lot shorter nowadays as well which makes life easier. It seems unlikely that pinching has caused deformations, although anything is possible.

May 1, 2013 marke 646 posts	Topic: General Discussion / New Graduate in DAFNE As others have said, welcome and please feel free to ask questions, there is never a shortage of opinions or people happy to help. Doing DAFNE is the start of the journey and there are still plenty of interesting places to left to go