Recent Posts - DAFNE Online

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 1,819 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 425 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 425 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 425 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 686 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 686 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 1, 2013

marke 686 posts

Topic: General Discussion / Exercise

I'm with Warwick, although I would say that your BG can be lower for upto 48 hours it doesn't necessarily equate to hypo's it just means be aware you may need less insulin than usual. In all the years I went to a gym I never once hypo-ed during exercise, it made my BG higher than normal a few times but never too low, so I wouldn't worry about hypo's or masked hypo awareness. As stated as well the DAFNE Handbook has a section on exercise that provides the basics.
I think the over-riding message is , don't worry ! enjoy the exercise it has loads of benefits and really is good for you. The benefits far out weight the negatives Very Happy

May 1, 2013

JayBee 587 posts

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

After several highs, I have decided to try testing my BI again. I will be doing the evening slot - diary above. I forgot about the 2 hour after meal thing, but I'm not convinced completely since I know QA is still working.

Will update.

May 1, 2013

Alan 49 284 posts

Topic: General Discussion / My current Diary

Leighton
If you're running consistently high, I hope you're testing for Ketones.

May 1, 2013

gills29 5 posts

Topic: Questions for HCPs / Diabetes Education for nurses

Hi there, I am a DAFNE Graduate, but I am also a nurse with an interest in diabetes education. I am looking to get a post graduate qualification in Diabetes, but theres so many to choose from out there. Is there any that the HCP's (in particular the DSN's) can recommend as an actual accredited qualification?

Thanks Gillian x

May 1, 2013

Apollo 45 posts

Topic: General Discussion / injection technequie and body deformation

That link is brilliant, I'm going to read over that in great detail later thanks Warwick!

I'm not getting lumps, it's almost like when seated my belly looks like the correct pinch technique illustration for 8mm -12mm needles but without me needing to pinch it.

If I stand tall it gets stretched out evenly but once I sit everything bunches into a band between the belly button and the top of the hips.

like you I'm on the 4mm needles, was on a mix of 5mm & 6mm 3 years ago.

Looking at the rotation diagram they offer as a print off for the belly I don't think I've got enough fat above the belly button to rotate to the extent they suggest there.

May 1, 2013

Apollo 45 posts

Topic: General Discussion / New Graduate in DAFNE

Hi,

If you have any questions don't be afraid to ask, I've been a type 1 for 7 years and a DAFNE grad for 6 years. I considered myself to be quite knowledgeable on diabeties till I joined here and started to learn new things I'd not previously considered. There are a lot of people here with a lot of know how and real world experience so if you have something your not sure about just ask and be flooded by opinions Very Happy

May 1, 2013

Garry 328 posts

Topic: General Discussion / New Graduate in DAFNE

Welcome nitaparmar Smile

Hope you find the forum useful and when necessary, supportive.
We are all in the same boat and sometimes need help with the paddling!
Regards
Garry

May 1, 2013

Apollo 45 posts

Topic: General Discussion / My current Diary

I actually think the BI is about right.

Tuesday Bed to Wed Morning, no QA and less than 1 unit of variation
Wednesday Lunch, no QA or carbs 7 hours later there has has been only 1.5mmols change in BG

I did think you needed to split your BI based on Sunday but then I noticed that you took the Saturday BI at 18:00 rather than your normal 21:00-22:00 so the high on Sunday night would be because you were walking round for 3 hours with no insulin at all in your system, maybe even longer if you're on Levimir as that often doesn't do a full 24 hour cycle.

Assuming your thyroid function is normal then I'd go with one of two potential issues

1) your carb counting is off, to check this eat foods that come in packets with the carbs printed on the side, if necessary weigh the foods and see if this makes a difference.

2) you are a phantom snacker but have not documented your snacking. I won't say that's something we have all done at some point but I know I have, The great thing about DAFNE is you can snack if you really want to but you do need to address it if you are.

Also what are your activity levels, by which I mean do you tend to exert yourself about the same amount day to day or are there some days you will do a much higher or lower level of physical activity.

May 1, 2013

Warwick 425 posts

Topic: General Discussion / My current Diary

Hello,

As Apollo says, knowing what types of insulin you are on would be very helpful.

I think there are enough bedtime tests in the diary, but unfortunately we can't actually use a bedtime test on these readings because there is always the need to correct at bedtime, so we can't tell what of the morning reading comes from the BI and what from the QA.

Faced with such a sea of red, my initial feeling is similar to SA2010 - that your BI is too low, but without the true bedtime tests, we can't actually tell - it might be that your QA ratios are too low.

Some of those CP readings are a bit strange - 93.5 and 92.1 CPs? That is almost a kilo of carbs... Are you sure about that?

If you can concentrate on getting your bedtime reading below 10, then we can look at bedtime tests. I would suggest if you get a bedtime reading of 10 or below, then don't correct, but test at 3 am, and again before breakfast and we can then see whether BI is correct or not.

If the 3 am test shows a large rise into the high teens or twenties, then do please do correct. DKA is not the goal :-)

Cheers,
Warwick.

May 1, 2013

Warwick 425 posts

Topic: General Discussion / injection technequie and body deformation

Hello Apollo,

I switched from 8 mm to 4 mm needles on the DAFNE course a year ago, and we were told then that we didn't need to pinch with a 4mm needle. (I have a BMI of about 24).

Do make sure that you are rotating your sites regularly though. This site covers correct technique:

http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7282

I'm not sure whether you are saying that you are developing lumps in your abdomen as a result of injecting into the same place too often, or just developing visceral fat around the abdomen which I also experience. I am slim and muscular everywhere else, but a slight thickening around the girth due to my current messy divorce with Mrs Chocolate. I've only noticed it since being diagnosed 3 years ago, so it is possible that that is related to injecting.

There are many other sites that you can inject though. One of my diabetes support group only injects QA in her arms (skin above the tricep). I tend to inject QA into the abdomen, and BI into my sides. I tried the back, but it was too hard to work out whether I had injected or not when I couldn't see what I was doing. Thighs and calves are also possibilities.

Cheers,
Warwick.

May 1, 2013

Warwick 425 posts

Topic: General Discussion / Exercise

Hello Diane,

You may actually find that your BGs rise after exercise if it is anaerobic and that you need more insulin prior to exercise as Gari found in this thread:

http://dafneonline.co.uk/forums/1/topics/2128

It really is a question of trial and error. Personally I find that if I exercise for an hour, then I either need to do it shortly after a meal (with slightly reduced QA), or I need to take some carbs (about 30 g) before or during the exercise.

I also recommend regular and increased testing afterwards - hypos can occur for up to 48 hours after exercise depending on the intensity and duration of the exercise.

Despite all that, it is still definitely worth it to keep exercising.

In terms of losing weight, the best time to exercise is shortly after eating because you can reduce QA rather than needing to take extra carbs to avoid a hypo. If you experience dawn phenomenon, then another good time to exercise to lose weight is prior to breakfast when your BGs are high from the rush of hormones as you don't need to take carbs, AND your BGs will come down from their high levels.

I recently attended a conference on exercising with type 1 diabetes. The general advice from that was that there is no BG reading that is too high to exercise as long as your ketone levels are normal. Follow the DAFNE advice with regards to that - any BG reading above 13 prior to exercise should be accompanied by a ketone test. If ketones are present (0.5 or above), then do not exercise. Take some QA to bring the ketones down and exercise later, or another day when ketone levels are normal.

All the best,
Warwick.

Apr 30, 2013

Warwick 425 posts

Topic: General Discussion / New Graduate in DAFNE

Hello,

Welcome to DAFNE. I was diagnosed September 2010, so there has been a steep learning curve. Coming up to my DAFNE 12 month review tomorrow which I am looking forward to, and looking at the difference pre-DAFNE and 12 months on, the differences are quite considerable.

All the best with it and looking forward to seeing you in these forums.

Warwick.

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 1,819 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 425 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 425 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 425 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 686 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 686 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

May 1, 2013 marke 686 posts	Topic: General Discussion / Exercise I'm with Warwick, although I would say that your BG can be lower for upto 48 hours it doesn't necessarily equate to hypo's it just means be aware you may need less insulin than usual. In all the years I went to a gym I never once hypo-ed during exercise, it made my BG higher than normal a few times but never too low, so I wouldn't worry about hypo's or masked hypo awareness. As stated as well the DAFNE Handbook has a section on exercise that provides the basics. I think the over-riding message is , don't worry ! enjoy the exercise it has loads of benefits and really is good for you. The benefits far out weight the negatives

May 1, 2013 JayBee 587 posts	Topic: General Discussion / Your Diabetes Science Experiment - Experiment 1 After several highs, I have decided to try testing my BI again. I will be doing the evening slot - diary above. I forgot about the 2 hour after meal thing, but I'm not convinced completely since I know QA is still working. Will update.

May 1, 2013 Alan 49 284 posts	Topic: General Discussion / My current Diary Leighton If you're running consistently high, I hope you're testing for Ketones.

May 1, 2013 gills29 5 posts	Topic: Questions for HCPs / Diabetes Education for nurses Hi there, I am a DAFNE Graduate, but I am also a nurse with an interest in diabetes education. I am looking to get a post graduate qualification in Diabetes, but theres so many to choose from out there. Is there any that the HCP's (in particular the DSN's) can recommend as an actual accredited qualification? Thanks Gillian x

May 1, 2013 Apollo 45 posts	Topic: General Discussion / injection technequie and body deformation That link is brilliant, I'm going to read over that in great detail later thanks Warwick! I'm not getting lumps, it's almost like when seated my belly looks like the correct pinch technique illustration for 8mm -12mm needles but without me needing to pinch it. If I stand tall it gets stretched out evenly but once I sit everything bunches into a band between the belly button and the top of the hips. like you I'm on the 4mm needles, was on a mix of 5mm & 6mm 3 years ago. Looking at the rotation diagram they offer as a print off for the belly I don't think I've got enough fat above the belly button to rotate to the extent they suggest there.

May 1, 2013 Apollo 45 posts	Topic: General Discussion / New Graduate in DAFNE Hi, If you have any questions don't be afraid to ask, I've been a type 1 for 7 years and a DAFNE grad for 6 years. I considered myself to be quite knowledgeable on diabeties till I joined here and started to learn new things I'd not previously considered. There are a lot of people here with a lot of know how and real world experience so if you have something your not sure about just ask and be flooded by opinions

May 1, 2013 Garry 328 posts	Topic: General Discussion / New Graduate in DAFNE Welcome nitaparmar Hope you find the forum useful and when necessary, supportive. We are all in the same boat and sometimes need help with the paddling! Regards Garry

May 1, 2013 Apollo 45 posts	Topic: General Discussion / My current Diary I actually think the BI is about right. Tuesday Bed to Wed Morning, no QA and less than 1 unit of variation Wednesday Lunch, no QA or carbs 7 hours later there has has been only 1.5mmols change in BG I did think you needed to split your BI based on Sunday but then I noticed that you took the Saturday BI at 18:00 rather than your normal 21:00-22:00 so the high on Sunday night would be because you were walking round for 3 hours with no insulin at all in your system, maybe even longer if you're on Levimir as that often doesn't do a full 24 hour cycle. Assuming your thyroid function is normal then I'd go with one of two potential issues 1) your carb counting is off, to check this eat foods that come in packets with the carbs printed on the side, if necessary weigh the foods and see if this makes a difference. 2) you are a phantom snacker but have not documented your snacking. I won't say that's something we have all done at some point but I know I have, The great thing about DAFNE is you can snack if you really want to but you do need to address it if you are. Also what are your activity levels, by which I mean do you tend to exert yourself about the same amount day to day or are there some days you will do a much higher or lower level of physical activity.

May 1, 2013 Warwick 425 posts	Topic: General Discussion / My current Diary Hello, As Apollo says, knowing what types of insulin you are on would be very helpful. I think there are enough bedtime tests in the diary, but unfortunately we can't actually use a bedtime test on these readings because there is always the need to correct at bedtime, so we can't tell what of the morning reading comes from the BI and what from the QA. Faced with such a sea of red, my initial feeling is similar to SA2010 - that your BI is too low, but without the true bedtime tests, we can't actually tell - it might be that your QA ratios are too low. Some of those CP readings are a bit strange - 93.5 and 92.1 CPs? That is almost a kilo of carbs... Are you sure about that? If you can concentrate on getting your bedtime reading below 10, then we can look at bedtime tests. I would suggest if you get a bedtime reading of 10 or below, then don't correct, but test at 3 am, and again before breakfast and we can then see whether BI is correct or not. If the 3 am test shows a large rise into the high teens or twenties, then do please do correct. DKA is not the goal :-) Cheers, Warwick.

May 1, 2013 Warwick 425 posts	Topic: General Discussion / injection technequie and body deformation Hello Apollo, I switched from 8 mm to 4 mm needles on the DAFNE course a year ago, and we were told then that we didn't need to pinch with a 4mm needle. (I have a BMI of about 24). Do make sure that you are rotating your sites regularly though. This site covers correct technique: http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7282 I'm not sure whether you are saying that you are developing lumps in your abdomen as a result of injecting into the same place too often, or just developing visceral fat around the abdomen which I also experience. I am slim and muscular everywhere else, but a slight thickening around the girth due to my current messy divorce with Mrs Chocolate. I've only noticed it since being diagnosed 3 years ago, so it is possible that that is related to injecting. There are many other sites that you can inject though. One of my diabetes support group only injects QA in her arms (skin above the tricep). I tend to inject QA into the abdomen, and BI into my sides. I tried the back, but it was too hard to work out whether I had injected or not when I couldn't see what I was doing. Thighs and calves are also possibilities. Cheers, Warwick.

May 1, 2013 Warwick 425 posts	Topic: General Discussion / Exercise Hello Diane, You may actually find that your BGs rise after exercise if it is anaerobic and that you need more insulin prior to exercise as Gari found in this thread: http://dafneonline.co.uk/forums/1/topics/2128 It really is a question of trial and error. Personally I find that if I exercise for an hour, then I either need to do it shortly after a meal (with slightly reduced QA), or I need to take some carbs (about 30 g) before or during the exercise. I also recommend regular and increased testing afterwards - hypos can occur for up to 48 hours after exercise depending on the intensity and duration of the exercise. Despite all that, it is still definitely worth it to keep exercising. In terms of losing weight, the best time to exercise is shortly after eating because you can reduce QA rather than needing to take extra carbs to avoid a hypo. If you experience dawn phenomenon, then another good time to exercise to lose weight is prior to breakfast when your BGs are high from the rush of hormones as you don't need to take carbs, AND your BGs will come down from their high levels. I recently attended a conference on exercising with type 1 diabetes. The general advice from that was that there is no BG reading that is too high to exercise as long as your ketone levels are normal. Follow the DAFNE advice with regards to that - any BG reading above 13 prior to exercise should be accompanied by a ketone test. If ketones are present (0.5 or above), then do not exercise. Take some QA to bring the ketones down and exercise later, or another day when ketone levels are normal. All the best, Warwick.

Apr 30, 2013 Warwick 425 posts	Topic: General Discussion / New Graduate in DAFNE Hello, Welcome to DAFNE. I was diagnosed September 2010, so there has been a steep learning curve. Coming up to my DAFNE 12 month review tomorrow which I am looking forward to, and looking at the difference pre-DAFNE and 12 months on, the differences are quite considerable. All the best with it and looking forward to seeing you in these forums. Warwick.