Recent Posts - DAFNE Online

Apr 30, 2013

Apollo 45 posts

Topic: General Discussion / injection technequie and body deformation

When I was diagnosed I was taught pinch up some fat, stick in a needle (which I generally do slowly rather than a quick stab in). Now at the time I had a BMI of 16.1 so you could practically make out my skeleton. This wasn't due to an eating disorders it just took me a while to seek help and my body had burned off all my fat by the time I did. As such if I didn't pinch I wasn't going to get a lump of flesh thick enough to put a needle in.

I was just emptying a box of needles into the trays I use to help track what shots I've done that day (think of it like a pill box with meals marked out but for needles) and I did something I don't normally do these days. I glanced over the instructions, as a man we tend to ignore these even when we don't know what we are doing but when we do reading guidance is almost unheard of but it was a few lines of large type on the flaps of the box and one of them read:

Suggested injection technique: insert straight in, without pinch-up."

These are 4mm needles where as when I was diagnosed I was on 6mm needles so maybe not needing to pinch is something to do with that. Although I'm not flabby my belly is a little deformed and maybe all the pinching has a part to play as you pull the fat out 3 times a day then it's going to have a tendency to stay there after a while.

So my question is what do other people do and has anyone got any advice on how to tone up my abs a little without compromising my ability to inject there? I'm not looking to develop a 6 pack but I'd like to do something about the slight sag I've developed in the belly area as a result of my injecting insulin. My current BMI is 21.2 so I'm far from overweight but I guess it does bother me that my stomach area almost seems to contradict that statement.

So what do other people do and has anyone got any tips?

Apr 30, 2013

DianeW 115 posts

Topic: General Discussion / Exercise

Can anyone advise me as someone who has never used a gym before or done much exercise please. If I'm doing say an hour's exercise, DAFNE says to reduce insulin by 20-50% prior to the exercise. Does that mean short acting AND long acting? Do I also take extra cps? Or does that depend on my blood sugar? I also read that if you want to lose weight it is better to decrease the insulin. I am really nervious about going. I know I will have to work it out for myself as I go along but I wondered if anyone had any advice, thank you.

Apr 29, 2013

SA2010 69 posts

Topic: General Discussion / My current Diary

I have not seen BGs so high before and so consistently high and even with high doses with insulin ! If I get a BG of 15.0 I think of it as really serious and try not repeat what gave rise to it climbing to 15. Often for me it is eating out in restaurants where I seem to always underestimate CPs. I am on Novorapid and split Lantus. I guess your insulin is different?

Observations:
There is not always a Bedtime BG test. Need to have good Bedtime BGs to establish BI level for good fasting BG in the morning. In my case with Novorapid which acts for 4-4.5 hours, i always make sure bedtime is 5 hours after dinner - it is hard but I have achieved so far (3 years into diabetes) and try to have my BG between 7 and 8. Guidelines say 6-8. If bedtime BG is high then next morning BG tends to be high. So I would say, try to get good bedtime BG for a couple of days by increasing evening meal ratio and then look at the BI and probably find it needs increasing. We are all different obviously as i only need 9 units of lantus a day (6 at 11pm and 3 at 11am) - It does look that the BI needs to be increased or probably split. The QA:CP ratios increases for lunch and dinner have helped but not enough. The Sunday 9pm high BG after no CPs for a while and good BG reading before does indicate that BI ran out. So need to concentrate on getting BI right first

Apr 29, 2013

Apollo 45 posts

Topic: General Discussion / My current Diary

I'm a firm believing in making someone work at it themselves so they gain an understanding, so what patterns are you seeing and what is it that you think you need to do next? Even if you don't know how to correct the pattern, being able to spot it is an important skill.

So what do you see?

Also what insulins are you on? I would guess your background is Levimir.

The one thing I will say before I hear your thoughts though is your corrections are to high. DAFNE says you should never give yourself a correction of more than 4, if you feel the need to give more than that then your ratios of background must be out.

Apr 29, 2013

Apollo 45 posts

Topic: General Discussion / Rapid-acting Insulin - Overstacking

Same as Vickyp

Although this was discussed in another thread and someone pointed out that there are meters which will calculate how much of the insulin will still be active in your system from your earlier shot. They take some calibration and setting up though apparently.

Apr 29, 2013

Warwick 434 posts

Topic: Questions ? / "Bed time" testing time & BG hit and miss

I'm coming to this thread late, and you appear to be on top of it anyway, but thought I'd share my experience.

Like you, I am on Humalog and Lantus. And like you, I was getting highs in the evenings before bed. In January I switched to twice a day, and the issue disappeared. Before the switch I was taking 23-24 units of Lantus at night. After the switch, I found that I needed 13 units morning and night - an increase of 2-3 units overall.

The alternative was to up my dinner QA, but I kept hypoing when I did that. So if you do need to split again, then keep in mind that you may need to slightly increase your BI.

Cheers,
Warwick.

Apr 29, 2013

Anthony Murray 9 posts

Topic: Questions ? / "Bed time" testing time & BG hit and miss

Thanks

Apr 29, 2013

Leighton84 3 posts

Topic: General Discussion / My current Diary

I will upload my Diary every week so that other people can comment on it and see if there are any patterns i am missing. Very Happy

Apr 29, 2013

novorapidboi26 1,818 posts

Topic: Questions ? / "Bed time" testing time & BG hit and miss

impressive...... Wink

Apr 29, 2013

Anthony Murray 9 posts

Topic: Questions ? / "Bed time" testing time & BG hit and miss

Just a little update on how my sugars have been the past week. I've only had 1 high that I had to do an adjustment for. I know my BED results are mostly in the red but I like to be between 6 and 8.5 at night. I don't know what caused those hypos on Friday morning but it seems to have been a one off.

I was able to get my "bed time" BG lower by changing how I counted cps that weren't full numbers i.e.
Before last week if I had two items for dinner and both were say 5.7 cps each I would usually count it as 11.5 and would only take 11 units as my pen only gives single units and then make any necessary adjustments for high/low BG. Now I would count it as 12 cps and then make adjustments.

Apr 28, 2013

Vickyp 135 posts

Topic: General Discussion / Rapid-acting Insulin - Overstacking

I would inject qa for what I am eating but wouldnt do a correction

Apr 28, 2013

mum2westiesGill 502 posts

Topic: General Discussion / Rapid-acting Insulin - Overstacking

Wondering what others would do if you had eaten a meal but wanted to eat your next meal before the insulin duration (3 - 5 hrs) is over?

Apr 28, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

no test - bedtime
21.8 - this morning

BG 5.1 - teatime

Apr 27, 2013

GLS 12 posts

Topic: Questions ? / Lantus to Levimer

Hey everyone.

Thanks for the info on insulin Warwick. That makes sense to me and explains why I am needing more Levimer compared to lantus. Although I am struggling slightly with the fasting BIs over night, I have found the Levimer really useful after exercise. Reducing it by 1u really helps stop those post exercise lows. So definitely work considering if you are quite active.

Regarding the lantus effects, Apollo, to be Honest I didn't adjust my lantus dose at all, as just took hospital advice, that the changes take a few days to take effect. So didnt really give it a go as took their word for it!

As for my troubles- I got one good week of morning blood sugars but back to being a bit Stuck now. Fasting tests for me through tonight!

Apr 27, 2013

Apollo 45 posts

Topic: General Discussion / 7-day waking average

Hi Becky,

Is have started a new topic of I were you as this is a question in its own right.

When you took the 12.9 reading how long had it been since you last took any quick acting (QA) insulin? If it was less than 4 hours prior then you will likely still have had some QA in your system and it may be that which caused your sugar levels to drop.

If it was over 4 hours since your last dose of QA then it would be worth dropping your back ground a few units and keeping an eye on it for the next few days.

Apr 27, 2013

beckyshaw 1 post

Topic: General Discussion / 7-day waking average

Hiya

I was 8.4 waking up this morning which had dropped from 12.9... I didmt do a correction as this happened the night before so I am seeing if my bi needs changing... what do people think? Smile

Apr 27, 2013

SA2010 69 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

novorapidboi26 said:
You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........

Thanks James - may be. But I worry about all the things that might go wrong with the pump and leaving this decision until I really have to have one, I remember my hospital days with canulars and how they leak sometimes and need to be checked all the time and moved and replaced and repositioned. My conerns about pumps are :
* risk of infection at the site
* risk of knocking it of its place - I am sometimes clumsy with hardware ! Seat Belts when driving? seat belt on airplane. Knocking and bumping into things that might dislodge the positioning of the pump and when dressing/undressing or when cycling or moving my arms or whatever.......
* need to reposition it every few days
* impact on pump when taking shower or bath.
* always worrying if it is making good contact and primed or has moved

There may be answers to all these and I may be wrong worrying about these ! There is also probably a psychological element - getting wired to a pump permanently - a realisation that i have a serious problem. It is, but at least i think of it as just a few injections a day. Anyway - probably this is more suitable for a thread on pumps.

Apr 27, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

Sun 21/04
10.9 - bedtime
18.8 - this morning

Mon 22/04
6.8 - bedtime
6.5 - this morning

Tue 23/04
9.4 - bedtime
15.3 - this morning

Wed 24/04
5.9 - bedtime
10.7 - this morning

Thu 25/04
10.8 - bedtime
5.4 - this morning

Fri 26/04
4.7 - bedtime
8.4 - this morning

Sat 27/04
5.8 - bedtime
7.2 - this morning

Apr 27, 2013

Vickyp 135 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

I use a half unit pen and am awaiting funding for the pump! As am very sensitive with ratios of 0.5:1 at lunch and dinner and 0.5:1-0.5 at breakfast! Lots of reading labels and weighing food!

Apr 27, 2013

novorapidboi26 1,818 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........ Very Happy

Apr 26, 2013

Apollo 45 posts

Topic: General Discussion / DAFNE Returner

I haven't had a bad reaction myself but I was told when going from Levimir to Lantus that some people did experience a burning sensation at the injection point.

May I ask what sort of reactions you had & to which insulin?

Apr 26, 2013

Apollo 45 posts

Topic: Questions ? / Lantus to Levimer

I have to say I've never heard of anyone using both Levimir and Lantus so I don't know if there are any potential complications that could arise from it but I'd have thought they would work together in much the same way that BI & QA do. Obviously it's going to make it more of an arse to get your background set right as you effectively have to 2 modes you need to define so certainly worth trying a total switch to Levimir first and seeing how you get on with it, but if you need to take 2 shots of BI anyway then I'd have thought you would get on with it fine. If you look at those graphs I posted back on page 1 of this it will give you a better idea of the difference of how aggressively each works from the time you take it so you have a better idea of what to expect.

Certainly if you take a shot before you go to sleep make sure you are over 8 before hand as it was normal with Levimir (atleast for me) to drop a little in the night.

A question just to clear some things up for me, people say that Lantus is not quick to change, so if they lower the dose it takes a few days to see the result of that. I can't say I have really had cause to play with mine to much in the last year since I changed but I have had the odd day where I've forgot to take the shot due to exhaustion and the next day I've been stupid high because there was no background in my system.

To me that says that the Lantus had all left my system so if I'd taken say a half dose the night before because I was going to do something the next day that was going to be seriously physically exerting then that change would have taken for the next day. I accept that once you put the stuff in it's there for 24 hours and if you put in to much then you're going to have to manage that with extra carbs but it almost seems like Wariwick and a few others are saying that if they change what they take Sunday bedtime then they won't really see that change in their readings till Wednesday. Have I got the wrong end of the stick here or is that most peoples experience?

Apr 26, 2013

ladybirdov6 6 posts

Topic: Questions ? / Lantus to Levimer

Just come bact to DAFNE. Had 6 month break due to problems with Levemir. Am now back on Lantus, which I have had before, just injected a quick acting at meal-time years before DAFNE was even thought of.

Apr 30, 2013 Apollo 45 posts	Topic: General Discussion / injection technequie and body deformation When I was diagnosed I was taught pinch up some fat, stick in a needle (which I generally do slowly rather than a quick stab in). Now at the time I had a BMI of 16.1 so you could practically make out my skeleton. This wasn't due to an eating disorders it just took me a while to seek help and my body had burned off all my fat by the time I did. As such if I didn't pinch I wasn't going to get a lump of flesh thick enough to put a needle in. I was just emptying a box of needles into the trays I use to help track what shots I've done that day (think of it like a pill box with meals marked out but for needles) and I did something I don't normally do these days. I glanced over the instructions, as a man we tend to ignore these even when we don't know what we are doing but when we do reading guidance is almost unheard of but it was a few lines of large type on the flaps of the box and one of them read: Suggested injection technique: insert straight in, without pinch-up." These are 4mm needles where as when I was diagnosed I was on 6mm needles so maybe not needing to pinch is something to do with that. Although I'm not flabby my belly is a little deformed and maybe all the pinching has a part to play as you pull the fat out 3 times a day then it's going to have a tendency to stay there after a while. So my question is what do other people do and has anyone got any advice on how to tone up my abs a little without compromising my ability to inject there? I'm not looking to develop a 6 pack but I'd like to do something about the slight sag I've developed in the belly area as a result of my injecting insulin. My current BMI is 21.2 so I'm far from overweight but I guess it does bother me that my stomach area almost seems to contradict that statement. So what do other people do and has anyone got any tips?

Apr 30, 2013 DianeW 115 posts	Topic: General Discussion / Exercise Can anyone advise me as someone who has never used a gym before or done much exercise please. If I'm doing say an hour's exercise, DAFNE says to reduce insulin by 20-50% prior to the exercise. Does that mean short acting AND long acting? Do I also take extra cps? Or does that depend on my blood sugar? I also read that if you want to lose weight it is better to decrease the insulin. I am really nervious about going. I know I will have to work it out for myself as I go along but I wondered if anyone had any advice, thank you.

Apr 29, 2013 SA2010 69 posts	Topic: General Discussion / My current Diary I have not seen BGs so high before and so consistently high and even with high doses with insulin ! If I get a BG of 15.0 I think of it as really serious and try not repeat what gave rise to it climbing to 15. Often for me it is eating out in restaurants where I seem to always underestimate CPs. I am on Novorapid and split Lantus. I guess your insulin is different? Observations: There is not always a Bedtime BG test. Need to have good Bedtime BGs to establish BI level for good fasting BG in the morning. In my case with Novorapid which acts for 4-4.5 hours, i always make sure bedtime is 5 hours after dinner - it is hard but I have achieved so far (3 years into diabetes) and try to have my BG between 7 and 8. Guidelines say 6-8. If bedtime BG is high then next morning BG tends to be high. So I would say, try to get good bedtime BG for a couple of days by increasing evening meal ratio and then look at the BI and probably find it needs increasing. We are all different obviously as i only need 9 units of lantus a day (6 at 11pm and 3 at 11am) - It does look that the BI needs to be increased or probably split. The QA:CP ratios increases for lunch and dinner have helped but not enough. The Sunday 9pm high BG after no CPs for a while and good BG reading before does indicate that BI ran out. So need to concentrate on getting BI right first

Apr 29, 2013 Apollo 45 posts	Topic: General Discussion / My current Diary I'm a firm believing in making someone work at it themselves so they gain an understanding, so what patterns are you seeing and what is it that you think you need to do next? Even if you don't know how to correct the pattern, being able to spot it is an important skill. So what do you see? Also what insulins are you on? I would guess your background is Levimir. The one thing I will say before I hear your thoughts though is your corrections are to high. DAFNE says you should never give yourself a correction of more than 4, if you feel the need to give more than that then your ratios of background must be out.

Apr 29, 2013 Apollo 45 posts	Topic: General Discussion / Rapid-acting Insulin - Overstacking Same as Vickyp Although this was discussed in another thread and someone pointed out that there are meters which will calculate how much of the insulin will still be active in your system from your earlier shot. They take some calibration and setting up though apparently.

Apr 29, 2013 Warwick 434 posts	Topic: Questions ? / "Bed time" testing time & BG hit and miss I'm coming to this thread late, and you appear to be on top of it anyway, but thought I'd share my experience. Like you, I am on Humalog and Lantus. And like you, I was getting highs in the evenings before bed. In January I switched to twice a day, and the issue disappeared. Before the switch I was taking 23-24 units of Lantus at night. After the switch, I found that I needed 13 units morning and night - an increase of 2-3 units overall. The alternative was to up my dinner QA, but I kept hypoing when I did that. So if you do need to split again, then keep in mind that you may need to slightly increase your BI. Cheers, Warwick.

Apr 29, 2013 Anthony Murray 9 posts	Topic: Questions ? / "Bed time" testing time & BG hit and miss Thanks

Apr 29, 2013 Leighton84 3 posts	Topic: General Discussion / My current Diary I will upload my Diary every week so that other people can comment on it and see if there are any patterns i am missing.

Apr 29, 2013 novorapidboi26 1,818 posts	Topic: Questions ? / "Bed time" testing time & BG hit and miss impressive......

Apr 29, 2013 Anthony Murray 9 posts	Topic: Questions ? / "Bed time" testing time & BG hit and miss Just a little update on how my sugars have been the past week. I've only had 1 high that I had to do an adjustment for. I know my BED results are mostly in the red but I like to be between 6 and 8.5 at night. I don't know what caused those hypos on Friday morning but it seems to have been a one off. I was able to get my "bed time" BG lower by changing how I counted cps that weren't full numbers i.e. Before last week if I had two items for dinner and both were say 5.7 cps each I would usually count it as 11.5 and would only take 11 units as my pen only gives single units and then make any necessary adjustments for high/low BG. Now I would count it as 12 cps and then make adjustments.

Apr 28, 2013 Vickyp 135 posts	Topic: General Discussion / Rapid-acting Insulin - Overstacking I would inject qa for what I am eating but wouldnt do a correction

Apr 28, 2013 mum2westiesGill 502 posts	Topic: General Discussion / Rapid-acting Insulin - Overstacking Wondering what others would do if you had eaten a meal but wanted to eat your next meal before the insulin duration (3 - 5 hrs) is over?

Apr 28, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average no test - bedtime 21.8 - this morning BG 5.1 - teatime

Apr 27, 2013 GLS 12 posts	Topic: Questions ? / Lantus to Levimer Hey everyone. Thanks for the info on insulin Warwick. That makes sense to me and explains why I am needing more Levimer compared to lantus. Although I am struggling slightly with the fasting BIs over night, I have found the Levimer really useful after exercise. Reducing it by 1u really helps stop those post exercise lows. So definitely work considering if you are quite active. Regarding the lantus effects, Apollo, to be Honest I didn't adjust my lantus dose at all, as just took hospital advice, that the changes take a few days to take effect. So didnt really give it a go as took their word for it! As for my troubles- I got one good week of morning blood sugars but back to being a bit Stuck now. Fasting tests for me through tonight!

Apr 27, 2013 Apollo 45 posts	Topic: General Discussion / 7-day waking average Hi Becky, Is have started a new topic of I were you as this is a question in its own right. When you took the 12.9 reading how long had it been since you last took any quick acting (QA) insulin? If it was less than 4 hours prior then you will likely still have had some QA in your system and it may be that which caused your sugar levels to drop. If it was over 4 hours since your last dose of QA then it would be worth dropping your back ground a few units and keeping an eye on it for the next few days.

Apr 27, 2013 beckyshaw 1 post	Topic: General Discussion / 7-day waking average Hiya I was 8.4 waking up this morning which had dropped from 12.9... I didmt do a correction as this happened the night before so I am seeing if my bi needs changing... what do people think?

Apr 27, 2013 SA2010 69 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging novorapidboi26 said: You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........ Thanks James - may be. But I worry about all the things that might go wrong with the pump and leaving this decision until I really have to have one, I remember my hospital days with canulars and how they leak sometimes and need to be checked all the time and moved and replaced and repositioned. My conerns about pumps are : * risk of infection at the site * risk of knocking it of its place - I am sometimes clumsy with hardware ! Seat Belts when driving? seat belt on airplane. Knocking and bumping into things that might dislodge the positioning of the pump and when dressing/undressing or when cycling or moving my arms or whatever....... * need to reposition it every few days * impact on pump when taking shower or bath. * always worrying if it is making good contact and primed or has moved There may be answers to all these and I may be wrong worrying about these ! There is also probably a psychological element - getting wired to a pump permanently - a realisation that i have a serious problem. It is, but at least i think of it as just a few injections a day. Anyway - probably this is more suitable for a thread on pumps.

Apr 27, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average Sun 21/04 10.9 - bedtime 18.8 - this morning Mon 22/04 6.8 - bedtime 6.5 - this morning Tue 23/04 9.4 - bedtime 15.3 - this morning Wed 24/04 5.9 - bedtime 10.7 - this morning Thu 25/04 10.8 - bedtime 5.4 - this morning Fri 26/04 4.7 - bedtime 8.4 - this morning Sat 27/04 5.8 - bedtime 7.2 - this morning

Apr 27, 2013 Vickyp 135 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging I use a half unit pen and am awaiting funding for the pump! As am very sensitive with ratios of 0.5:1 at lunch and dinner and 0.5:1-0.5 at breakfast! Lots of reading labels and weighing food!

Apr 27, 2013 novorapidboi26 1,818 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........

Apr 26, 2013 Apollo 45 posts	Topic: General Discussion / DAFNE Returner I haven't had a bad reaction myself but I was told when going from Levimir to Lantus that some people did experience a burning sensation at the injection point. May I ask what sort of reactions you had & to which insulin?

Apr 26, 2013 Apollo 45 posts	Topic: Questions ? / Lantus to Levimer I have to say I've never heard of anyone using both Levimir and Lantus so I don't know if there are any potential complications that could arise from it but I'd have thought they would work together in much the same way that BI & QA do. Obviously it's going to make it more of an arse to get your background set right as you effectively have to 2 modes you need to define so certainly worth trying a total switch to Levimir first and seeing how you get on with it, but if you need to take 2 shots of BI anyway then I'd have thought you would get on with it fine. If you look at those graphs I posted back on page 1 of this it will give you a better idea of the difference of how aggressively each works from the time you take it so you have a better idea of what to expect. Certainly if you take a shot before you go to sleep make sure you are over 8 before hand as it was normal with Levimir (atleast for me) to drop a little in the night. A question just to clear some things up for me, people say that Lantus is not quick to change, so if they lower the dose it takes a few days to see the result of that. I can't say I have really had cause to play with mine to much in the last year since I changed but I have had the odd day where I've forgot to take the shot due to exhaustion and the next day I've been stupid high because there was no background in my system. To me that says that the Lantus had all left my system so if I'd taken say a half dose the night before because I was going to do something the next day that was going to be seriously physically exerting then that change would have taken for the next day. I accept that once you put the stuff in it's there for 24 hours and if you put in to much then you're going to have to manage that with extra carbs but it almost seems like Wariwick and a few others are saying that if they change what they take Sunday bedtime then they won't really see that change in their readings till Wednesday. Have I got the wrong end of the stick here or is that most peoples experience?

Apr 26, 2013 ladybirdov6 6 posts	Topic: Questions ? / Lantus to Levimer Just come bact to DAFNE. Had 6 month break due to problems with Levemir. Am now back on Lantus, which I have had before, just injected a quick acting at meal-time years before DAFNE was even thought of.