Recent Posts - DAFNE Online

Apr 25, 2013

Vickyp 135 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

It also depends on the individual. I am insulin sensitive and if I always round up it could cause me to gave too much insulin!
Agree with Apollo about BGs at time of having the CPs, as this plays a massive role for me too!

Apr 25, 2013

Alan 49 280 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

We were told on our DAFNE course always to round partial CPs up to the next whole CP.

Apr 25, 2013

NuMo 28 posts

Topic: Questions for HCPs / Lantus to Levimer

Hi Warwick

I haven't switched to Levemir as I was put on it from the start, but I do find it quite versatile. I am on 2 doses of BI daily. This means that I can reduce the dose prior to exercise in the morning, or if I have been exercising in the evening I can reduce the overnight dose. Also, not that this will affect you in sunny Melbourne, but on cold inactive days in the winter I increased the BI to cover. I have found the quicker reacting effect of Levemir over Lantus suits me well.

Apr 25, 2013

Warwick 430 posts

Topic: Questions for HCPs / Lantus to Levimer

To answer the original question, from the book "Think Like a Pancreas" by Gary Scheiner page 40:

"Insulin is measured in units. A unit of insulin should lower the blood sugar by the same amount no matter what kind of insulin you use. A unit of short-acting insulin will lower your blood sugar the same as a unit of long-acting insulin ; it just does so in a shorter period of time. One exception is a long-acting basal insulin called detemir (brand name Levemir) which is approximately 25 percent less potent than other insulins.

In summary, if switching from Lantus to Levemir, then you would expect to need to increase your dose to get the same results.

I'm interested in hearing others' experiences in switching from Lantus to Levemir. I'm on a split dose of Lantus right now (because it wasn't lasting 24 hours for me), but the lag between changing the dose and its effect is annoying.

I cycle to work every day, and my BGs are excellent throughout the week as I have a desk job so activity levels are predictable, but reducing BI before the weekends which are much more active aren't giving me the reduction in hypos that I want, and instead, Monday and Tuesday tend to run a little high as a carry-over from the BI reduction at the weekend.

Looking through some of the threads on Levemir, there seem to be more users of it experiencing unpredictable results than stable ones. Lantus is very stable for me; it is only the lag between changing doses that I don't like and I won't make a switch if it is likely to cause more unpredictable results.

I'd love to hear from anyone who has switched as to whether they would recommend switching, especially from anyone who is reasonably active and exercises frequently.

Thanks,
Warwick.

Apr 24, 2013

Apollo 45 posts

Topic: Carbohydrate Counting / Tesco sandwich labelling

I had the same issue in a Tescos about 4 years ago. I'd bought it for lunch and only realised it didn't have the weight on it as I was walking to the exit so I about turned and walked to customer services and demanded they weigh it for me.

Apr 24, 2013

Apollo 45 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

As novorapidboi26 says it's important to add all the carbs in a meal time together first.

Don't do your rounding then add it together. That includes your puddings as otherwise if you round up on your main and your pudding and maybe there is surgar in your drink and it happens that you round up on that too then you could end up taking 2 or 3 units more than if you added everything together and then rounded up. It maybe that one rounds up another rounds down and it all balances out anyway but it's better to add up all the accurate figures first and be sure.

Also for me my BG figure can be a factor. If I'm 4.5 mmols before the meal then and having got all the complete CPs I've got 6g of carbs left over I'll round it down because the BG level is in the low end of target so it can go up a little without to much worry. Where as if I'm 7.2 mmols I'll round it up because there is enough in my blood for that to be ok.

Apr 24, 2013

fishnetsboi 10 posts

Topic: Questions for HCPs / insulin pump

Outstanding results novorapidboi can't wait to get back to work to really test it out.

Apr 24, 2013

Apollo 45 posts

Topic: Site Development / Insulins

Look forward to seeing it rolled out.

Apr 24, 2013

Apollo 45 posts

Topic: Site Development / how to guides

As some of the users on the site don't have access to a DAFNE course it seems there are some questions that are being asked quite a bit, or at the least there is some advice which seems to be a staple answer to various questions.

For graduates there is the handbook to reference but even for graduates (and certainly for non-graduates) I was thinking it could be useful to do out some short 'how to' style guides to address these issues. So when someone says are having difficulty working out their background insulin then you can reference the 'how to' which will contain all the general theory like how you can go high from a hypo in the night, how to check if it's holding steady & the importance of getting your background right before working on your mealtime ratios etc.

This then means that you can then just reference the guide on how to get your background right rather than trying to explain it all again. As if we have someone do it right once that has to be better than dozens of people taking quick stabs at it every few weeks.

If you want to do it with low overheads then you could set up a how to board which was read only to all but those selected to author said guides.

Apr 24, 2013

novorapidboi26 1,816 posts

Topic: Questions for HCPs / insulin pump

fishnetsboi said:
I'm on a Medtronic which has a bolus wizard option, it calculated CP's and insulin from your BG readings and automatically works it out for you depending on what correction you program into your pump.

hows it going with the pump?

I am on the same one as you likely, the larger reservoir model.................so far its brilliant......

Apr 24, 2013

Simon 574 posts

Topic: Site Development / Insulins

Good idea! I'll put it on the list of things we need to add.

Apr 23, 2013

Warwick 430 posts

Topic: General Discussion / Increased blood glucose after exercise

Hi James,

The book is self-published by Ginger and the only place I have seen it for sale is on Amazon. It is well worth the money though. It certainly cleared a lot of my thinking about type 1 diabetes. Competitive exercise usually raises BGLs too as adrenaline produced blunts the effects of insulin.

Cheers,
Warwick.

Apr 23, 2013

fishnetsboi 10 posts

Topic: Questions for HCPs / insulin pump

I'm on a Medtronic which has a bolus wizard option, it calculated CP's and insulin from your BG readings and automatically works it out for you depending on what correction you program into your pump.

Apr 23, 2013

JamesW 24 posts

Topic: General Discussion / Increased blood glucose after exercise

Some very interesting findings. I always thought that there was a significant difference between anaerobic and aerobic activity on my levels and this reinforces my belief. The science element coincides with my thinking too, which is encouraging. My view was built around what I had read about non-diabetics and their consumption of carbohydrates for cycling although this is for events that last over three hours and will be a mixture of efforts. I will have to see if I can get hold of a copy of the book mentioned to read further in to the subject. I am looking to improve my cycling so hopefully now armed with a bit more knowledge and resources I may yet be able to see some advancement.

Apr 23, 2013

mum2westiesGill 502 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

Hi,

Staying away from home wouldn't be possible as I have a lot of family commitments. I am however currently doing a similar course in my local area.

Apr 23, 2013

Apollo 45 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

If they do one near a friend you can stay with it would be well worth your while trying to arrange it. I went on the course with some scepticism about how much I would really get out of it but I'm self employed and work was slow so I did it. When things picked up a bit a few days before the course was due to start I almost pulled out but I'm so glad I didn't as I learned so much.

We can tell you what we have been told and how personal experience has born it out, but (and I may just be speaking for myself ) it will be a shadow of what you would get out of the course itself as they use interactive learning look at all the topics in a structured way that forums just don't seem to be able to replicate.

But my point with the previoud post was you will have some high results while you find your feet. It's normal and part of the process but don't let it get you down. It is the same as when some one starts to exercise after having been lazy for a while. At first they get shocked by how little they can do, how easy they get out of breath, but they need to work through that and then they become better. The same will happen for your BG levels. It may get a little worse for a few weeks msybe even s monyh or two but you will get to a point where you're better than ever before.

Apr 23, 2013

mum2westiesGill 502 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

Hi travler,

Yes you are correct I'm not a dafne graduate & can't be because there are no dafne courses in my immediate area.

Apr 23, 2013

Apollo 45 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

As it doesn't show you as a dafne graduate I'm guessing you have yet to do the course. A lot of the stuff we do to work our BI and ratios means we start with a lot of high reads. There was one guy in my group who didn't go under 15 for a single reading all week which frustrated the life out of him but when we came back for our review it was a different story as he had worked out how to balance his insulin to his food in take.

You are going to have to go through some high readings but we all do it is part of the process, but there are good times ahead. Just make one change at a time and evaluate it. In the case of your BI this will have to be done fasting as if you take QA you won't know which insulin is responsible for putting you off target. Then once you know you BI is correct and keeping you level then you can evaluate how your QA is effecting you.

Apr 23, 2013

mum2westiesGill 502 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

Hi,

I'm going to reduce my BI from 10u am & pm to 8u am & pm and see what happens for the next few days, also basing it on some of the fasting readings. I'm just a bit worried about seeing all the red numbers in there during the day, but obviously we have to deal with one thing at a time.

Apr 22, 2013

Apollo 45 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

You are consistently dropping over night when you have only BI in your system or when you do take QA the cp intake is drasticly higher so you should have been much higher by morning if your BI was spot on. Both I and vickyp agreed you should have lowered your BI based on your fasting test in the last batch of test data so I really can't understand why you are even contemplating increasing it. Increasing it will harm your control and increase your chance of hypos, you need to drop it down to 8 not increase it.

Your corrections are also still too high. Really I'm just telling you the same the things I told you last time so please reread what I said then.

If you think I'm wrong then talk to your diabetic care team as I'm quite sure they are going to tell you the same thing and until you take that on board your not going to have the control you want.

Apr 22, 2013

mum2westiesGill 502 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

Hi,

Thank you to everyone who comments on my BG diary and although I may not always reply straight away I do always read through & take all comments on board.

Please can I have comments for the last 7 days
Tue 16/04/2013 - Mon 22/04/2013

I was wondering whether I might increase my BI from 10u am & pm to 12u am & pm. I like to have a 50/50 split if I can. The last time I made adjustments/tweaked my BI was March 9th

Apr 25, 2013 Vickyp 135 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging It also depends on the individual. I am insulin sensitive and if I always round up it could cause me to gave too much insulin! Agree with Apollo about BGs at time of having the CPs, as this plays a massive role for me too!

Apr 25, 2013 Alan 49 280 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging We were told on our DAFNE course always to round partial CPs up to the next whole CP.

Apr 25, 2013 NuMo 28 posts	Topic: Questions for HCPs / Lantus to Levimer Hi Warwick I haven't switched to Levemir as I was put on it from the start, but I do find it quite versatile. I am on 2 doses of BI daily. This means that I can reduce the dose prior to exercise in the morning, or if I have been exercising in the evening I can reduce the overnight dose. Also, not that this will affect you in sunny Melbourne, but on cold inactive days in the winter I increased the BI to cover. I have found the quicker reacting effect of Levemir over Lantus suits me well.

Apr 25, 2013 Warwick 430 posts	Topic: Questions for HCPs / Lantus to Levimer To answer the original question, from the book "Think Like a Pancreas" by Gary Scheiner page 40: "Insulin is measured in units. A unit of insulin should lower the blood sugar by the same amount no matter what kind of insulin you use. A unit of short-acting insulin will lower your blood sugar the same as a unit of long-acting insulin ; it just does so in a shorter period of time. One exception is a long-acting basal insulin called detemir (brand name Levemir) which is approximately 25 percent less potent than other insulins. In summary, if switching from Lantus to Levemir, then you would expect to need to increase your dose to get the same results. I'm interested in hearing others' experiences in switching from Lantus to Levemir. I'm on a split dose of Lantus right now (because it wasn't lasting 24 hours for me), but the lag between changing the dose and its effect is annoying. I cycle to work every day, and my BGs are excellent throughout the week as I have a desk job so activity levels are predictable, but reducing BI before the weekends which are much more active aren't giving me the reduction in hypos that I want, and instead, Monday and Tuesday tend to run a little high as a carry-over from the BI reduction at the weekend. Looking through some of the threads on Levemir, there seem to be more users of it experiencing unpredictable results than stable ones. Lantus is very stable for me; it is only the lag between changing doses that I don't like and I won't make a switch if it is likely to cause more unpredictable results. I'd love to hear from anyone who has switched as to whether they would recommend switching, especially from anyone who is reasonably active and exercises frequently. Thanks, Warwick.

Apr 24, 2013 Apollo 45 posts	Topic: Carbohydrate Counting / Tesco sandwich labelling I had the same issue in a Tescos about 4 years ago. I'd bought it for lunch and only realised it didn't have the weight on it as I was walking to the exit so I about turned and walked to customer services and demanded they weigh it for me.

Apr 24, 2013 Apollo 45 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging As novorapidboi26 says it's important to add all the carbs in a meal time together first. Don't do your rounding then add it together. That includes your puddings as otherwise if you round up on your main and your pudding and maybe there is surgar in your drink and it happens that you round up on that too then you could end up taking 2 or 3 units more than if you added everything together and then rounded up. It maybe that one rounds up another rounds down and it all balances out anyway but it's better to add up all the accurate figures first and be sure. Also for me my BG figure can be a factor. If I'm 4.5 mmols before the meal then and having got all the complete CPs I've got 6g of carbs left over I'll round it down because the BG level is in the low end of target so it can go up a little without to much worry. Where as if I'm 7.2 mmols I'll round it up because there is enough in my blood for that to be ok.

Apr 24, 2013 fishnetsboi 10 posts	Topic: Questions for HCPs / insulin pump Outstanding results novorapidboi can't wait to get back to work to really test it out.

Apr 24, 2013 Apollo 45 posts	Topic: Site Development / Insulins Look forward to seeing it rolled out.

Apr 24, 2013 Apollo 45 posts	Topic: Site Development / how to guides As some of the users on the site don't have access to a DAFNE course it seems there are some questions that are being asked quite a bit, or at the least there is some advice which seems to be a staple answer to various questions. For graduates there is the handbook to reference but even for graduates (and certainly for non-graduates) I was thinking it could be useful to do out some short 'how to' style guides to address these issues. So when someone says are having difficulty working out their background insulin then you can reference the 'how to' which will contain all the general theory like how you can go high from a hypo in the night, how to check if it's holding steady & the importance of getting your background right before working on your mealtime ratios etc. This then means that you can then just reference the guide on how to get your background right rather than trying to explain it all again. As if we have someone do it right once that has to be better than dozens of people taking quick stabs at it every few weeks. If you want to do it with low overheads then you could set up a how to board which was read only to all but those selected to author said guides.

Apr 24, 2013 novorapidboi26 1,816 posts	Topic: Questions for HCPs / insulin pump fishnetsboi said: I'm on a Medtronic which has a bolus wizard option, it calculated CP's and insulin from your BG readings and automatically works it out for you depending on what correction you program into your pump. hows it going with the pump? I am on the same one as you likely, the larger reservoir model.................so far its brilliant......

Apr 24, 2013 Simon 574 posts	Topic: Site Development / Insulins Good idea! I'll put it on the list of things we need to add.

Apr 23, 2013 Warwick 430 posts	Topic: General Discussion / Increased blood glucose after exercise Hi James, The book is self-published by Ginger and the only place I have seen it for sale is on Amazon. It is well worth the money though. It certainly cleared a lot of my thinking about type 1 diabetes. Competitive exercise usually raises BGLs too as adrenaline produced blunts the effects of insulin. Cheers, Warwick.

Apr 23, 2013 fishnetsboi 10 posts	Topic: Questions for HCPs / insulin pump I'm on a Medtronic which has a bolus wizard option, it calculated CP's and insulin from your BG readings and automatically works it out for you depending on what correction you program into your pump.

Apr 23, 2013 JamesW 24 posts	Topic: General Discussion / Increased blood glucose after exercise Some very interesting findings. I always thought that there was a significant difference between anaerobic and aerobic activity on my levels and this reinforces my belief. The science element coincides with my thinking too, which is encouraging. My view was built around what I had read about non-diabetics and their consumption of carbohydrates for cycling although this is for events that last over three hours and will be a mixture of efforts. I will have to see if I can get hold of a copy of the book mentioned to read further in to the subject. I am looking to improve my cycling so hopefully now armed with a bit more knowledge and resources I may yet be able to see some advancement.

Apr 23, 2013 mum2westiesGill 502 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! Hi, Staying away from home wouldn't be possible as I have a lot of family commitments. I am however currently doing a similar course in my local area.

Apr 23, 2013 Apollo 45 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! If they do one near a friend you can stay with it would be well worth your while trying to arrange it. I went on the course with some scepticism about how much I would really get out of it but I'm self employed and work was slow so I did it. When things picked up a bit a few days before the course was due to start I almost pulled out but I'm so glad I didn't as I learned so much. We can tell you what we have been told and how personal experience has born it out, but (and I may just be speaking for myself ) it will be a shadow of what you would get out of the course itself as they use interactive learning look at all the topics in a structured way that forums just don't seem to be able to replicate. But my point with the previoud post was you will have some high results while you find your feet. It's normal and part of the process but don't let it get you down. It is the same as when some one starts to exercise after having been lazy for a while. At first they get shocked by how little they can do, how easy they get out of breath, but they need to work through that and then they become better. The same will happen for your BG levels. It may get a little worse for a few weeks msybe even s monyh or two but you will get to a point where you're better than ever before.

Apr 23, 2013 mum2westiesGill 502 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! Hi travler, Yes you are correct I'm not a dafne graduate & can't be because there are no dafne courses in my immediate area.

Apr 23, 2013 Apollo 45 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! As it doesn't show you as a dafne graduate I'm guessing you have yet to do the course. A lot of the stuff we do to work our BI and ratios means we start with a lot of high reads. There was one guy in my group who didn't go under 15 for a single reading all week which frustrated the life out of him but when we came back for our review it was a different story as he had worked out how to balance his insulin to his food in take. You are going to have to go through some high readings but we all do it is part of the process, but there are good times ahead. Just make one change at a time and evaluate it. In the case of your BI this will have to be done fasting as if you take QA you won't know which insulin is responsible for putting you off target. Then once you know you BI is correct and keeping you level then you can evaluate how your QA is effecting you.

Apr 23, 2013 mum2westiesGill 502 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! Hi, I'm going to reduce my BI from 10u am & pm to 8u am & pm and see what happens for the next few days, also basing it on some of the fasting readings. I'm just a bit worried about seeing all the red numbers in there during the day, but obviously we have to deal with one thing at a time.

Apr 22, 2013 Apollo 45 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! You are consistently dropping over night when you have only BI in your system or when you do take QA the cp intake is drasticly higher so you should have been much higher by morning if your BI was spot on. Both I and vickyp agreed you should have lowered your BI based on your fasting test in the last batch of test data so I really can't understand why you are even contemplating increasing it. Increasing it will harm your control and increase your chance of hypos, you need to drop it down to 8 not increase it. Your corrections are also still too high. Really I'm just telling you the same the things I told you last time so please reread what I said then. If you think I'm wrong then talk to your diabetic care team as I'm quite sure they are going to tell you the same thing and until you take that on board your not going to have the control you want.

Apr 22, 2013 mum2westiesGill 502 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! Hi, Thank you to everyone who comments on my BG diary and although I may not always reply straight away I do always read through & take all comments on board. Please can I have comments for the last 7 days Tue 16/04/2013 - Mon 22/04/2013 I was wondering whether I might increase my BI from 10u am & pm to 12u am & pm. I like to have a 50/50 split if I can. The last time I made adjustments/tweaked my BI was March 9th