Recent Posts - DAFNE Online

Apr 26, 2013

ladybirdov6 6 posts

Topic: General Discussion / DAFNE Returner

Just come back after 6 month break. Has anyone elses had bad reaction to background insulin? Were they told begining symptoms 'were due to age' ? Looking forward to hearing from anyone. Ladybird.

Apr 25, 2013

SA2010 69 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

Just a comment on Alan's note re what DAFNE says. It is my belief that DAFNE says what it says because they want it to be simple for the masses. So everything rounded in whole numbers and all ratios in half unit ratios. I decided not to accept this advice because I can and because I believe I am very sensitive to Insulin. I add numbers with decimal points for the Carbs and I go overboard perhaps and instead of rounding the total, I work out from my QA:CP ratio for that meal what would the CP number have to be so that no rounding occurs and I top up meal by a few grams of a biscuit or a wafer or half a mini flapjack, Over the top you would say but there are so many factors that affect BG that I want to eliminate as much as I can.

I actually go a step further and have QA:CP ratios with decimal point fractions - so I am on 1.3:1 for QA:CP for breakfast, 0.7:1 for lunch and 0.8:1 for dinner. And I switched to a QA pen with half units !

Goes against DAFNE but that was the system I had in place before I was put on DAFNE and after 9 months of adhering to the DAFNE advice I went back to my system.

I only approximate and round when I eat out and probably over 50% of the time my BGs are wrong afterwards

What does it mean ? I use a calculator all the time when I eat at home. I weight food. I read all labels and complain to tyhe store when they do not have the nutrition data, Well in a few years time they will be forced to have it on all packaged food.

Apr 25, 2013

SA2010 69 posts

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

Hi

Just noticed that you are still having lows. I have not been online for a while. I recall saying that you had to be more aggressive in reducing your BI.

I am on split BI as well similar to you in timing. mine is 11am and 11pm. First I got the overnight level right and then started to look at the morning one. Basically I found that the BI at 11am and the QA with lunch at about 1:00pm-2:00pm start to work together and about 5-7 hours after 11am there are risks of low BGs. Despite what people say, I think lantus peaks at about 7 hours. and what that coincides with 3 hours after QA then there would be risk of low BG/Hypo if the doses are high. My 11am BI dose is now 3 units and 11pm at 6 units. I started in 2010 on about 18 units a day of BI.

Because of interaction of fresh BI coming in the morning and QA for lunch, my lunch QA:CP ratio is lowest and I see that 0.5 u/1 CP has been suggested to you.

Points to note: bedtime: you had a time when you did not do anything with BG below 6 at bedtime. I try to get mine close 8 at bedtime. Need to have half a toast probably if BG between 5 and 6 at bedtime.

As advised, do reduce your morning BI dose - wait 3 days before making another change - if you can. Lantus takes a while to settle down. I think you are on lantus.

Remember the meters are not very accurate - in fact repeating a test may give a different reading. I find different hands give different results - 1-2 mmols ! So for that reason I treat 4.0 and 3.8 and 3.5 all the same - as hypos.

Hope this is not confusing.

For driving it has to be 5.0 or above. There is some news coming about driving and BG testing rules. I passed the info to the admin team.

Apr 25, 2013

Warwick 434 posts

Topic: Questions ? / Lantus to Levimer

Thanks NuMo and Apollo. It ain't that sunny in Melbourne right now :-( I am actually finding that I am having to up my BI to cope with the season change right now.

Interesting idea Apollo. Insulin prescriptions give about a 6-month supply here in Australia, but I could ask my GP about a 2-month supply of Levemir and go back to Lantus if it doesn't work for me. The idea of mixing BI insulins is one that I hadn't considered. I have my 12-month DAFNE review on Thursday. I'll mention it to my DAFNE diabetes educator and get her opinion on that.

Thanks,
Warwick.

Apr 25, 2013

Apollo 45 posts

Topic: Questions ? / Lantus to Levimer

I switched the other way from Levimir to Lantus but only because I didn't want to be taking two shots of background each day. I never really found it to be unstable, the results were quite predictable just didn't last long enough on a single shot.

I don't know how prescriptions etc work in Aus, over here before I switched the diabetic unit gave me a single cartridge of Lantus (which was enough to last me almost 2 weeks) and said have a play and see how it works for you, could you do the same?

or could use your Lantus only for mid week and then on the weekends still take your lantus but top it up a bit with some levimir? That way you get the boost to your BI that you need on the weekends and everything is back to normal again come Monday.

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 ? / 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 434 posts

Topic: Questions ? / 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 ? / 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 1,818 posts

Topic: Questions ? / 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 434 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 ? / 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 26, 2013 ladybirdov6 6 posts	Topic: General Discussion / DAFNE Returner Just come back after 6 month break. Has anyone elses had bad reaction to background insulin? Were they told begining symptoms 'were due to age' ? Looking forward to hearing from anyone. Ladybird.

Apr 25, 2013 SA2010 69 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging Just a comment on Alan's note re what DAFNE says. It is my belief that DAFNE says what it says because they want it to be simple for the masses. So everything rounded in whole numbers and all ratios in half unit ratios. I decided not to accept this advice because I can and because I believe I am very sensitive to Insulin. I add numbers with decimal points for the Carbs and I go overboard perhaps and instead of rounding the total, I work out from my QA:CP ratio for that meal what would the CP number have to be so that no rounding occurs and I top up meal by a few grams of a biscuit or a wafer or half a mini flapjack, Over the top you would say but there are so many factors that affect BG that I want to eliminate as much as I can. I actually go a step further and have QA:CP ratios with decimal point fractions - so I am on 1.3:1 for QA:CP for breakfast, 0.7:1 for lunch and 0.8:1 for dinner. And I switched to a QA pen with half units ! Goes against DAFNE but that was the system I had in place before I was put on DAFNE and after 9 months of adhering to the DAFNE advice I went back to my system. I only approximate and round when I eat out and probably over 50% of the time my BGs are wrong afterwards What does it mean ? I use a calculator all the time when I eat at home. I weight food. I read all labels and complain to tyhe store when they do not have the nutrition data, Well in a few years time they will be forced to have it on all packaged food.

Apr 25, 2013 SA2010 69 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! Hi Just noticed that you are still having lows. I have not been online for a while. I recall saying that you had to be more aggressive in reducing your BI. I am on split BI as well similar to you in timing. mine is 11am and 11pm. First I got the overnight level right and then started to look at the morning one. Basically I found that the BI at 11am and the QA with lunch at about 1:00pm-2:00pm start to work together and about 5-7 hours after 11am there are risks of low BGs. Despite what people say, I think lantus peaks at about 7 hours. and what that coincides with 3 hours after QA then there would be risk of low BG/Hypo if the doses are high. My 11am BI dose is now 3 units and 11pm at 6 units. I started in 2010 on about 18 units a day of BI. Because of interaction of fresh BI coming in the morning and QA for lunch, my lunch QA:CP ratio is lowest and I see that 0.5 u/1 CP has been suggested to you. Points to note: bedtime: you had a time when you did not do anything with BG below 6 at bedtime. I try to get mine close 8 at bedtime. Need to have half a toast probably if BG between 5 and 6 at bedtime. As advised, do reduce your morning BI dose - wait 3 days before making another change - if you can. Lantus takes a while to settle down. I think you are on lantus. Remember the meters are not very accurate - in fact repeating a test may give a different reading. I find different hands give different results - 1-2 mmols ! So for that reason I treat 4.0 and 3.8 and 3.5 all the same - as hypos. Hope this is not confusing. For driving it has to be 5.0 or above. There is some news coming about driving and BG testing rules. I passed the info to the admin team.

Apr 25, 2013 Warwick 434 posts	Topic: Questions ? / Lantus to Levimer Thanks NuMo and Apollo. It ain't that sunny in Melbourne right now :-( I am actually finding that I am having to up my BI to cope with the season change right now. Interesting idea Apollo. Insulin prescriptions give about a 6-month supply here in Australia, but I could ask my GP about a 2-month supply of Levemir and go back to Lantus if it doesn't work for me. The idea of mixing BI insulins is one that I hadn't considered. I have my 12-month DAFNE review on Thursday. I'll mention it to my DAFNE diabetes educator and get her opinion on that. Thanks, Warwick.

Apr 25, 2013 Apollo 45 posts	Topic: Questions ? / Lantus to Levimer I switched the other way from Levimir to Lantus but only because I didn't want to be taking two shots of background each day. I never really found it to be unstable, the results were quite predictable just didn't last long enough on a single shot. I don't know how prescriptions etc work in Aus, over here before I switched the diabetic unit gave me a single cartridge of Lantus (which was enough to last me almost 2 weeks) and said have a play and see how it works for you, could you do the same? or could use your Lantus only for mid week and then on the weekends still take your lantus but top it up a bit with some levimir? That way you get the boost to your BI that you need on the weekends and everything is back to normal again come Monday.

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 ? / 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 434 posts	Topic: Questions ? / 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 ? / 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 1,818 posts	Topic: Questions ? / 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 434 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 ? / 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.