Recent Posts - DAFNE Online

Apr 17, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / novo-rapid insulin duration

Obviously these meters, and all the insulin pumps that provide on board insulin calculations, require an initial set up where you input the duration of your bolus/QA insulin......so they are real world tools in that sense, they are used and with a high reliability......have a look online at these meters.....you could probably get one free to try out...... Wink

You would need to work out the insulin duration for each individual by testing, but I personally was put on a 4 hour duration when beginning with the pump, I have now increased that to 4:30 hours.....

its pretty reliable, but as I mentioned before, if the carb count is correct and the duration has been fine tuned, you shouldn't ever need to give additional correction when eating in between the usual meal times....

Apr 17, 2013

Apollo 45 posts

Topic: Site Development / Figure 17

Sorry Marke,

No offense meant, a really good friend of mine is an Aussie and we often make light hearted digs at eachothers expense so it was intended as friendly banter rather than an offensive remark. I take the point that its not always easy to tell the difference between sarcastic humour and abuse with a text based forum though so I'll be sure to be more mindful of it in the future.

If it's any consolation I have been beaten into accepting that the fruit from a pepper plant is called a capsicum rather than a pepper ;)

Apr 17, 2013

marke 681 posts

Topic: Site Development / Figure 17

Hi, can we avoid stuff like the last post please or I will just delete offending posts. This is a diabetes website not a bash other users website. Last time I walked down an english high street at night, there were plenty of people with a strange approach to class and sophistication Sad

Apr 17, 2013

Apollo 45 posts

Topic: Questions for HCPs / novo-rapid insulin duration

Interesting, I didn't know that there were meters that did that, I'd personally take what they say with a little suspicion though as the real world data compared to the graph I posted is roughly similar but no where near as smooth and perfectly predictable. It's the kind of feature I'd expect to come with a massive disclaimer and be more intended as a gimmicky little feature than real world tool.

If in doubt (especially when operating a car, bike or bus) always safer to run high. I imaginr it was hard getting the ok to drive a bus as it is so you don't want to be giving anyone any reason to want to revoke your license by start hypoing

Apr 17, 2013

Apollo 45 posts

Topic: Site Development / Figure 17

Aussies think a lot of odd things, for example drinking Stella is considered a sign of class and sophistication rather than domestic violance.

Apr 17, 2013

novorapidboi26 1,819 posts

Topic: Site Development / Insulins

great idea....... Wink

Apr 17, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / novo-rapid insulin duration

Great explanation by travler there.......

If you do have to eat within the 4 - 5 hours you would simply take insulin for the meal without considering a correction, so you don't really need to test your blood sugar at this intermediate meal/snack....

however, there are now several meters on the market: Accu Check combo, InsulinX, which have a bolus wizard and on board insulin calculator on them.......these can tell you how much insulin is actually left in your system and whether or not you need some correction or not......

provided your carb count is correct and the insulin action is behaving as you would expect, there will never be a need to correct mid meal, as the wizard should work out that the correction you need for the 'mid meal' snack is in fact what is left in your system at that time......

Apr 17, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

Tue 16/04
8.9 - bedtime
3.6 - this morning

- 18.11pm - tea & QA
- 22.41pm - bedtime test was done
- treated this mornings hypo with 4 jelly babies then 15 mins later BS was 5.0

Wed 17/04
14.5 - bedtime
10.2 - this morning

- 18.58pm - tea & QA
- 22.42pm - bedtime test was done

Apr 17, 2013

Gari 17 posts

Topic: General Discussion / Dealing with large carb meals

Thanks you one I like your way of thinking. I think I will try this today at lunch I will report back and let you know how it goes. Fingers crossed for me.

Apr 17, 2013

Gari 17 posts

Topic: General Discussion / Dealing with large carb meals

Hi travler
My normal time is just before I start eating my meal. The kind of meals include all takeaways and any meal with some carbs e.g bout 8 to 10 cp's plus dessert of maybe 5 to 7 cp's. I take novo rapid and a single dose of lantus.

Apr 17, 2013

Warwick 423 posts

Topic: General Discussion / Dealing with large carb meals

I can't take more than 8 units of QA at a time without hypoing, so I also split my doses for very high carb meals. I usually test 2 hours after the first injection and correct any high value at that time to take my BGLs down to 8.0. That gives me a bit of leeway with the QA already on board.

I find I also need to do this with slow-release foods like beans, chick peas and lentils. It feels a bit odd injecting QA when my BGLS are in the 5s before bed after a Nachos dinner, but I forgot to do this correction a couple of nights ago and had BGLs of 12.5 before breakfast after going to bed with BGLs of 5.8. The times that I have remembered, I've been fine overnight and woken with normal range BGLs.

Apr 17, 2013

Warwick 423 posts

Topic: General Discussion / Increased blood glucose after exercise

Anaerobic exercise happens at high intensity, so if your cycling was at high intensity both ways, then that would be anaerobic, but if it is the sort of cycling that you could whistle a tune while riding, then it will be very aerobic instead.

I cycle to and from work each week day, (an hour each way, gradual uphill on the way to work, nice and downhill on the way home) and my BGLs follow the pattern of aerobic activity. It is fairly rare that I cycle with intensity - having a newborn in the house means I am too sleep-deprived to feel energetic enough :-) I never hypo on the way to work because it is within a couple of hours after breakfast and I have both carbs and QA on board, but I do have to be careful in the hours afterwards until lunchtime. Going home, I have to eat before cycling or I will with 100% certainty hypo. I could lower BI, but it tends to lead to highs at other times, so I don't.

I'd suggest that you don't take additional QA unless you see a definite pattern of highs after cycling. If you do, then you can cautiously increase your QA before cycling, but one-off rises in BGLs do happen, especially with new activities so you may not see that again.

Take care,
Warwick.

Apr 16, 2013

Apollo 45 posts

Topic: Questions for HCPs / novo-rapid insulin duration

Hi Paul,

just another bumbling graduate rather than a HCP here but I think it's pretty hard to give set guidelines on how much of your insulin is spent and how much is still working. as a VERY rough guide there is the graph in the DAFNE handbook which I suspect you have seen already as some of what you said is almost a direct quote from it.

As a rough guide though you can see by hour 3 there is very little life left in it and by hour 4 you can almost assume it's all gone as a general rule. There are however a number of factors that can change how quickly the insulin will work, some are down to your physiology, some are environmental so that can only ever be taken as a rough guide and certain not something to do precision maths with to keep you just above 4mmols

Personally I try to keep 4 hours between meals but if I had a late breakfast and can't push back lunch so there has only been 2 hours between the meals and I test and find I'm high, I choose to trust that I gave enough insulin earlier and it will bring me back down given time to finish working and take only the insulin that my lunch dictates (i.e. no correction)

If I were you then should I find myself eating again less than 4 hours after my last shot I'd test, eat & inject without correction for any highs (obviously correct if there is a low) and then test again in 4-5 hours time and correct if required then. Also should you find yourself a bit close to the 4 mark the quickest way to get your levels up is with a sugary liquid, personally I go with a can of coke which I find hits the blood in under 5 mins.

Not sure that's quite the advice you were looking for but I think there are probably a few to many unknowns to do exactly what you hoped to do, that said after a few months you may find you get a better understanding of how you personally react to the insulins you use and you may be able to refine things slightly better.

Another thing that may be worth while to you is a continuous glucose monitor, which is a test meter you leave attached to you and tests every few minutes. Most have the option to then alert you if you're going low so you can prevent yourself going under 4mmols. I'm not sure if these are available on the NHS or not though so there may need to be an element of self funding on your part if this was something you wanted to look into. certainly asking you diabetic healthcare team what your options are with it though, they do tend to be expensive though.

Apr 16, 2013

Apollo 45 posts

Topic: Site Development / Insulins

I'm on a motorbike forum and we have it set up so that we can put what bikes we have under our user name in forum posts. This is useful as if someone starts saying "on my bike I..." you know without them needing to point it out what kind of bike out is and how better to advise them or how their experience relates to what you were asking about.

As such I wondered if we could set it up so that we could list what insulins we are on in the same way?

Or as a signature file. In fact a signature file would be brilliant to as every time I give someone an opinion I find myself wishing I could turn on a signature that said something like "I'm guessing here as much as you are if it makes sense then take the advice at your own risk, if it doesn't then talk to a medical professional"

Apr 16, 2013

Apollo 45 posts

Topic: General Discussion / Dealing with large carb meals

When is your normal time?

I know some take it before the meal, while others like myself prefer after so they have a better idea of how much carbs they have consumed. If your in the former group then taking the shot after would mean that your BG levels would already be slightly elevated which may help counter the fact that the sugars are being released more slowly.

Can you give some examples of the kinds of meals you experience this with? Also what insulins are you on? If your BI is levemir is it split?

As the release of sugars 4 hours after meal sounds to be very slow and this most often occurs with your evening meal have you considered putting one or two extra units of your BI in to deal with it as the slow release pattern seems to better match the sugar release profile you mention and I'm wondering if the large meal is actually having an impact on your metabolism and what your experiencing is actually fat being burned to BG rather than carbs. ÃŒ know when I have a hot curry that I have to put in a few extra units than the carbs there would typically suggest. If it is metabolism in your case then a great way to slow it down is alcohol...

Apr 16, 2013

youone 102 posts

Topic: General Discussion / Dealing with large carb meals

Hi
This is the issue I've tried to understand and control like yourself over the years I've tackled it in different ways until I settled on an option similar to what Dafne teaches us.
The method which I use is based on my experience over the 40 years i,'be been type 1,
I guessed that it wasn't the amount of CP's I was taking it was the amount of insulin QA, I had no knowledge of Dafne or their principal's, but I took an educated guess that my body couldn't use the amounts of insulin I was taking in response to large meals of CP's.
In response to this I set a limit of 10 units of QA maximum I would inject at a time.
Hence a very large meal of 240 carbohydrates this was the way I controlled by condition before Dafne. My QA would be split into 3, 10 before meal 10 after the meal usually 2 hours then after 4 hours I would do a BG and do a correction, I use the word correction because of Dafne, I responded to the BG test, if it was OK I didn't inject if it was high I did.
I found this method of drip feeding small amounts of QA worked or in other words my body could cope with the amounts of QA and was able to use it, I may have been just lucky that the amount I settled on 10 was right for me, where all different,
Now with Dafne I use a lower number since I know now that 1 unit of QA will bring down my BG by 2 to 3
So for example if I had 18 CP's
Soon as I have ordered I would take 6 QA if my ratio was 1:1
Two hours later I would take or when the meal had finished after a test 6 more QA
Finally 4 hours after again re a BG reading I would correct
Most occursions I would have to take the full 6, but I find the drip method gives me least chance of overkill and going into a hypo spiral.
This method only differs from ture Dafne to the point where you inject before you eat but we all carry something for low BG and if the group or party your with know your a type1 it shouldn't be an issue,since I've sometimes taken a CP while waiting for the meal to come.
I don't think there's an ideal way in tackling really high CP meals since I believe your body can only use so much QA at a time.
Saturation occurs and like a flood you may experience a hypo later on. I'm not an expert and may be totally incorrect, but it worked for me
Like you I'm very interested in other members views and methods to control large CP meals
I look at it like this, we all eat about 20+ CP's a day you control this by taking your QA to match your CP intake at a meal usually 3 meals
By doing this when taking similar amounts of CP's at once, by splitting your QA by 3 over a period you give your body a chance to use it correctly.

Apr 16, 2013

Gari 17 posts

Topic: General Discussion / Increased blood glucose after exercise

Hi Warrick i went for a 30 minute cycle in to london and then walked round for about 30 mins then cycled back again about 30 minutes. I was hovering around 4.5 for a few hours after. I gave a 40% reduction for my dinner and had a hypo. So i suppose w
Your theory about eating extra carbs for aerobic exercise is right. What i worry about is finding the right balance of knowong when i am doing aerobic or anaerobic this could e a fine line. So the taking of QA before exercise sounds a little scary incase when i start it turns out that it will be aerobic. Any thoughts

Apr 16, 2013

Gari 17 posts

Topic: General Discussion / Dealing with large carb meals

Hi all.
I seem to be generally well controlled with my blood glucose levels. Except when it comes to eating very large carb meals. I have a huge appetite. Generally my meals are never huge in carbs probably no more than 10cp's worth. But when i seem to approach the 15cp size meal or over i do seem to have trouble. This is especially an issue if i want to have a dessert. (Which is not that often). I know that high fat and carb meals can take longer to process, and have been advised to split my QA dose e.g take half the dose at normal time and half 1 hour later. Having attempt this on a few occasions and had hypos, i have tried taking the first half of the dose and then kept an eye on my blood glucose levels. What i have noticed is that it isn't until the first QA dose has worn off e.g 4 hours that my blood glucose seems to then rise and therefore need the rest of the dose. So obviously this is an issue if it is an evening meal. Also if i give the full second dose just as my levels start to rise that also seems to send me into hypo. If i don't give the second dose i wake up with the very high levels that obviously needed the second dose of QA.
Has anyone had any issues with large carb and fat meals, and have any advice on how to manage. This is also a major issue when eating out with friends.

Apr 16, 2013

paulj 36 posts

Topic: Questions for HCPs / novo-rapid insulin duration

by my understanding the above quick-acting insulin has onset period of less than 15 minutes. a peak between 50 and 90 minutes and a duration of up to 5 hours. not trying to be to technical is it known in percentage terms how this time period is broken down ie how much insulin is still to be used after a meal which was consumed say 4 hours ago and 10 units of the above insulin was used in total? why i ask is that as a bus driver i work various shift patterns and on some occassions will have another meal break within the total effective period of this insulin which in turn would i suspect have a bearing on my next insulin dosage to combat my next meal/snack.obviously if i take to much and go to low i.e below 4mll i would be unable to drive.iam curious if anyone could shed any light on this matter or whether i am looking to deeply into the above.any thoughts would be much appreciated

cheers paulj Very Happy

Apr 16, 2013

hollylouise 7 posts

Topic: General Discussion / feeling unnormal

I dont care now because at the end of the day thatbisnkeeping me alive so if people wont to be narrow minded then let them after going into a coma andnmy parents being told to ring faimlynand freinds to come up and say their last goodbyes was a reall eye opener im me I think diabitse has made me the person I am todaynive had it since I was 5 yearsnold andnim now 19 going to be 20 in october asni said at the end of the daynim taking my insulin to keep me alive so if you dont like it dontnlook why shouldni hide away if people wont to be so dam rude

Apr 16, 2013

Apollo 45 posts

Topic: General Discussion / feeling unnormal

bit late to the party but incase anyone else is reading over this here is my two cents.

When I was diagnosed I felt like I was defective and it was something to be ashamed of, I didn't want to eat out or have anyone see me taking a blood glucose reading let alone a shot. When I did go to eat out some months later I went to a restaurant run by a family friend largely because it meant I could use their office to take the shot.

As has been said the longer you have had it the more you get used to it and the less you care. It's something a lot of people don't really understand so they see you taking a shot and they wonder if your doing drugs. My way of dealing with it is now rather than trying to shy away and be embarrassed about it I try to be as open as I can. I do try to be discrete but I won't suspiciously slink away to a secluded corner. Then every so often I'll make a bit of a show of it, for example I was in the comedy store a while back, the show had ended & most people were leaving. It's a very narrow exit and my date had decided to use the toilet while the crowds cleared. I then realised I'd not taken a shot for the meal I'd had before the show so I preped a shot up. I saw some of the people in the crowd giving me odd looks but rather than hide away I carried on and as I started to inject the insulin allowed this euphoric look to appear on my face and then gave them the old "crazy eyes" smile Cool

You do have off days though and sometimes it may not even be diabetes that is the reason. You may be upset with a loved one, work may be getting you down or what ever else but then you have to go take a shot and it will be the straw that breaks the camels back and an easy one to vent on because there is no fix, there is no reason it's just something you have to manage. But by getting upset about that is saves you having to deal with the other things that are bothering you that maybe you can fix but just don't feel like dealing with.

Apr 17, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / novo-rapid insulin duration Obviously these meters, and all the insulin pumps that provide on board insulin calculations, require an initial set up where you input the duration of your bolus/QA insulin......so they are real world tools in that sense, they are used and with a high reliability......have a look online at these meters.....you could probably get one free to try out...... You would need to work out the insulin duration for each individual by testing, but I personally was put on a 4 hour duration when beginning with the pump, I have now increased that to 4:30 hours..... its pretty reliable, but as I mentioned before, if the carb count is correct and the duration has been fine tuned, you shouldn't ever need to give additional correction when eating in between the usual meal times....

Apr 17, 2013 Apollo 45 posts	Topic: Site Development / Figure 17 Sorry Marke, No offense meant, a really good friend of mine is an Aussie and we often make light hearted digs at eachothers expense so it was intended as friendly banter rather than an offensive remark. I take the point that its not always easy to tell the difference between sarcastic humour and abuse with a text based forum though so I'll be sure to be more mindful of it in the future. If it's any consolation I have been beaten into accepting that the fruit from a pepper plant is called a capsicum rather than a pepper ;)

Apr 17, 2013 marke 681 posts	Topic: Site Development / Figure 17 Hi, can we avoid stuff like the last post please or I will just delete offending posts. This is a diabetes website not a bash other users website. Last time I walked down an english high street at night, there were plenty of people with a strange approach to class and sophistication

Apr 17, 2013 Apollo 45 posts	Topic: Questions for HCPs / novo-rapid insulin duration Interesting, I didn't know that there were meters that did that, I'd personally take what they say with a little suspicion though as the real world data compared to the graph I posted is roughly similar but no where near as smooth and perfectly predictable. It's the kind of feature I'd expect to come with a massive disclaimer and be more intended as a gimmicky little feature than real world tool. If in doubt (especially when operating a car, bike or bus) always safer to run high. I imaginr it was hard getting the ok to drive a bus as it is so you don't want to be giving anyone any reason to want to revoke your license by start hypoing

Apr 17, 2013 Apollo 45 posts	Topic: Site Development / Figure 17 Aussies think a lot of odd things, for example drinking Stella is considered a sign of class and sophistication rather than domestic violance.

Apr 17, 2013 novorapidboi26 1,819 posts	Topic: Site Development / Insulins great idea.......

Apr 17, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / novo-rapid insulin duration Great explanation by travler there....... If you do have to eat within the 4 - 5 hours you would simply take insulin for the meal without considering a correction, so you don't really need to test your blood sugar at this intermediate meal/snack.... however, there are now several meters on the market: Accu Check combo, InsulinX, which have a bolus wizard and on board insulin calculator on them.......these can tell you how much insulin is actually left in your system and whether or not you need some correction or not...... provided your carb count is correct and the insulin action is behaving as you would expect, there will never be a need to correct mid meal, as the wizard should work out that the correction you need for the 'mid meal' snack is in fact what is left in your system at that time......

Apr 17, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average Tue 16/04 8.9 - bedtime 3.6 - this morning - 18.11pm - tea & QA - 22.41pm - bedtime test was done - treated this mornings hypo with 4 jelly babies then 15 mins later BS was 5.0 Wed 17/04 14.5 - bedtime 10.2 - this morning - 18.58pm - tea & QA - 22.42pm - bedtime test was done

Apr 17, 2013 Gari 17 posts	Topic: General Discussion / Dealing with large carb meals Thanks you one I like your way of thinking. I think I will try this today at lunch I will report back and let you know how it goes. Fingers crossed for me.

Apr 17, 2013 Gari 17 posts	Topic: General Discussion / Dealing with large carb meals Hi travler My normal time is just before I start eating my meal. The kind of meals include all takeaways and any meal with some carbs e.g bout 8 to 10 cp's plus dessert of maybe 5 to 7 cp's. I take novo rapid and a single dose of lantus.

Apr 17, 2013 Warwick 423 posts	Topic: General Discussion / Dealing with large carb meals I can't take more than 8 units of QA at a time without hypoing, so I also split my doses for very high carb meals. I usually test 2 hours after the first injection and correct any high value at that time to take my BGLs down to 8.0. That gives me a bit of leeway with the QA already on board. I find I also need to do this with slow-release foods like beans, chick peas and lentils. It feels a bit odd injecting QA when my BGLS are in the 5s before bed after a Nachos dinner, but I forgot to do this correction a couple of nights ago and had BGLs of 12.5 before breakfast after going to bed with BGLs of 5.8. The times that I have remembered, I've been fine overnight and woken with normal range BGLs.

Apr 17, 2013 Warwick 423 posts	Topic: General Discussion / Increased blood glucose after exercise Anaerobic exercise happens at high intensity, so if your cycling was at high intensity both ways, then that would be anaerobic, but if it is the sort of cycling that you could whistle a tune while riding, then it will be very aerobic instead. I cycle to and from work each week day, (an hour each way, gradual uphill on the way to work, nice and downhill on the way home) and my BGLs follow the pattern of aerobic activity. It is fairly rare that I cycle with intensity - having a newborn in the house means I am too sleep-deprived to feel energetic enough :-) I never hypo on the way to work because it is within a couple of hours after breakfast and I have both carbs and QA on board, but I do have to be careful in the hours afterwards until lunchtime. Going home, I have to eat before cycling or I will with 100% certainty hypo. I could lower BI, but it tends to lead to highs at other times, so I don't. I'd suggest that you don't take additional QA unless you see a definite pattern of highs after cycling. If you do, then you can cautiously increase your QA before cycling, but one-off rises in BGLs do happen, especially with new activities so you may not see that again. Take care, Warwick.

Apr 16, 2013 Apollo 45 posts	Topic: Questions for HCPs / novo-rapid insulin duration Hi Paul, just another bumbling graduate rather than a HCP here but I think it's pretty hard to give set guidelines on how much of your insulin is spent and how much is still working. as a VERY rough guide there is the graph in the DAFNE handbook which I suspect you have seen already as some of what you said is almost a direct quote from it. As a rough guide though you can see by hour 3 there is very little life left in it and by hour 4 you can almost assume it's all gone as a general rule. There are however a number of factors that can change how quickly the insulin will work, some are down to your physiology, some are environmental so that can only ever be taken as a rough guide and certain not something to do precision maths with to keep you just above 4mmols Personally I try to keep 4 hours between meals but if I had a late breakfast and can't push back lunch so there has only been 2 hours between the meals and I test and find I'm high, I choose to trust that I gave enough insulin earlier and it will bring me back down given time to finish working and take only the insulin that my lunch dictates (i.e. no correction) If I were you then should I find myself eating again less than 4 hours after my last shot I'd test, eat & inject without correction for any highs (obviously correct if there is a low) and then test again in 4-5 hours time and correct if required then. Also should you find yourself a bit close to the 4 mark the quickest way to get your levels up is with a sugary liquid, personally I go with a can of coke which I find hits the blood in under 5 mins. Not sure that's quite the advice you were looking for but I think there are probably a few to many unknowns to do exactly what you hoped to do, that said after a few months you may find you get a better understanding of how you personally react to the insulins you use and you may be able to refine things slightly better. Another thing that may be worth while to you is a continuous glucose monitor, which is a test meter you leave attached to you and tests every few minutes. Most have the option to then alert you if you're going low so you can prevent yourself going under 4mmols. I'm not sure if these are available on the NHS or not though so there may need to be an element of self funding on your part if this was something you wanted to look into. certainly asking you diabetic healthcare team what your options are with it though, they do tend to be expensive though.

Apr 16, 2013 Apollo 45 posts	Topic: Site Development / Insulins I'm on a motorbike forum and we have it set up so that we can put what bikes we have under our user name in forum posts. This is useful as if someone starts saying "on my bike I..." you know without them needing to point it out what kind of bike out is and how better to advise them or how their experience relates to what you were asking about. As such I wondered if we could set it up so that we could list what insulins we are on in the same way? Or as a signature file. In fact a signature file would be brilliant to as every time I give someone an opinion I find myself wishing I could turn on a signature that said something like "I'm guessing here as much as you are if it makes sense then take the advice at your own risk, if it doesn't then talk to a medical professional"

Apr 16, 2013 Apollo 45 posts	Topic: General Discussion / Dealing with large carb meals When is your normal time? I know some take it before the meal, while others like myself prefer after so they have a better idea of how much carbs they have consumed. If your in the former group then taking the shot after would mean that your BG levels would already be slightly elevated which may help counter the fact that the sugars are being released more slowly. Can you give some examples of the kinds of meals you experience this with? Also what insulins are you on? If your BI is levemir is it split? As the release of sugars 4 hours after meal sounds to be very slow and this most often occurs with your evening meal have you considered putting one or two extra units of your BI in to deal with it as the slow release pattern seems to better match the sugar release profile you mention and I'm wondering if the large meal is actually having an impact on your metabolism and what your experiencing is actually fat being burned to BG rather than carbs. ÃŒ know when I have a hot curry that I have to put in a few extra units than the carbs there would typically suggest. If it is metabolism in your case then a great way to slow it down is alcohol...

Apr 16, 2013 youone 102 posts	Topic: General Discussion / Dealing with large carb meals Hi This is the issue I've tried to understand and control like yourself over the years I've tackled it in different ways until I settled on an option similar to what Dafne teaches us. The method which I use is based on my experience over the 40 years i,'be been type 1, I guessed that it wasn't the amount of CP's I was taking it was the amount of insulin QA, I had no knowledge of Dafne or their principal's, but I took an educated guess that my body couldn't use the amounts of insulin I was taking in response to large meals of CP's. In response to this I set a limit of 10 units of QA maximum I would inject at a time. Hence a very large meal of 240 carbohydrates this was the way I controlled by condition before Dafne. My QA would be split into 3, 10 before meal 10 after the meal usually 2 hours then after 4 hours I would do a BG and do a correction, I use the word correction because of Dafne, I responded to the BG test, if it was OK I didn't inject if it was high I did. I found this method of drip feeding small amounts of QA worked or in other words my body could cope with the amounts of QA and was able to use it, I may have been just lucky that the amount I settled on 10 was right for me, where all different, Now with Dafne I use a lower number since I know now that 1 unit of QA will bring down my BG by 2 to 3 So for example if I had 18 CP's Soon as I have ordered I would take 6 QA if my ratio was 1:1 Two hours later I would take or when the meal had finished after a test 6 more QA Finally 4 hours after again re a BG reading I would correct Most occursions I would have to take the full 6, but I find the drip method gives me least chance of overkill and going into a hypo spiral. This method only differs from ture Dafne to the point where you inject before you eat but we all carry something for low BG and if the group or party your with know your a type1 it shouldn't be an issue,since I've sometimes taken a CP while waiting for the meal to come. I don't think there's an ideal way in tackling really high CP meals since I believe your body can only use so much QA at a time. Saturation occurs and like a flood you may experience a hypo later on. I'm not an expert and may be totally incorrect, but it worked for me Like you I'm very interested in other members views and methods to control large CP meals I look at it like this, we all eat about 20+ CP's a day you control this by taking your QA to match your CP intake at a meal usually 3 meals By doing this when taking similar amounts of CP's at once, by splitting your QA by 3 over a period you give your body a chance to use it correctly.

Apr 16, 2013 Gari 17 posts	Topic: General Discussion / Increased blood glucose after exercise Hi Warrick i went for a 30 minute cycle in to london and then walked round for about 30 mins then cycled back again about 30 minutes. I was hovering around 4.5 for a few hours after. I gave a 40% reduction for my dinner and had a hypo. So i suppose w Your theory about eating extra carbs for aerobic exercise is right. What i worry about is finding the right balance of knowong when i am doing aerobic or anaerobic this could e a fine line. So the taking of QA before exercise sounds a little scary incase when i start it turns out that it will be aerobic. Any thoughts

Apr 16, 2013 Gari 17 posts	Topic: General Discussion / Dealing with large carb meals Hi all. I seem to be generally well controlled with my blood glucose levels. Except when it comes to eating very large carb meals. I have a huge appetite. Generally my meals are never huge in carbs probably no more than 10cp's worth. But when i seem to approach the 15cp size meal or over i do seem to have trouble. This is especially an issue if i want to have a dessert. (Which is not that often). I know that high fat and carb meals can take longer to process, and have been advised to split my QA dose e.g take half the dose at normal time and half 1 hour later. Having attempt this on a few occasions and had hypos, i have tried taking the first half of the dose and then kept an eye on my blood glucose levels. What i have noticed is that it isn't until the first QA dose has worn off e.g 4 hours that my blood glucose seems to then rise and therefore need the rest of the dose. So obviously this is an issue if it is an evening meal. Also if i give the full second dose just as my levels start to rise that also seems to send me into hypo. If i don't give the second dose i wake up with the very high levels that obviously needed the second dose of QA. Has anyone had any issues with large carb and fat meals, and have any advice on how to manage. This is also a major issue when eating out with friends.

Apr 16, 2013 paulj 36 posts	Topic: Questions for HCPs / novo-rapid insulin duration by my understanding the above quick-acting insulin has onset period of less than 15 minutes. a peak between 50 and 90 minutes and a duration of up to 5 hours. not trying to be to technical is it known in percentage terms how this time period is broken down ie how much insulin is still to be used after a meal which was consumed say 4 hours ago and 10 units of the above insulin was used in total? why i ask is that as a bus driver i work various shift patterns and on some occassions will have another meal break within the total effective period of this insulin which in turn would i suspect have a bearing on my next insulin dosage to combat my next meal/snack.obviously if i take to much and go to low i.e below 4mll i would be unable to drive.iam curious if anyone could shed any light on this matter or whether i am looking to deeply into the above.any thoughts would be much appreciated cheers paulj

Apr 16, 2013 hollylouise 7 posts	Topic: General Discussion / feeling unnormal I dont care now because at the end of the day thatbisnkeeping me alive so if people wont to be narrow minded then let them after going into a coma andnmy parents being told to ring faimlynand freinds to come up and say their last goodbyes was a reall eye opener im me I think diabitse has made me the person I am todaynive had it since I was 5 yearsnold andnim now 19 going to be 20 in october asni said at the end of the daynim taking my insulin to keep me alive so if you dont like it dontnlook why shouldni hide away if people wont to be so dam rude

Apr 16, 2013 Apollo 45 posts	Topic: General Discussion / feeling unnormal bit late to the party but incase anyone else is reading over this here is my two cents. When I was diagnosed I felt like I was defective and it was something to be ashamed of, I didn't want to eat out or have anyone see me taking a blood glucose reading let alone a shot. When I did go to eat out some months later I went to a restaurant run by a family friend largely because it meant I could use their office to take the shot. As has been said the longer you have had it the more you get used to it and the less you care. It's something a lot of people don't really understand so they see you taking a shot and they wonder if your doing drugs. My way of dealing with it is now rather than trying to shy away and be embarrassed about it I try to be as open as I can. I do try to be discrete but I won't suspiciously slink away to a secluded corner. Then every so often I'll make a bit of a show of it, for example I was in the comedy store a while back, the show had ended & most people were leaving. It's a very narrow exit and my date had decided to use the toilet while the crowds cleared. I then realised I'd not taken a shot for the meal I'd had before the show so I preped a shot up. I saw some of the people in the crowd giving me odd looks but rather than hide away I carried on and as I started to inject the insulin allowed this euphoric look to appear on my face and then gave them the old "crazy eyes" smile You do have off days though and sometimes it may not even be diabetes that is the reason. You may be upset with a loved one, work may be getting you down or what ever else but then you have to go take a shot and it will be the straw that breaks the camels back and an easy one to vent on because there is no fix, there is no reason it's just something you have to manage. But by getting upset about that is saves you having to deal with the other things that are bothering you that maybe you can fix but just don't feel like dealing with.