Recent Posts - DAFNE Online

Feb 8, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Differing hBa1c results

I suppose its perfectly possible to have that kind of change within a 2 week period.........

Did you record noticeably lower readings in the 2 weeks prior to the latest test.....

The 8.6 may have been a finger blood test...who took that one after your operation...... Question

Feb 8, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

5.8 - bedtime
2.9 - this morning

Last 5 days 04/02 - 08/02

Mon 04/02
2.7

Tue 05/02
Bedtime - forgot to test
Am - 7.8

Wed 06/02
Bedtime - 9.3
Am - 7.4

Thur 07/02
Bedtime - 21.7
Am - 2.8

Fri 08/02
Bedtime - 5.8
Am - 2.9

Feb 8, 2013

DianeW 115 posts

Topic: General Discussion / Differing hBa1c results

When I had a blood test as a matter of routine on 11 January for an operation they told me it was 8.5 (69). I was pretty horrified as since DAFNE a year ago it has been coming down and it had been 7.6 before that.

Had another blood test on 30 January, so 2-3 wks later, and it was 7.6!!

Something doesn't seem right, but I tend to believe the latest result given my daily readings more than the one before. And also it can't be possible to improve that much in 2 weeks?!

Anyone any ideas please?

Feb 8, 2013

JayBee 587 posts

Topic: General Discussion / 7-day waking average

12.7 BG today. Caused by overnight hypo at 3am.
High waking BGs might be common for a while.. I seem to have Dawn based on my current problem discussion.

Great fun.

Feb 8, 2013

Carolin 83 posts

Topic: General Discussion / Lantus Questions

Hi all,

It's great that people are thinking about and actually trying out Background Insulin twice daily as this is how the whole DAFNE regimen was originally developed; it's only with the advent of these newer insulin like Lantus that health professionals have started to use once daily Background Insulin in DAFNE, which is sad in some ways because as some of you have rightly identified, it does potentially reduce flexibility and may not be apporpriate if you do lots of exercise.

The usual recommendation when you first start a split BI is to do it 50/50, so half your dose as you go to bed and the other half as you get up (need to be 7hrs apart); this does mean that the doses overlap during the morning but this is considered to be beneficial to help control the Dawn Phenomenon.

Then you need to follow the Step-Wise Approach to adjust your doses as required, addressing each BI dose independently, i.e. the morning dose to maintain stable BG through the day; the bedtime dose to maintain stable BG during the night. It is not uncommon to end up needing totally different levels night and morning - they won't always necessarily stay equal.

Carolin

Feb 8, 2013

Carolin 83 posts

Topic: Questions for HCPs / Until I start a DAFNE course

Vikz2006 said:
...I am not sure of my ratios though for QA I use Novorapid and beleive its 1 unit to reduce BG by 2 does that mean its a 1:2? Sorry thats the only bit I dont know about /quote]

Just to clarify, your ratio is the amount of QA you need to cover your CPs, so if you use 1u of Novorapid for each 1CP (10g) then that's a 1:1 ratio.

The additoinal QA you need to bring down high BG is just known as your correction (or correction factor), and 1u to bring you down 2mmol/l sounds relevant; we usually say 1u can bring you down by between 2-3mmol/l so you need to be cautious.

Carolin

Feb 8, 2013

JayBee 587 posts

Topic: Site Development / Figure 17

Oooo I wonder what the main differences are? :-. I thought we all worked from the same book!

Feb 8, 2013

vic demain 87 posts

Topic: General Discussion / Nottingham.

Seems the QMC is the place then. Thanks landylara for your help. Very Happy

Feb 7, 2013

Warwick 423 posts

Topic: General Discussion / Lantus Questions

I split my Lantus a couple of weeks ago and I'm finding the change much better. Previously I was going high between dinner and bed because Lantus had run out, but taking extra QA would give me a hypo. With a 13/13 split, I am finding that everything stays pretty stable.

I didn't get professional advice on how to do it. I just subtracted 3 in the evening and added 3 in the morning, until I had an even split. Had a few hypos along the way, so there are probably better methods as per above.

Cheers,
Warwick.

Feb 7, 2013

Warwick 423 posts

Topic: Site Development / Figure 17

Cool. Looks good. Thanks for that.

Feb 7, 2013

Warwick 423 posts

Topic: Questions for HCPs / Until I start a DAFNE course

Out of interest, how much insulin did you take for that? You will go crazy if you try and work out the carb values of all of that. As you will learn on DAFNE, there are a lot of foods that you just don't need to worry about because the carb value is so low, and I think all of those foods that you mentioned come under that heading. I'm not sure about corgettes or the peas.

In general calculate carb values for the "carb portion" of a meal like potatoes, pasta, rice, cous cous, quinoa, weet bix, muesli, bread, dairy products etc. Also, look for the carb content of sauces (sweet chilli sauce has heaps), pasta sauces etc. Desserts obviously. Vegetables tend not to have much, but pretty much all fruit does. Biscuits, chocolate, crisps etc also have a high carb content.

Legumes - lentils, chick peas, beans etc do contain carb but it is very slow release. I love these foods but I find them a nightmare to dose for. If I give the correct amount of insulin, I will hypo as these release carbs too slowly. If I give only enough not to hypo, then my BGs will slowly rise later on and I will become too high. I only have these now for breakfast and sometimes lunch so I can correct for them at later meal times. Having them at dinner time will lead me to have very high BGs overnight.

My fellow DAFNE graduates swear by this website:

http://www.calorieking.com.au/

It is for Australians, but some of the foods will be similar to the UK. There is bound to be something similar for the UK diabetic population. You can always type carbohydrate and the name of the food into Google and you will probably get an answer pretty quickly.

Good work, and I look forward to seeing your diary.

Cheers,
Warwick.

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Lantus Questions

After learning that MDI is only 50% effective, this may explain why Lantus may tend to put weight on people more than Levemir, because your are stuck with one dose of Lantus, which probably means you will be taking too much at some point in the day.............where as Levemir can deliver a more accurate dose as its split am and pm........

Just a theory thought, no real evidence.........

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / ma diary

Oh, sorry about that............have they seen the results........?

Testing your background is exactly as your team has said, carb free, that way the only thing that will be effecting the blood glucose is the background, allowing you to put it up or down according to whether your blood sugar goes up or down.......

best starting overnight, you will be sleeping, which makes carb free easy........no carbs after dinner, take a bed time blood sugar, dont correct, then set alarm for 3 am to take another blood sugar..........repeat that for a few nights to confirm the pattern,,,,,,,,,,,,,,,,,if you hold steady from bed till 3 amm your dose is right........

When did you graduate? and what hospital in lanarkshire you at..........?

Feb 7, 2013

Teanosugar 25 posts

Topic: General Discussion / Lantus Questions

I have been on Lantus for about six months; before this it was isophane for many years. I haven't noticed any weight increase or decrease since changing to Lantus. I only know that injecting way too much insulin makes people put weight on. I don't think it's insulin specific.

Feb 7, 2013

Joe Smith 4 posts

Topic: Questions for HCPs / ma diary

I appreciate your input, but I was trying to share the diary with the staff I was going to see on Wednesday. As you can probably tell, I don't know how to do that! Embarassed

They've told me to go carb free to try sort out my BI, which is proving difficult so far due to being a fussy eater and my BI levels are WAYYYY off! Mad

Feb 7, 2013

landylara 14 posts

Topic: Carbohydrate Counting / My Carb Guess Challenge!

I have a 1/2 unit pen so i would take 5.5 units Very Happy

Feb 7, 2013

landylara 14 posts

Topic: General Discussion / Nottingham.

Dr Gazis is also a DAFNE Dr at QMC campus. Excellent diabetes unit.

Feb 7, 2013

googs 6 posts

Topic: General Discussion / Diabulemia is becoming a growing problem

once again highlighting how important dafne is,The education it would bring to these ladies would be invaluable(exercise and insulin intake etc)Cant say how important dafne is no.more russian roulette and guessing,Spread the word folks...

Feb 7, 2013

marke 681 posts

Topic: Questions for HCPs / Until I start a DAFNE course

Hi, you can access everything except the online handbook, because we are not allowed to give access to this unless you are a graduate. If others give you advice that is outside of our control Wink

With regards to the online carb book , you can add your own entries and eventually they get verified and approved by Health Care Professionals. Again the 'verified' entries in the carb book come from the standard course carb book I'm afraid. If you want a bigger list of carb values there are books around usually aimed at people dieting however if the contain carb values then they are just as good. I have two at home but can't remember the names of them, will try to remember to dig them out and post the names and ISBN of them later.

Feb 7, 2013

marke 681 posts

Topic: Site Development / Figure 17

Gentlemen, thank you for spotting this. It was the Australian sick day rules that you were trying to access, however the image was not working. I have recently uploaded the 'new' Oz handbook and had not noticed that some of the images did not work. They are fixed now.
Novarapid boy the link that you should be looking at is http://dafneonline.co.uk/hbook_topics/188 these Australians have their own ideas
about DAFNE which are very similiar but not identical. I should probably block access to another countries handbook, once I work out a way of doing it of course Wink

Feb 7, 2013

BeccyB 50 posts

Topic: Carbohydrate Counting / Sandwich Wraps

Thanks for the tips - will check them out!

Feb 7, 2013

marke 681 posts

Topic: Carbohydrate Counting / Greggs baguette sandwiches

I have updated the link to Greggs on the carb links page in the carb counting section to reference the new PDF above. Please do add links to the links page as and when you find them

Feb 7, 2013

marke 681 posts

Topic: General Discussion / Diabulemia is becoming a growing problem

There is no definite answers to this I'm afraid. I know people who lost a lot of weight, people who lost no weight and people who put on weight. People often put on weight just after the course because their insulin is more effective by virtual of the fact its more accurate to what your body needs were before the course there was too much or too little. However once you get past that you then have the flexibility to eat less and exercise more with the tools to manage these things so in theory losing weight is easier. I say in theory because losing weight never seems that easy Very Happy

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / 7-day waking average

If you don't correct before bed I assume the cream puffs ere not counted......?

I thought your insulin for them contributed to the hypo....

If there was no QA insulin overnight, the low was your BI........

Feb 8, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Differing hBa1c results I suppose its perfectly possible to have that kind of change within a 2 week period......... Did you record noticeably lower readings in the 2 weeks prior to the latest test..... The 8.6 may have been a finger blood test...who took that one after your operation......

Feb 8, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average 5.8 - bedtime 2.9 - this morning Last 5 days 04/02 - 08/02 Mon 04/02 2.7 Tue 05/02 Bedtime - forgot to test Am - 7.8 Wed 06/02 Bedtime - 9.3 Am - 7.4 Thur 07/02 Bedtime - 21.7 Am - 2.8 Fri 08/02 Bedtime - 5.8 Am - 2.9

Feb 8, 2013 DianeW 115 posts	Topic: General Discussion / Differing hBa1c results When I had a blood test as a matter of routine on 11 January for an operation they told me it was 8.5 (69). I was pretty horrified as since DAFNE a year ago it has been coming down and it had been 7.6 before that. Had another blood test on 30 January, so 2-3 wks later, and it was 7.6!! Something doesn't seem right, but I tend to believe the latest result given my daily readings more than the one before. And also it can't be possible to improve that much in 2 weeks?! Anyone any ideas please?

Feb 8, 2013 JayBee 587 posts	Topic: General Discussion / 7-day waking average 12.7 BG today. Caused by overnight hypo at 3am. High waking BGs might be common for a while.. I seem to have Dawn based on my current problem discussion. Great fun.

Feb 8, 2013 Carolin 83 posts	Topic: General Discussion / Lantus Questions Hi all, It's great that people are thinking about and actually trying out Background Insulin twice daily as this is how the whole DAFNE regimen was originally developed; it's only with the advent of these newer insulin like Lantus that health professionals have started to use once daily Background Insulin in DAFNE, which is sad in some ways because as some of you have rightly identified, it does potentially reduce flexibility and may not be apporpriate if you do lots of exercise. The usual recommendation when you first start a split BI is to do it 50/50, so half your dose as you go to bed and the other half as you get up (need to be 7hrs apart); this does mean that the doses overlap during the morning but this is considered to be beneficial to help control the Dawn Phenomenon. Then you need to follow the Step-Wise Approach to adjust your doses as required, addressing each BI dose independently, i.e. the morning dose to maintain stable BG through the day; the bedtime dose to maintain stable BG during the night. It is not uncommon to end up needing totally different levels night and morning - they won't always necessarily stay equal. Carolin

Feb 8, 2013 Carolin 83 posts	Topic: Questions for HCPs / Until I start a DAFNE course Vikz2006 said: ...I am not sure of my ratios though for QA I use Novorapid and beleive its 1 unit to reduce BG by 2 does that mean its a 1:2? Sorry thats the only bit I dont know about /quote] Just to clarify, your ratio is the amount of QA you need to cover your CPs, so if you use 1u of Novorapid for each 1CP (10g) then that's a 1:1 ratio. The additoinal QA you need to bring down high BG is just known as your correction (or correction factor), and 1u to bring you down 2mmol/l sounds relevant; we usually say 1u can bring you down by between 2-3mmol/l so you need to be cautious. Carolin

Feb 8, 2013 JayBee 587 posts	Topic: Site Development / Figure 17 Oooo I wonder what the main differences are? :-. I thought we all worked from the same book!

Feb 8, 2013 vic demain 87 posts	Topic: General Discussion / Nottingham. Seems the QMC is the place then. Thanks landylara for your help.

Feb 7, 2013 Warwick 423 posts	Topic: General Discussion / Lantus Questions I split my Lantus a couple of weeks ago and I'm finding the change much better. Previously I was going high between dinner and bed because Lantus had run out, but taking extra QA would give me a hypo. With a 13/13 split, I am finding that everything stays pretty stable. I didn't get professional advice on how to do it. I just subtracted 3 in the evening and added 3 in the morning, until I had an even split. Had a few hypos along the way, so there are probably better methods as per above. Cheers, Warwick.

Feb 7, 2013 Warwick 423 posts	Topic: Site Development / Figure 17 Cool. Looks good. Thanks for that.

Feb 7, 2013 Warwick 423 posts	Topic: Questions for HCPs / Until I start a DAFNE course Out of interest, how much insulin did you take for that? You will go crazy if you try and work out the carb values of all of that. As you will learn on DAFNE, there are a lot of foods that you just don't need to worry about because the carb value is so low, and I think all of those foods that you mentioned come under that heading. I'm not sure about corgettes or the peas. In general calculate carb values for the "carb portion" of a meal like potatoes, pasta, rice, cous cous, quinoa, weet bix, muesli, bread, dairy products etc. Also, look for the carb content of sauces (sweet chilli sauce has heaps), pasta sauces etc. Desserts obviously. Vegetables tend not to have much, but pretty much all fruit does. Biscuits, chocolate, crisps etc also have a high carb content. Legumes - lentils, chick peas, beans etc do contain carb but it is very slow release. I love these foods but I find them a nightmare to dose for. If I give the correct amount of insulin, I will hypo as these release carbs too slowly. If I give only enough not to hypo, then my BGs will slowly rise later on and I will become too high. I only have these now for breakfast and sometimes lunch so I can correct for them at later meal times. Having them at dinner time will lead me to have very high BGs overnight. My fellow DAFNE graduates swear by this website: http://www.calorieking.com.au/ It is for Australians, but some of the foods will be similar to the UK. There is bound to be something similar for the UK diabetic population. You can always type carbohydrate and the name of the food into Google and you will probably get an answer pretty quickly. Good work, and I look forward to seeing your diary. Cheers, Warwick.

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Lantus Questions After learning that MDI is only 50% effective, this may explain why Lantus may tend to put weight on people more than Levemir, because your are stuck with one dose of Lantus, which probably means you will be taking too much at some point in the day.............where as Levemir can deliver a more accurate dose as its split am and pm........ Just a theory thought, no real evidence.........

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / ma diary Oh, sorry about that............have they seen the results........? Testing your background is exactly as your team has said, carb free, that way the only thing that will be effecting the blood glucose is the background, allowing you to put it up or down according to whether your blood sugar goes up or down....... best starting overnight, you will be sleeping, which makes carb free easy........no carbs after dinner, take a bed time blood sugar, dont correct, then set alarm for 3 am to take another blood sugar..........repeat that for a few nights to confirm the pattern,,,,,,,,,,,,,,,,,if you hold steady from bed till 3 amm your dose is right........ When did you graduate? and what hospital in lanarkshire you at..........?

Feb 7, 2013 Teanosugar 25 posts	Topic: General Discussion / Lantus Questions I have been on Lantus for about six months; before this it was isophane for many years. I haven't noticed any weight increase or decrease since changing to Lantus. I only know that injecting way too much insulin makes people put weight on. I don't think it's insulin specific.

Feb 7, 2013 Joe Smith 4 posts	Topic: Questions for HCPs / ma diary I appreciate your input, but I was trying to share the diary with the staff I was going to see on Wednesday. As you can probably tell, I don't know how to do that! They've told me to go carb free to try sort out my BI, which is proving difficult so far due to being a fussy eater and my BI levels are WAYYYY off!

Feb 7, 2013 landylara 14 posts	Topic: Carbohydrate Counting / My Carb Guess Challenge! I have a 1/2 unit pen so i would take 5.5 units

Feb 7, 2013 landylara 14 posts	Topic: General Discussion / Nottingham. Dr Gazis is also a DAFNE Dr at QMC campus. Excellent diabetes unit.

Feb 7, 2013 googs 6 posts	Topic: General Discussion / Diabulemia is becoming a growing problem once again highlighting how important dafne is,The education it would bring to these ladies would be invaluable(exercise and insulin intake etc)Cant say how important dafne is no.more russian roulette and guessing,Spread the word folks...

Feb 7, 2013 marke 681 posts	Topic: Questions for HCPs / Until I start a DAFNE course Hi, you can access everything except the online handbook, because we are not allowed to give access to this unless you are a graduate. If others give you advice that is outside of our control With regards to the online carb book , you can add your own entries and eventually they get verified and approved by Health Care Professionals. Again the 'verified' entries in the carb book come from the standard course carb book I'm afraid. If you want a bigger list of carb values there are books around usually aimed at people dieting however if the contain carb values then they are just as good. I have two at home but can't remember the names of them, will try to remember to dig them out and post the names and ISBN of them later.

Feb 7, 2013 marke 681 posts	Topic: Site Development / Figure 17 Gentlemen, thank you for spotting this. It was the Australian sick day rules that you were trying to access, however the image was not working. I have recently uploaded the 'new' Oz handbook and had not noticed that some of the images did not work. They are fixed now. Novarapid boy the link that you should be looking at is http://dafneonline.co.uk/hbook_topics/188 these Australians have their own ideas about DAFNE which are very similiar but not identical. I should probably block access to another countries handbook, once I work out a way of doing it of course

Feb 7, 2013 BeccyB 50 posts	Topic: Carbohydrate Counting / Sandwich Wraps Thanks for the tips - will check them out!

Feb 7, 2013 marke 681 posts	Topic: Carbohydrate Counting / Greggs baguette sandwiches I have updated the link to Greggs on the carb links page in the carb counting section to reference the new PDF above. Please do add links to the links page as and when you find them

Feb 7, 2013 marke 681 posts	Topic: General Discussion / Diabulemia is becoming a growing problem There is no definite answers to this I'm afraid. I know people who lost a lot of weight, people who lost no weight and people who put on weight. People often put on weight just after the course because their insulin is more effective by virtual of the fact its more accurate to what your body needs were before the course there was too much or too little. However once you get past that you then have the flexibility to eat less and exercise more with the tools to manage these things so in theory losing weight is easier. I say in theory because losing weight never seems that easy

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / 7-day waking average If you don't correct before bed I assume the cream puffs ere not counted......? I thought your insulin for them contributed to the hypo.... If there was no QA insulin overnight, the low was your BI........