Recent Posts - DAFNE Online

Feb 7, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

Hi NR,

Thanks for replying/helping.

How did that happen______
Absolutely no idea

Too much QA, was the count right______
At teatime I had bolognese (homemade) left from the night before and also rice (packet of) the sort which you cook in the microwave - 52.0g carbs per sachet - had it hundreds of times - did 5u QA as i usually would for this.

What was your correction dose before bed______
I never do a correction dose at bedtime for fear of going hypo during my sleep. Maybe at the level I could/should.

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: Site Development / Figure 17

I just checked there and cant see it either........

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: Questions for HCPs / ma diary

There seem to be a few hypos there, with no real pattern, they are common at night/morning I suppose........

How is your background doing...........?

When did you lat test......?

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Sandwich Wraps

I recommend the smartphone app MyFitnessPal........

you just scan the product barcode and it allows you to add it to your food diary where you can get the calories and nutritional information.......

Feb 7, 2013

Vikz2006 8 posts

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

Warwick that is excellent! This has really explained alot to me and I agree with your point about after a meal-its very hard to keep the BG down within the insulin's lag time as I call it-just nothing we can do about that but if overall I can 1) keep stable rather than yo-yo and 2) keep as close to the 6-7 range i'd be very happy

I've already begun my diary and it lets me fill it all in so thats great-I'll send it to you in a week's time

One question-I am on a very healthy eating plan so, for example I made a turkey stir-fry last night from scratch with diced turkey breast, 2 small courgettes, pack of mange tous peas, some garlic, onion, ginger and chilli with a splash of light soy and some herbs. To calculate carb CP where can I find values for things like lean turkey, different vegetables? Or do I look at the packaging then calculate from there? I've looked in the CP booklet on here but that seems to be all fast foods rather than lean and clean?!

Thanks once again for everything

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / Insulin:Carbohydrate ratio change on swith over to the pump

I have answered this at diabetessupport...... Very Happy

Feb 7, 2013

novorapidboi26 1,819 posts

Topic: General Discussion / 7-day waking average

whiskysmum said:
Bedtime - 21.7
This morning for me 2.8

Bedtime
had supper - butter puffs x4 with literally a scraping of jam - apart from that nothing else during the evening done differently.

How did that happen.......

Too much QA, was the count right.......

What was your correction dose before bed........?

I was 9.2 this morning, carb free morning to work out basal rates.... Smile

Feb 7, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

Bedtime - 21.7 Evil or Very Mad

This morning for me 2.8

Bedtime
had supper - butter puffs x4 with literally a scraping of jam - apart from that nothing else during the evening done differently.

Feb 7, 2013

Warwick 423 posts

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

Oh, and you can use subtraction too. You can see on Wednesday that before breakfast I deducted 0.5 from my usual 3 units of QA because my BG was only 4.2 and I prefer it to be between 5.5-6.5. Taking my usual amount might have led to a hypo later on.

I should have also mentioned that the target BG range varies depending on type of day:

Before breakfast 5.5 â€“ 7.5 mmol/L
Before other meals 4.5 â€“ 7.5 mmol/L
Before bed 6.5 â€“ 8.0 mmol/L
At 3am 4.5 mmol/L or above
Before driving Above 5 mmol/L

In practice, I find it is just easier to aim for 6.0 at all times and that works better for me. Aiming for that usually gets me in the right range.

Oh, and read the fine print on your QA insulin and find out what its duration is. Most are about 3-4 hours. Don't bother testing within that duration unless you feel hypo symptoms. Your BGs tend to stay elevated during that period and there isn't anything that can really be done about that, but 3-4 hours after a meal, you will be wanting to be in the 4.0-8.0 range, preferably around 6.0.

Let me know if you have any questions.

Cheers,
Warwick.

Feb 7, 2013

Warwick 423 posts

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

Your ratio will be 0.5:1 - half ratio. You were correct with you 1:2, but I think the DAFNE diary like the second number to be a 1, so 0.5:1.

Cheers,
Warwick.

Feb 7, 2013

EMS 15 posts

Topic: DAFNE Online Mobile / Losing data betweene the iPhone app and the desktop version

Hi Simon,
used the iPad yesterday evening to record dinner and pre-bedtime data.
None of it transferred to the desktop version and i had the issue with the comments disapearing again.
Thanks
Elisa

Feb 7, 2013

Vikz2006 8 posts

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

Thats brilliant!! Thank you so much Warwick-I beleive I can use the BG diary on here so I'll crack on with that from today. 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 Rolling Eyes

Amazing reply! Thank you

Feb 7, 2013

Warwick 423 posts

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

Although DAFNE covers a huge range of material, all of which is important, the main way to reduce HbA1c is to get your BGs consistent without the wild dips and peaks.

The first step involves getting your basal insulin (long acting insulin) correct, and then once that is under control, fixing your QA ratios. DAFNE will teach you how to do this which involves counting carbs (if you don't know how to already).

Without being a graduate, are you able to use this website to keep a diary? If so, could you fill in the diary over the next week and share it? We can then give you pointers of things to try to help the control.

Some points to note for filling in the diary:

1) A CP is a Carbohydrate Portion = 10g of carbohydrate. You can use the carb counter link to the right of this website, or the nutrition panel on packets to identify this. E.g, dry pasta is about 70g carb per 100g, so if you are having 50g of pasta, then that is 50g x (70/100) = 35g carb = 3.5 CP. If you are having a hypo, or correcting with food, add a + symbol, e.g if you have 30g carb (jellybeans say) when having a hypo, then in this box write 0+3.

2) BG is your blood glucose reading.

3) QA is the number of units of quick acting insulin you take with the meal. Again, use a + symbol if doing any correction. E.g, say I have dinner which contains 50g of carbs, I would take 2.5 units of insulin for that usually. If however, my BGs are 12, and I expected them and want them to be around 6.0, then I'd take an additional 2 units of insulin to bring them down into that range. So in this box for this meal, I would write 2.5+2 where the 2.5 is for the meal, and the 2 is the correction.

4) BI is the number of units of Basal Insulin you take.

5) Ratio is the amount of QA you take for each CP. I am on 0.33:1 (a third ratio) for breakfast, 0.5:1 (half ratio) for other meals. So for example, I have 100g carb for breakfast and usually inject 3.5 units of QA for this. If I was having 100g carb at lunch, I would inject 5 units of QA. Don't worry if your ratios are significantly different to me. Some people are on as many as 2:1 or 3:1. Everyone is different.

6) If your BGs are higher than 13 on two consecutive readings, e.g. breakfast and lunch, or lunch and dinner, or higher than 17 on one reading, then take a ketones reading. Ketones above 1.5 are bad news and you should consider getting medical assistance if your ketones are this high. Ketones can be read with an Optium Exceed meter. There may be other meters that do this too.

I have attached a portion of my diary so you can see how I fill it out.

I exercise a lot too, so understand the point about overeating - I struggle with this myself. Before being diagnosed, I ate anything I liked as I exercised so much that I never needed to worry about weight, but my diet is now much better as a result of diabetes, although my chocolate addiction is hard to control.

Feb 7, 2013

petmcgratt 4 posts

Topic: General Discussion / Insulin:Carbohydrate ratio change on swith over to the pump

I have been doing DAFNE with MDI for 2 years until I got switched onto the Accuchek Aviva Combo insulin pump on Monday 4th Feb 2013. I would have been taking split dose Levemir (16 U am and 16 U pm) along with QA insulin:carb ratios 2:1 (breakfast & Lunch), 1:1 dinner time and 1.5:1 (bedtime).

Since starting the pump I have been put on a 1.0 u/hour basal rate in place of my Levemir and kept to the same ratios for my bolus injections. However for 2 days now I am constantly correcting hypos up until mid afternoon. I initially thought my basal rate was too high but having looked at my insulin and carbohydrate intake up until tea time over 48 hours my breakfast ratio has decreased from 2:1 to 1.5:1 and my lunchtime ratio has also decreased from 2:1 to 1.2:1.

has anyone else experienced such a quick change in some or all of their ratios going from MDI to the insulin pump or am I doing something fundamentally wrong.

Feb 6, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

9.3 - bedtime
7.4 - this morning

Feb 6, 2013

vic demain 87 posts

Topic: General Discussion / Nottingham.

Thanks very much for the info. Carolin, much appreciated. Very Happy

Feb 6, 2013

Carolin 83 posts

Topic: General Discussion / Nottingham.

Hi Vic,
Queens Medical Centre in Nottingham do DAFNE.
The main consultant there is Dr Mansell and he's also on the DAFNE Executive Board
ATB
Carolin

Feb 6, 2013

vic demain 87 posts

Topic: General Discussion / Nottingham.

Hi,
Any members from the Nottingham area and is DAFNE followed in that particular area of the Country please?
Thanks.
Vic.

Feb 6, 2013

Joe Smith 4 posts

Topic: Questions for HCPs / ma diary

ma diary

Feb 6, 2013

Vikz2006 8 posts

Topic: General Discussion / exercise

I do weights 3 x per week and 2-3 HIIT (30-40 mins) sessions per week and walk most mornings and lunch. I tend to do fasted exercise for walking and some weights sessions and then before lunch or dinner for the rest. I tend to have a banana then have say 2-4u Novorapid and also have a lucozade lite drink during the sessions Can sometimes hypo later so am hoping doing the DAFNE course will help me to stabilise more Also have Warwicks problem of late nite hypos and even the odd morning I do my BS at say 7.5 and by the time I've driven to gym its dropped to 2-3-maybe I should either reduce basal Lantus (currently AM 14u) or should I look to go onto Levimir to split?

Feb 6, 2013

Vikz2006 8 posts

Topic: General Discussion / Diabulemia is becoming a growing problem

I am trying to loose weight but would never ever try this. I am going on a DAFNE course in august or sooner if possible so will this aid weight loss as i'll be better controlled? I tend to yo-yo between very low and very high bs

Feb 6, 2013

Vikz2006 8 posts

Topic: General Discussion / Lantus Questions

Good questions on here. I too am on Lantus but use AM 14u. I'm trying to loose weight for my wedding in May (been on it for about 6 years now) and have heard it can bulk you up and that Levimir or Detimir are better-any views on this? Is splitting better dor someone like me who works out alot?

Feb 6, 2013

Vikz2006 8 posts

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

Hi

I've been a Type 1 diabetic for over 30 years and and really struggling to get my HBA1C lower than 10!! I also seem to be yo-yoing between very low and very high bloodsugars and I also do alot of exercise so either end up over eating to compensate for low bloodsuagrs or they run high. I've just had my latest hospital appointment and they said I really need to do a DAFNE course but I think there is quite a waiting list until at least August. In the meantime is there any basic guidance I can floow to start stabilising bloodsugars and stop having hypos almost once a day and the over compensating so then my bloodsugar goes high again! I inject 12 units og Glargine AM and 4-6 units of Novorapid between each meal

I'm also desperately trying to loose some weight (5ft 4 11 stone) for my wedding in May and as I've really read into insulin/cortisol etc I know the key has to be better diabetic control

Any help, links, websites etc much appreciated!!

Thanks

Vicky

Feb 6, 2013

JayBee 587 posts

Topic: Carbohydrate Counting / Greggs baguette sandwiches

Thanks for posting the PDF, I'll be adding that to my phone! I wonder why I could not find it... Oh well! Thanks again! Smile

Feb 6, 2013

Warwick 423 posts

Topic: Site Development / Figure 17

Hello,

I can't see figure 17 as mentioned here:

http://dafneonline.co.uk/hbook_topics/489

It is the sick day rules flow chart, but neither Firefox, nor IE will display it.

Does it actually exist on the server?

Thanks,
Warwick.

Feb 7, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average Hi NR, Thanks for replying/helping. How did that happen______ Absolutely no idea Too much QA, was the count right______ At teatime I had bolognese (homemade) left from the night before and also rice (packet of) the sort which you cook in the microwave - 52.0g carbs per sachet - had it hundreds of times - did 5u QA as i usually would for this. What was your correction dose before bed______ I never do a correction dose at bedtime for fear of going hypo during my sleep. Maybe at the level I could/should.

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: Site Development / Figure 17 I just checked there and cant see it either........

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: Questions for HCPs / ma diary There seem to be a few hypos there, with no real pattern, they are common at night/morning I suppose........ How is your background doing...........? When did you lat test......?

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Sandwich Wraps I recommend the smartphone app MyFitnessPal........ you just scan the product barcode and it allows you to add it to your food diary where you can get the calories and nutritional information.......

Feb 7, 2013 Vikz2006 8 posts	Topic: Questions for HCPs / Until I start a DAFNE course Warwick that is excellent! This has really explained alot to me and I agree with your point about after a meal-its very hard to keep the BG down within the insulin's lag time as I call it-just nothing we can do about that but if overall I can 1) keep stable rather than yo-yo and 2) keep as close to the 6-7 range i'd be very happy I've already begun my diary and it lets me fill it all in so thats great-I'll send it to you in a week's time One question-I am on a very healthy eating plan so, for example I made a turkey stir-fry last night from scratch with diced turkey breast, 2 small courgettes, pack of mange tous peas, some garlic, onion, ginger and chilli with a splash of light soy and some herbs. To calculate carb CP where can I find values for things like lean turkey, different vegetables? Or do I look at the packaging then calculate from there? I've looked in the CP booklet on here but that seems to be all fast foods rather than lean and clean?! Thanks once again for everything

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / Insulin:Carbohydrate ratio change on swith over to the pump I have answered this at diabetessupport......

Feb 7, 2013 novorapidboi26 1,819 posts	Topic: General Discussion / 7-day waking average whiskysmum said: Bedtime - 21.7 This morning for me 2.8 Bedtime had supper - butter puffs x4 with literally a scraping of jam - apart from that nothing else during the evening done differently. How did that happen....... Too much QA, was the count right....... What was your correction dose before bed........? I was 9.2 this morning, carb free morning to work out basal rates....

Feb 7, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average Bedtime - 21.7 This morning for me 2.8 Bedtime had supper - butter puffs x4 with literally a scraping of jam - apart from that nothing else during the evening done differently.

Feb 7, 2013 Warwick 423 posts	Topic: Questions for HCPs / Until I start a DAFNE course Oh, and you can use subtraction too. You can see on Wednesday that before breakfast I deducted 0.5 from my usual 3 units of QA because my BG was only 4.2 and I prefer it to be between 5.5-6.5. Taking my usual amount might have led to a hypo later on. I should have also mentioned that the target BG range varies depending on type of day: Before breakfast 5.5 â€“ 7.5 mmol/L Before other meals 4.5 â€“ 7.5 mmol/L Before bed 6.5 â€“ 8.0 mmol/L At 3am 4.5 mmol/L or above Before driving Above 5 mmol/L In practice, I find it is just easier to aim for 6.0 at all times and that works better for me. Aiming for that usually gets me in the right range. Oh, and read the fine print on your QA insulin and find out what its duration is. Most are about 3-4 hours. Don't bother testing within that duration unless you feel hypo symptoms. Your BGs tend to stay elevated during that period and there isn't anything that can really be done about that, but 3-4 hours after a meal, you will be wanting to be in the 4.0-8.0 range, preferably around 6.0. Let me know if you have any questions. Cheers, Warwick.

Feb 7, 2013 Warwick 423 posts	Topic: Questions for HCPs / Until I start a DAFNE course Your ratio will be 0.5:1 - half ratio. You were correct with you 1:2, but I think the DAFNE diary like the second number to be a 1, so 0.5:1. Cheers, Warwick.

Feb 7, 2013 EMS 15 posts	Topic: DAFNE Online Mobile / Losing data betweene the iPhone app and the desktop version Hi Simon, used the iPad yesterday evening to record dinner and pre-bedtime data. None of it transferred to the desktop version and i had the issue with the comments disapearing again. Thanks Elisa

Feb 7, 2013 Vikz2006 8 posts	Topic: Questions for HCPs / Until I start a DAFNE course Thats brilliant!! Thank you so much Warwick-I beleive I can use the BG diary on here so I'll crack on with that from today. 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 Amazing reply! Thank you

Feb 7, 2013 Warwick 423 posts	Topic: Questions for HCPs / Until I start a DAFNE course Although DAFNE covers a huge range of material, all of which is important, the main way to reduce HbA1c is to get your BGs consistent without the wild dips and peaks. The first step involves getting your basal insulin (long acting insulin) correct, and then once that is under control, fixing your QA ratios. DAFNE will teach you how to do this which involves counting carbs (if you don't know how to already). Without being a graduate, are you able to use this website to keep a diary? If so, could you fill in the diary over the next week and share it? We can then give you pointers of things to try to help the control. Some points to note for filling in the diary: 1) A CP is a Carbohydrate Portion = 10g of carbohydrate. You can use the carb counter link to the right of this website, or the nutrition panel on packets to identify this. E.g, dry pasta is about 70g carb per 100g, so if you are having 50g of pasta, then that is 50g x (70/100) = 35g carb = 3.5 CP. If you are having a hypo, or correcting with food, add a + symbol, e.g if you have 30g carb (jellybeans say) when having a hypo, then in this box write 0+3. 2) BG is your blood glucose reading. 3) QA is the number of units of quick acting insulin you take with the meal. Again, use a + symbol if doing any correction. E.g, say I have dinner which contains 50g of carbs, I would take 2.5 units of insulin for that usually. If however, my BGs are 12, and I expected them and want them to be around 6.0, then I'd take an additional 2 units of insulin to bring them down into that range. So in this box for this meal, I would write 2.5+2 where the 2.5 is for the meal, and the 2 is the correction. 4) BI is the number of units of Basal Insulin you take. 5) Ratio is the amount of QA you take for each CP. I am on 0.33:1 (a third ratio) for breakfast, 0.5:1 (half ratio) for other meals. So for example, I have 100g carb for breakfast and usually inject 3.5 units of QA for this. If I was having 100g carb at lunch, I would inject 5 units of QA. Don't worry if your ratios are significantly different to me. Some people are on as many as 2:1 or 3:1. Everyone is different. 6) If your BGs are higher than 13 on two consecutive readings, e.g. breakfast and lunch, or lunch and dinner, or higher than 17 on one reading, then take a ketones reading. Ketones above 1.5 are bad news and you should consider getting medical assistance if your ketones are this high. Ketones can be read with an Optium Exceed meter. There may be other meters that do this too. I have attached a portion of my diary so you can see how I fill it out. I exercise a lot too, so understand the point about overeating - I struggle with this myself. Before being diagnosed, I ate anything I liked as I exercised so much that I never needed to worry about weight, but my diet is now much better as a result of diabetes, although my chocolate addiction is hard to control.

Feb 7, 2013 petmcgratt 4 posts	Topic: General Discussion / Insulin:Carbohydrate ratio change on swith over to the pump I have been doing DAFNE with MDI for 2 years until I got switched onto the Accuchek Aviva Combo insulin pump on Monday 4th Feb 2013. I would have been taking split dose Levemir (16 U am and 16 U pm) along with QA insulin:carb ratios 2:1 (breakfast & Lunch), 1:1 dinner time and 1.5:1 (bedtime). Since starting the pump I have been put on a 1.0 u/hour basal rate in place of my Levemir and kept to the same ratios for my bolus injections. However for 2 days now I am constantly correcting hypos up until mid afternoon. I initially thought my basal rate was too high but having looked at my insulin and carbohydrate intake up until tea time over 48 hours my breakfast ratio has decreased from 2:1 to 1.5:1 and my lunchtime ratio has also decreased from 2:1 to 1.2:1. has anyone else experienced such a quick change in some or all of their ratios going from MDI to the insulin pump or am I doing something fundamentally wrong.

Feb 6, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average 9.3 - bedtime 7.4 - this morning

Feb 6, 2013 vic demain 87 posts	Topic: General Discussion / Nottingham. Thanks very much for the info. Carolin, much appreciated.

Feb 6, 2013 Carolin 83 posts	Topic: General Discussion / Nottingham. Hi Vic, Queens Medical Centre in Nottingham do DAFNE. The main consultant there is Dr Mansell and he's also on the DAFNE Executive Board ATB Carolin

Feb 6, 2013 vic demain 87 posts	Topic: General Discussion / Nottingham. Hi, Any members from the Nottingham area and is DAFNE followed in that particular area of the Country please? Thanks. Vic.

Feb 6, 2013 Joe Smith 4 posts	Topic: Questions for HCPs / ma diary ma diary

Feb 6, 2013 Vikz2006 8 posts	Topic: General Discussion / exercise I do weights 3 x per week and 2-3 HIIT (30-40 mins) sessions per week and walk most mornings and lunch. I tend to do fasted exercise for walking and some weights sessions and then before lunch or dinner for the rest. I tend to have a banana then have say 2-4u Novorapid and also have a lucozade lite drink during the sessions Can sometimes hypo later so am hoping doing the DAFNE course will help me to stabilise more Also have Warwicks problem of late nite hypos and even the odd morning I do my BS at say 7.5 and by the time I've driven to gym its dropped to 2-3-maybe I should either reduce basal Lantus (currently AM 14u) or should I look to go onto Levimir to split?

Feb 6, 2013 Vikz2006 8 posts	Topic: General Discussion / Diabulemia is becoming a growing problem I am trying to loose weight but would never ever try this. I am going on a DAFNE course in august or sooner if possible so will this aid weight loss as i'll be better controlled? I tend to yo-yo between very low and very high bs

Feb 6, 2013 Vikz2006 8 posts	Topic: General Discussion / Lantus Questions Good questions on here. I too am on Lantus but use AM 14u. I'm trying to loose weight for my wedding in May (been on it for about 6 years now) and have heard it can bulk you up and that Levimir or Detimir are better-any views on this? Is splitting better dor someone like me who works out alot?

Feb 6, 2013 Vikz2006 8 posts	Topic: Questions for HCPs / Until I start a DAFNE course Hi I've been a Type 1 diabetic for over 30 years and and really struggling to get my HBA1C lower than 10!! I also seem to be yo-yoing between very low and very high bloodsugars and I also do alot of exercise so either end up over eating to compensate for low bloodsuagrs or they run high. I've just had my latest hospital appointment and they said I really need to do a DAFNE course but I think there is quite a waiting list until at least August. In the meantime is there any basic guidance I can floow to start stabilising bloodsugars and stop having hypos almost once a day and the over compensating so then my bloodsugar goes high again! I inject 12 units og Glargine AM and 4-6 units of Novorapid between each meal I'm also desperately trying to loose some weight (5ft 4 11 stone) for my wedding in May and as I've really read into insulin/cortisol etc I know the key has to be better diabetic control Any help, links, websites etc much appreciated!! Thanks Vicky

Feb 6, 2013 JayBee 587 posts	Topic: Carbohydrate Counting / Greggs baguette sandwiches Thanks for posting the PDF, I'll be adding that to my phone! I wonder why I could not find it... Oh well! Thanks again!

Feb 6, 2013 Warwick 423 posts	Topic: Site Development / Figure 17 Hello, I can't see figure 17 as mentioned here: http://dafneonline.co.uk/hbook_topics/489 It is the sick day rules flow chart, but neither Firefox, nor IE will display it. Does it actually exist on the server? Thanks, Warwick.