Recent Posts - DAFNE Online

Dec 23, 2012

richard_g 14 posts

Thanks for your quick response and your right I'll have to contact the diabetes team in the new year for advice and to find out exactly whats been spotted in eye exam. Unfortunately the letter reached me before the results reached my GP and it is a bit scary and lacking in information.

Dec 23, 2012

marke 681 posts

Topic: Questions for HCPs / DAFNE Courses

hmm, interesting question I'm not sure if you can do DAFNE out of area since I think you may have to be referred. Carolin can probably answer this if she reads this post, if not I will ask DAFNE Central if there is a way of this happening. I suspected it was not DAFNE, I'm in East Kent and we have now lost DAFNE in favour of KATIE (??) so people here are in the same position.

Dec 23, 2012

marke 681 posts

Topic: General Discussion / retinopathy

I think you should speak to your Diabetes team about it. I don't believe that reducing your BG quickly can cause retinopathy but I have no medical training. I appreciate that speaking to anyone will be difficult at the moment but you need expert advice rather than that of other Diabetics.
I know its easy to say, but try not to worry about the letter too much. I have received one in the past and its scary because they don't provide any real advice with it. Personally I think they should speak to you in person and explain exactly what the letter means and answer the questions everyone immediately has when they get the letter. The important thing is it is picked up early and can then be monitored. The fact you have reduced your HBA1C is good it will reduce the chances of it worsening. My consultants opinion is things like this are almost inevitable if you have had Diabetes long term and is not necessarily a major problem.

Dec 23, 2012

richard_g 14 posts

Topic: General Discussion / retinopathy

Just had the dreaded letter from my eye examination saying I have early stage retinopathy. I've been wrestling with getting my HBA1C down this year as well as blood pressure and now worry I've caused some of the damage in doing so. I know long term it is better to get the BG down but what is the advice, can doing it too quickly cause more problems?

Dec 23, 2012

Ati 2 posts

Topic: Questions for HCPs / sensitivity to exercise

hi,

thanks for your reply. i now write down all my daily excercise activities and this has helped to monitor my insulin doses. i have found when i stop excercising it takes 3+ days for my bg to increase and i to tend to have lows before then. Thanks for your help i will focus on reducing the lows.

Dec 23, 2012

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here??

What does an over night basal test show for you roger, like every hour......I know that might not be possible in your case......

I am also about confused about your theory that there is insufficient carbs in your system because there is insufficient insulin to convert it into energy.......so you then burn fat.....

It is us that put the carbs in to which we then match with insulin and inject. The food is then digested and the glucose is delivered in to the blood stream. The insulin then allows the glucose to pass into the cells. So no conversion as such, at least on the insulin front....

Everyone will have some fat burning overnight as our stomach are empty, there will also ketone production, very small amounts, but they are used by the brain and other parts of the body......our basal dose will process these.....

High readings in the morning are common for everyone....

Dec 23, 2012

Ahmentep 99 posts

Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here??

I find that I frequently go very low overnight, despite taking a tiny amount of QA with supper (ratio 0.6:1). When this happens I usually awake, at around mid-day, with BG well into double figures, often over 20. Over 30 a few days ago. This is, I believe, because there is insufficient carbohydrate in my system due to insufficient insulin to convert it into energy. As a result my body starts to convert my fat for energy but since the body's control system does not work in type1 diabetics there is no means of stopping the conversion of fat once it has begun, this results in high BG readings. I find that taking more insulin at night, either QA or BI results in hypos so bad that an ambulance is needed and reducing it, or cutting it out results in dangerously high BG readings, so I haven't cracked this one yet.

The level of BI (Levemir) I use keeps me level overnight if I take no carbs or QA at suppertime. The level of QA taken at suppertime keeps me at a reasonable level for much of the time, but I have frequent, inexplicable swings, both high and low. I have been trying for over thirty years to identify a reason for these without success. The medics have been trying too, enjoying much the same level of success as I.

I don't know how relevant any of this is to you, but it occurred to me that your body too is breaking down fat with insufficient insulin to convert that into energy, resulting in your high BG levels.

Kind regards, and Merry Christmas,

Roger

Dec 22, 2012

krf 10 posts

Topic: General Discussion / Swollen ankle

Hi there,
I am wondering if anyone is able to answer a simple question! I have mild kidney function issues and realise one symptom of this is swollen ankles. I have swelling in one ankle only though and was wondering if this could be a kidney issue of if I should see my podiatrist in case it is a foot issue ( I also have neuropathy)

Dec 21, 2012

Elvie 6 posts

Topic: Questions for HCPs / overnight BGs

Thank you so much Carolin, I didn't know that about BI's and thought I was doing the right thing by having them as close to 12 hours apart as possible, I'll make the change. Smile

Dec 21, 2012

Alan 49 284 posts

Topic: Questions for HCPs / DAFNE Courses

Mark, you're right - it's not DAFNE, Medway doesn't do DAFNE anymore. They've got what they call the Patient Education Programme and it's 4 one day courses, spread over 4 weeks. Sorry I got the information wrong - I've not been able to speak directly with my niece about this - I get the details from her mother.

I think they still do DAFNE courses at Maidstone - my local hospital. Would my niece be able to get on a course run by a Healthcare Trust (or whatever they're called now) outside her area?

Dec 21, 2012

RichFreed 51 posts

Topic: Questions for HCPs / sensitivity to exercise

When I was on DAFNE regime my QA ratio when not exercising was 1.6 times that of my while exercising QA ratio.

I am now on a pump and its my BI insulin that changes now, Surprise surprise my BI while not exercising is 1.6ish times that of excercise.

When I excercise regularly it takes abount 5 hours for my body to convert from non-exercise insulin requirements to the with exercise requirements. When I stop exercising regularly it takes around 12+hours for my body to start converting to its non excercise requirements. Totally converted after 24hrs.

Everyone will be different. So you just have to monitor what happens to you, apply the usual techniques to correct QA ratios etc. for me it was working out the non excercise ratios & BI because I do a bike ride 3 times a day more often than not, so when I stop exercise my BGs start to go up. In your case your going the other way which may well lead to hypos .... More testing while you try to figure it out... Maybe start off slowly so your changes are less dramatic.

Dec 21, 2012

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here??

your AM dose it too much, your PM dose may be too little.........

tackling one period at a time is wise though........

So make a change to the AM dose first, record 3 days, continue dose adjustment until you get 2-3 days steady, repeat for PM......

Cool

Dec 21, 2012

Carolin 83 posts

Topic: Questions for HCPs / overnight BGs

Hi Elvie,

The first thing I noticed was that you're taking your evening BI at tea-time. For the majority of people following DAFNE and using BI twice a day, you will get the maximum benefit from taking your morning dose on getting up and your evening dose as you go to bed (ensuring they are 7hrs apart overnight) - this helps to control those morning (Dawn Phenomenon) BG better.

If you have done CP-free meals in the day to test out your morning BI and found that it needs to be higher, please bear in mind that once you have increased it you may need to re-evaluate your QA:CP ratios as they may need to be reduced with better BI coverage - follow the Step-Wise Approach Smile

As always, usually best to speak to your local Educator team if possible as they will know your medical history better.

Good luck,

Carolin

Dec 21, 2012

Warwick 423 posts

Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here??

I think that correcting with QA without a meal is fine. You just need to avoid over-correcting. If you hadn't corrected, at 07.06, you would have been high all day. I correct quite often with QA and without carbs, and I don't usually have any hypos as a result as long as I follow the DAFNE principles of correction - 1 unit of QA tends to drop BGs by 2-3 mmol/L. So your 4 unit dose of QA at 07.06 should have dropped the BGs by 8-12 units once the QA was absorbed, and looking at your 11.40 reading, it had dropped by 10.4 units which is within that 8-12 range.

Is your insulin good quality? Has it been out of the fridge for more than 30 days? Has it got hotter than 30 degrees at any point, does it look OK - not cloudy before injecting? It is very unusual that in the space of 90 minutes, you went from 5.2 to 15.3. It may just be a one-off though, and if you don't usually fast, then perhaps it is your body's way of coping without food. Also, unexplained rising of BGs can indicate that you are getting sick, or battling a virus etc.

Instead of fasting, you can achieve much the same result by having carbless meals - green vegetables, protein etc. Try an omelette with salad, and the carbs in that are very negligible, but you might see less fluctuations in your BGs.

If you get a reading higher than 13, then certainly correct with QA, with or without carbs. Two consecutive readings that are above 13 (e.g breakfast and lunch, lunch and dinner, dinner and bed, or bed and breakfast) is cause for a concern and you should be testing ketones if that happens. Any reading higher than 17 should always have a ketones check. If ketones are higher than 1.5, you need to follow the sick day rules - see the section "Coping when you are ill" in the DAFNE handbook.

In the data above, there is no record of a ketones check. Is that because you aren't doing one? It is really important to do one in the above situations as elevated ketones could lead to diabetic ketoacidosis.

All the best with it.
Warwick.

Dec 20, 2012

Guy 3 posts

Topic: Site Development / Do you use the Diary Graphs?

Hi
I have just spotted chrisinbrum's post about treating the absence of BG readings as zero values. I noticed the same issue when viewing my Blood Glucose Trend Chart. This does throw off the results.

Thanks

Guy

Dec 20, 2012

Gemsa 20 posts

Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here??

So I did DAFNE in October and I believe I totally understand the 'rules' in theory, they just don't seem to be replicating in practice. I know my background insulin is not right and have changed from lantus to levemir but still haven't got the dose right (I got two good days but none since).

So did a big long fast to try and see why its not behaving. I went low in the early afternoon so had a small snack of long acting (carb points are certainly correct as off the back of the packet... I don't eat anything unless I have exact carbs for it) and then just shot up and kept going up ever since. I reduced evening levemir because of morning levemir making me go low and I didn't want to go low overnight (possible reason for the 20 in the morning as was only 8 the night before). And I know I shouldn't have corrected with QA without eating a meal but I couldn't stand being so high as it was making me feel sick.

So which part of my dose is wrong?!

Dec 20, 2012

Warwick 423 posts

Topic: Questions for HCPs / overnight BGs

I don't feel qualified to comment sorry. Perhaps a HCP can comment?

Thanks,
Warwick.

Dec 19, 2012

marke 681 posts

Topic: Questions for HCPs / DAFNE Courses

Alan, who told you that Medway were running DAFNE ? The reason I ask is they were a DAFNE Centre but dropped out, as did my centre East Kent. Unfortunately in Kent they like to invent their own education programmes so as well as modifying DESMOND and calling it DEREK, they have also 'dropped'
DAFNE and come up with 'KATIE' ( which I'm still trying to get information on).
It would not suprise me if Meday have also invented their own course, it should NOT be called DAFNE however since it is not. Let us know if you find out what they are doing....

Dec 19, 2012

Elvie 6 posts

Topic: Questions for HCPs / overnight BGs

It's Levemir which lasts for 18 hours Sad

Dec 19, 2012

DianeW 115 posts

Topic: Carbohydrate Counting / Xmas pudding

Sorry novorapidboi, I was looking at your answer on my phone and it didn't show a link LOL how funny.

That is really useful, thanks so much Very Happy

Have a very merry Xmas!

Dec 19, 2012

Sweetpea 4 posts

Topic: General Discussion / Help and advice please

15 is not a lot for ME, it's come from trying to get very tight control and working with my diabetes team.
I am planning for a pregnancy and need to get very tight control which means having as many basal rates as my body needs. Every person is different and have different things which affect their sugar levels, I have extra things which affect me such as stress, driving times, hormones etc etc.
Since having 15 basal rates I got my HBA1c down from 9.3% to 6.4%!

Dec 19, 2012

Warwick 423 posts

Topic: Questions for HCPs / overnight BGs

What sort of basal insulin are you on? Do you know its profile? E.g, does it last for 12 hours, 18 hours, 24 hours? If it only lasts for 12 hours, then I would suggest that you could leave your night time BI at 9 or 10, but increase the daytime BI by 1 or 2. If it lasts 18 or 24 hours, then it would be more complicated and need someone else to answer your query.

Thanks,
Warwick.

Dec 18, 2012

Garry 328 posts

Topic: Carbohydrate Counting / Xmas pudding

What a good guide. You don't half pick out some belting info novarapidboi.
An early Merry Christmas to us all.
Regards
Garry

Dec 18, 2012

Elvie 6 posts

Topic: Questions for HCPs / overnight BGs

Hi Warwick, you are right that my BI levels are too low during the day, I've been aware of this for a while, but whenever I try to raise them I end up going hypo overnight, so I end up taking a couple of extra units at lunchtime to compensate. The whole situation is really frustrating.

Dec 18, 2012

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Xmas pudding

There is a link embedded in the word 'THIS

lol

Dec 23, 2012 richard_g 14 posts	Topic: General Discussion / retinopathy Thanks for your quick response and your right I'll have to contact the diabetes team in the new year for advice and to find out exactly whats been spotted in eye exam. Unfortunately the letter reached me before the results reached my GP and it is a bit scary and lacking in information.

Dec 23, 2012 marke 681 posts	Topic: Questions for HCPs / DAFNE Courses hmm, interesting question I'm not sure if you can do DAFNE out of area since I think you may have to be referred. Carolin can probably answer this if she reads this post, if not I will ask DAFNE Central if there is a way of this happening. I suspected it was not DAFNE, I'm in East Kent and we have now lost DAFNE in favour of KATIE (??) so people here are in the same position.

Dec 23, 2012 marke 681 posts	Topic: General Discussion / retinopathy I think you should speak to your Diabetes team about it. I don't believe that reducing your BG quickly can cause retinopathy but I have no medical training. I appreciate that speaking to anyone will be difficult at the moment but you need expert advice rather than that of other Diabetics. I know its easy to say, but try not to worry about the letter too much. I have received one in the past and its scary because they don't provide any real advice with it. Personally I think they should speak to you in person and explain exactly what the letter means and answer the questions everyone immediately has when they get the letter. The important thing is it is picked up early and can then be monitored. The fact you have reduced your HBA1C is good it will reduce the chances of it worsening. My consultants opinion is things like this are almost inevitable if you have had Diabetes long term and is not necessarily a major problem.

Dec 23, 2012 richard_g 14 posts	Topic: General Discussion / retinopathy Just had the dreaded letter from my eye examination saying I have early stage retinopathy. I've been wrestling with getting my HBA1C down this year as well as blood pressure and now worry I've caused some of the damage in doing so. I know long term it is better to get the BG down but what is the advice, can doing it too quickly cause more problems?

Dec 23, 2012 Ati 2 posts	Topic: Questions for HCPs / sensitivity to exercise hi, thanks for your reply. i now write down all my daily excercise activities and this has helped to monitor my insulin doses. i have found when i stop excercising it takes 3+ days for my bg to increase and i to tend to have lows before then. Thanks for your help i will focus on reducing the lows.

Dec 23, 2012 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here?? What does an over night basal test show for you roger, like every hour......I know that might not be possible in your case...... I am also about confused about your theory that there is insufficient carbs in your system because there is insufficient insulin to convert it into energy.......so you then burn fat..... It is us that put the carbs in to which we then match with insulin and inject. The food is then digested and the glucose is delivered in to the blood stream. The insulin then allows the glucose to pass into the cells. So no conversion as such, at least on the insulin front.... Everyone will have some fat burning overnight as our stomach are empty, there will also ketone production, very small amounts, but they are used by the brain and other parts of the body......our basal dose will process these..... High readings in the morning are common for everyone....

Dec 23, 2012 Ahmentep 99 posts	Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here?? I find that I frequently go very low overnight, despite taking a tiny amount of QA with supper (ratio 0.6:1). When this happens I usually awake, at around mid-day, with BG well into double figures, often over 20. Over 30 a few days ago. This is, I believe, because there is insufficient carbohydrate in my system due to insufficient insulin to convert it into energy. As a result my body starts to convert my fat for energy but since the body's control system does not work in type1 diabetics there is no means of stopping the conversion of fat once it has begun, this results in high BG readings. I find that taking more insulin at night, either QA or BI results in hypos so bad that an ambulance is needed and reducing it, or cutting it out results in dangerously high BG readings, so I haven't cracked this one yet. The level of BI (Levemir) I use keeps me level overnight if I take no carbs or QA at suppertime. The level of QA taken at suppertime keeps me at a reasonable level for much of the time, but I have frequent, inexplicable swings, both high and low. I have been trying for over thirty years to identify a reason for these without success. The medics have been trying too, enjoying much the same level of success as I. I don't know how relevant any of this is to you, but it occurred to me that your body too is breaking down fat with insufficient insulin to convert that into energy, resulting in your high BG levels. Kind regards, and Merry Christmas, Roger

Dec 22, 2012 krf 10 posts	Topic: General Discussion / Swollen ankle Hi there, I am wondering if anyone is able to answer a simple question! I have mild kidney function issues and realise one symptom of this is swollen ankles. I have swelling in one ankle only though and was wondering if this could be a kidney issue of if I should see my podiatrist in case it is a foot issue ( I also have neuropathy)

Dec 21, 2012 Elvie 6 posts	Topic: Questions for HCPs / overnight BGs Thank you so much Carolin, I didn't know that about BI's and thought I was doing the right thing by having them as close to 12 hours apart as possible, I'll make the change.

Dec 21, 2012 Alan 49 284 posts	Topic: Questions for HCPs / DAFNE Courses Mark, you're right - it's not DAFNE, Medway doesn't do DAFNE anymore. They've got what they call the Patient Education Programme and it's 4 one day courses, spread over 4 weeks. Sorry I got the information wrong - I've not been able to speak directly with my niece about this - I get the details from her mother. I think they still do DAFNE courses at Maidstone - my local hospital. Would my niece be able to get on a course run by a Healthcare Trust (or whatever they're called now) outside her area?

Dec 21, 2012 RichFreed 51 posts	Topic: Questions for HCPs / sensitivity to exercise When I was on DAFNE regime my QA ratio when not exercising was 1.6 times that of my while exercising QA ratio. I am now on a pump and its my BI insulin that changes now, Surprise surprise my BI while not exercising is 1.6ish times that of excercise. When I excercise regularly it takes abount 5 hours for my body to convert from non-exercise insulin requirements to the with exercise requirements. When I stop exercising regularly it takes around 12+hours for my body to start converting to its non excercise requirements. Totally converted after 24hrs. Everyone will be different. So you just have to monitor what happens to you, apply the usual techniques to correct QA ratios etc. for me it was working out the non excercise ratios & BI because I do a bike ride 3 times a day more often than not, so when I stop exercise my BGs start to go up. In your case your going the other way which may well lead to hypos .... More testing while you try to figure it out... Maybe start off slowly so your changes are less dramatic.

Dec 21, 2012 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here?? your AM dose it too much, your PM dose may be too little......... tackling one period at a time is wise though........ So make a change to the AM dose first, record 3 days, continue dose adjustment until you get 2-3 days steady, repeat for PM......

Dec 21, 2012 Carolin 83 posts	Topic: Questions for HCPs / overnight BGs Hi Elvie, The first thing I noticed was that you're taking your evening BI at tea-time. For the majority of people following DAFNE and using BI twice a day, you will get the maximum benefit from taking your morning dose on getting up and your evening dose as you go to bed (ensuring they are 7hrs apart overnight) - this helps to control those morning (Dawn Phenomenon) BG better. If you have done CP-free meals in the day to test out your morning BI and found that it needs to be higher, please bear in mind that once you have increased it you may need to re-evaluate your QA:CP ratios as they may need to be reduced with better BI coverage - follow the Step-Wise Approach As always, usually best to speak to your local Educator team if possible as they will know your medical history better. Good luck, Carolin

Dec 21, 2012 Warwick 423 posts	Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here?? I think that correcting with QA without a meal is fine. You just need to avoid over-correcting. If you hadn't corrected, at 07.06, you would have been high all day. I correct quite often with QA and without carbs, and I don't usually have any hypos as a result as long as I follow the DAFNE principles of correction - 1 unit of QA tends to drop BGs by 2-3 mmol/L. So your 4 unit dose of QA at 07.06 should have dropped the BGs by 8-12 units once the QA was absorbed, and looking at your 11.40 reading, it had dropped by 10.4 units which is within that 8-12 range. Is your insulin good quality? Has it been out of the fridge for more than 30 days? Has it got hotter than 30 degrees at any point, does it look OK - not cloudy before injecting? It is very unusual that in the space of 90 minutes, you went from 5.2 to 15.3. It may just be a one-off though, and if you don't usually fast, then perhaps it is your body's way of coping without food. Also, unexplained rising of BGs can indicate that you are getting sick, or battling a virus etc. Instead of fasting, you can achieve much the same result by having carbless meals - green vegetables, protein etc. Try an omelette with salad, and the carbs in that are very negligible, but you might see less fluctuations in your BGs. If you get a reading higher than 13, then certainly correct with QA, with or without carbs. Two consecutive readings that are above 13 (e.g breakfast and lunch, lunch and dinner, dinner and bed, or bed and breakfast) is cause for a concern and you should be testing ketones if that happens. Any reading higher than 17 should always have a ketones check. If ketones are higher than 1.5, you need to follow the sick day rules - see the section "Coping when you are ill" in the DAFNE handbook. In the data above, there is no record of a ketones check. Is that because you aren't doing one? It is really important to do one in the above situations as elevated ketones could lead to diabetic ketoacidosis. All the best with it. Warwick.

Dec 20, 2012 Guy 3 posts	Topic: Site Development / Do you use the Diary Graphs? Hi I have just spotted chrisinbrum's post about treating the absence of BG readings as zero values. I noticed the same issue when viewing my Blood Glucose Trend Chart. This does throw off the results. Thanks Guy

Dec 20, 2012 Gemsa 20 posts	Topic: Questions for HCPs / Fasting blood sugars... what on earth is going on here?? So I did DAFNE in October and I believe I totally understand the 'rules' in theory, they just don't seem to be replicating in practice. I know my background insulin is not right and have changed from lantus to levemir but still haven't got the dose right (I got two good days but none since). So did a big long fast to try and see why its not behaving. I went low in the early afternoon so had a small snack of long acting (carb points are certainly correct as off the back of the packet... I don't eat anything unless I have exact carbs for it) and then just shot up and kept going up ever since. I reduced evening levemir because of morning levemir making me go low and I didn't want to go low overnight (possible reason for the 20 in the morning as was only 8 the night before). And I know I shouldn't have corrected with QA without eating a meal but I couldn't stand being so high as it was making me feel sick. So which part of my dose is wrong?!

Dec 20, 2012 Warwick 423 posts	Topic: Questions for HCPs / overnight BGs I don't feel qualified to comment sorry. Perhaps a HCP can comment? Thanks, Warwick.

Dec 19, 2012 marke 681 posts	Topic: Questions for HCPs / DAFNE Courses Alan, who told you that Medway were running DAFNE ? The reason I ask is they were a DAFNE Centre but dropped out, as did my centre East Kent. Unfortunately in Kent they like to invent their own education programmes so as well as modifying DESMOND and calling it DEREK, they have also 'dropped' DAFNE and come up with 'KATIE' ( which I'm still trying to get information on). It would not suprise me if Meday have also invented their own course, it should NOT be called DAFNE however since it is not. Let us know if you find out what they are doing....

Dec 19, 2012 Elvie 6 posts	Topic: Questions for HCPs / overnight BGs It's Levemir which lasts for 18 hours

Dec 19, 2012 DianeW 115 posts	Topic: Carbohydrate Counting / Xmas pudding Sorry novorapidboi, I was looking at your answer on my phone and it didn't show a link LOL how funny. That is really useful, thanks so much Have a very merry Xmas!

Dec 19, 2012 Sweetpea 4 posts	Topic: General Discussion / Help and advice please 15 is not a lot for ME, it's come from trying to get very tight control and working with my diabetes team. I am planning for a pregnancy and need to get very tight control which means having as many basal rates as my body needs. Every person is different and have different things which affect their sugar levels, I have extra things which affect me such as stress, driving times, hormones etc etc. Since having 15 basal rates I got my HBA1c down from 9.3% to 6.4%!

Dec 19, 2012 Warwick 423 posts	Topic: Questions for HCPs / overnight BGs What sort of basal insulin are you on? Do you know its profile? E.g, does it last for 12 hours, 18 hours, 24 hours? If it only lasts for 12 hours, then I would suggest that you could leave your night time BI at 9 or 10, but increase the daytime BI by 1 or 2. If it lasts 18 or 24 hours, then it would be more complicated and need someone else to answer your query. Thanks, Warwick.

Dec 18, 2012 Garry 328 posts	Topic: Carbohydrate Counting / Xmas pudding What a good guide. You don't half pick out some belting info novarapidboi. An early Merry Christmas to us all. Regards Garry

Dec 18, 2012 Elvie 6 posts	Topic: Questions for HCPs / overnight BGs Hi Warwick, you are right that my BI levels are too low during the day, I've been aware of this for a while, but whenever I try to raise them I end up going hypo overnight, so I end up taking a couple of extra units at lunchtime to compensate. The whole situation is really frustrating.

Dec 18, 2012 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Xmas pudding There is a link embedded in the word 'THIS lol