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You can see that the Lantus is making a big impact 11 hours after. DAFNE rules say you can reduce BI by 10%-20% so for you that would be 3u-6u. BG 2.4 is far too low to wake up to. At 00:08 assuming this was sleep time, with BG at 4.3 you should have taken some CPs. A toast ? Did you do anything about it? Bedtime BG should be between 6 and 8. For me I try to be at the top end of this target.

Go with minimum of 4u drop for Lantus. You can afford to drop more. You could always bring it up again later on once the hypos are eliminated and you find you need to do that. How did you establish you needed so much BI ? Apologise if you explained it elsewhere, Once the right level of BI has been established and settled down you may find you need higher QA:CP ratios but leave that tinkering till later and in the interim just have QA corrections when you find you need it.

Simon

Nov 26, 2012

gab 2 posts

Topic: Site Development / Uploading Data (Re-visited)

Hi there

I am relatively new to this site, and was checking the forums to see what others are doing.
I wanted to see if it was possible to upload data direct to the site, instead of typing it all in manually.I have read the older posts made by NiVZ concerning uploads, but this was using OneTouch meters, and trying to read the meter contents directly from this site.

I have an Abbot Freestyle InsulinX meter, which allows connection via USB. It contains in-built self installing software which allows you to change the meter settings and create reports.It also allows direct export from the meter, where it produces a text file with all readings, carbs, QA and BI doses, including corrective doses and manual corrections (Tab delimited). The contents of the file are far more complex than necessary for upload, but could easily be trimmed, modified and presented as an uploadable text file.

I have already developed software with Visual Basic 6 (Windows platforms only. 95/98/2000/Vista/7, Not tested on Windows Eight [using figure eight posts a smiley: 8]) to filter this file, and store only the required values in an Access database (DAO 3.6, compatible with Office 2000 onwards). The meter file always has the full set of values from the first use onwards, so when later files are produced, the software ignores values already stored and updates only the new data. Internally the meter works with the US units so has to be converted to read mmol as used in the UK. The comments you can store on the meter are only a list of pre-defined comments, so fairly limited. By storing all the values in a database, this can then be edited to add more meaningful comments if required.

I developed the software to allow me to print a sheet of values in the same format as used in the DAFNE course for presenting to my GP or at post-DAFNE re-unions. At the moment it prints using VB's inbuilt Printer object, but I intended to automate Excel from within the software to produce a fully formatted worksheet at some point. I then started to use this site, and realised there was no need, as I could store everything here and print directly!

The InsulinX meter is an excellent piece of kit, allowing you to use all the information, targets, ratios and calculations used by DAFNE.Once set up, it calculates dose based on the carbs you are about to consume, your ratio for that time of day, and any corrections needed for BG out of range at that time. Background Insulin can be input manually at the time of injection. By using this meter all the information used on this site is stored at the time of use, and it is easy to go on without recording this information externally, either in a log book, or here. I tend to log on here every few days and manually go through the meter to enter all the data.

If it were possible to upload directly, this would be great.

In the meantime I will experiment with using the Windows SetCursorPos and GetCursorPos api's and VB's SendKeys function to see if I can fill in the "Add multiple entries" grid programmatically.

Anybody familiar with VB6 I will happily send you the source code produced so far

Nov 26, 2012

mum2westiesGill 502 posts

BI/lantus last reduced on Friday evening by 2u from 32u to 30u so it's been three days so I'm going to reduce it tonight by maybe 4u.

Ps - I know there are some things missing from my diary so please ask away for any further info.

Nov 26, 2012

mum2westiesGill 502 posts

novorapidboi26,

Thank you very much! But I can only try & do it with help from people like yourself who have been lucky enough to do DAFNE.

I come on to the forum to ask my questions because I get more help here than I do at a 10 minute/half hour appt with my DSN. No disrespect to her because when I do see her she's very good.

I like to get involved with the forum by asking my questions and by lurking around to see what others are saying/doing about things. I wish there had been something like this 20 years ago when I was dx.

To you nrb26 and to all other DAFNE people on here thank you for all your help.

Very Happy

Nov 25, 2012

novorapidboi26 1,819 posts

Gill,

I have to say that your recent efforts have been very impressive, and you haven't even done DAFNE. You are always on the forums asking questions and getting involved. It has been nice to see, helps keep people motivated, including me......

Keep up the good work........

Wink

Nov 25, 2012

mum2westiesGill 502 posts

SA2010 said:
Yes. For QA:CP ratio of 1.5:1 then you would inject 3u of QA for 2 CPs (20g carbs).
QA:CP is the ratio that DAFNE teaches.

QA:CP ratio of 1.5:1 maps to 1u QA for 6.7g CHO (Carbs).

Simon

Thank you Simon & for replying so quickly Very Happy

I just like to keep checking on here cause I doubt myself and incase I'm wrong.

Gill

Nov 25, 2012

SA2010 69 posts

Yes. For QA:CP ratio of 1.5:1 then you would inject 3u of QA for 2 CPs (20g carbs).
QA:CP is the ratio that DAFNE teaches.

QA:CP ratio of 1.5:1 maps to 1u QA for 6.7g CHO (Carbs).

Simon

Nov 25, 2012

mum2westiesGill 502 posts

How many units of insulin would you have on a
1.5:10 ratio

for example 2 CPs / being 20g of carbs?

would it be 1.5 times 2 = 3
so 3u QA

Nov 25, 2012

Kieran Pierce 6 posts

Topic: General Discussion / Surgery and insulin doses

Keep an eye on your sugars pre and post op just to make sure.

As richard.arkle has said from previous experience, I myself have had an op in which the anethiest has put me on a glucose drip Smile

Nov 25, 2012

Kieran Pierce 6 posts

Topic: General Discussion / Whiskysmum - Dafne Diary - all comments welcomed (4)

Hi, definately agree with victorri on this one.

Let us know how you get on with it Smile

Nov 25, 2012

novorapidboi26 1,819 posts

its all new to me as well, so far the experience hasn't been bad at all, I just feel fortunate to have the opportunity......

Nov 25, 2012

novorapidboi26 1,819 posts

the 3 day rule is just that you need to wait that long, sometimes less, to see the effect of a Lantus change....

So I would get the risk of night time hypo away first, then think about fine tuning the dose...

Simon makes a good point, take more off the dose in the first instance, then you can always add on some more..... Cool

Nov 25, 2012

Derek Brown 32 posts

Topic: General Discussion / Hypo one day high the next day after similar meal - Delayed Activity impact / new pen?

Thanks novorapidboi26,

I suppose list is a misleading term for it.

It's useful to know the workings behind the actual proceedings.

Nov 25, 2012

SA2010 69 posts

Thanks James for looking into this.

I am not active and activity such as walking to the station, travelling on the underground etc does lead to significant drop in BG. For travelling from West London to UCLH and back for appointments I normally reduce QA dose by 30% for the meal before the travel and that has worked fine. On this day it was only a trip to Acton but the walking was the same so 30% reduction for QA at lunch time. I was back 3 hours before evening meal. May be there is a delayed effect on BG.

With regards to corrections I will review my corrections and see if there is evidence of needing higher correction doses for BGs of 15+ mmol/l.

I am also finding the QA and BI peak times is a factor (despite what people say, Lantus effect does peak for me after 7 hours) so I am trying to make sure QA + 3 hours does not coincide with BI + 7 hours and that was the reason for choosing 11am and 11pm for the BI doses. The hypo was 4 hours after end of the activity, 1 hour after the QA and 9 hours after the BI,

Simon

Nov 25, 2012

SA2010 69 posts

Some input from me - I would go for 2 day wait between Lantus changes. But your issue I recall from other threads you posted is the level of lantus reduction. 10% to 20% reduction I believe gave 4 to 7 units in your case so if I was you I would leave the delay of 2 days minimum between changes but be more aggressive for how much you reduce the Lantus by. Not 2 units at a time but 4 units whilst 10% - 20% remains to be much more than 1 or 2 units.

simon

Nov 25, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Hypo one day high the next day after similar meal - Delayed Activity impact / new pen?

novorapidboi26 said:
If your having constant hypos in the middle of the night then keep reducing until you don't have them, then you can fine tune it with the 3 day rule.......

your priority at the moment is being safe and hypo free, the 3 day rule is in place so you can get accurate dose adjustment......

What is the 3 day rule?

Also would you do 1, 2 or 3?

Nov 25, 2012

novorapidboi26 1,819 posts

I think you have basically covered all the bases, well done, now all you need to do is find out what the explanation is..........

I personally don't think a change of pen would give such a noticeable effect.......

the activity in the afternoon is definitely a good one!! Where you walking a lot?

We all know alcohol inhibits the liver, but I don't think one glass would do that much, however everyone is different. If it doesn't normally do this then its unlikely to be the wine......

It is known that insulin resistance does increase the higher your blood sugar is, but an easier way to deal with this, with manageable dose adjustment in mind for the future, is to give yourself more correction the higher you go........

If I am over 17mmol/l I need 1 unit of QA for every 1 mmol/l, as opposed to the normal correction of 1 unit for every 2.5mmol when I am below 10.....

changing ratios depending on BG would make the DAFNE approach impossible...... Very Happy

If you have seen an effect with beans then they should definitely be considered. Do a test to confirm the effect if any

Nov 25, 2012

novorapidboi26 1,819 posts

If your having constant hypos in the middle of the night then keep reducing until you don't have them, then you can fine tune it with the 3 day rule.......

your priority at the moment is being safe and hypo free, the 3 day rule is in place so you can get accurate dose adjustment......

Nov 25, 2012

novorapidboi26 1,819 posts

I would be delighted to answer your questions if i can............

I don't actually know of any list as such............ I was aware that the our PCT had acquired funding for 18 pumps for the adult clinics and a further 18 for the children's clinic.....so I wasn't surprised when my consultant mentioned it to me, I had actually asked about it 6 months previously and the reaction was very different........

The next stage was to have a consultant meeting up at Monklands, the pump centre for Lanarkshire, I then had a further meeting with the pump nurse and dietician, this was just to asses that I was aware what I was getting in to and was competent enough. The pump team then have a meeting every month were they decide on who has greatest priority. They said I was an ideal candidate..........

However its not the same as it is normally would be as there is finding in place for 18 pumps, a lot more than would usually be in place, so I am quite fortunate. So there are definitely other people on the 'list' you could call it, but there probably wont be many folk that wont get one, as the consultants still made the decision at the beginning...

The time frame was 6 months............and that was just down to the busyness of the clinic........it was a few months to get the first meeting, then the rest of the appointments came quickly,..

I think there are 2 main ones that Monklands issue and they are the Medronic Paragigm an the Accu Ceck Combo I think...........

Nov 25, 2012

Derek Brown 32 posts

novorapidboi26, I'm hopefully being referred to the consultant very soon about an insulin pump. As your also in Lanarksire do you mind me asking a few nosey questions on your pump approval?

How many people were on the list when you were placed on it?

What timeframe did it take from being on the list to your pump date of jan/feb next year?

What models are available in Lanarkshire? I've looked at all the models out there online but don't have a source for availability through Lanarkshire PCT.

Cheers,

Derek

Nov 25, 2012

Simon 578 posts

Topic: DAFNE Online Mobile / How to upload diary from app to website

Hi Anna,

Have you been to the settings page of the app, and set diary upload to 'on'?

Also which iPhone are you using?

Simon

Nov 24, 2012

AnnaConstant... 5 posts

Topic: DAFNE Online Mobile / How to upload diary from app to website

thank you both for your replies. unfortunately it doesn't upload when entering a new entry.

Marke - is the android app different to the iphone app as i don't actually have a download button on the iphone app.

unfortunately i think i may just have to manually enter onto the website Sad

Nov 24, 2012

mum2westiesGill 502 posts