Recent Posts - DAFNE Online

Nov 23, 2012

mum2westiesGill 502 posts

"I think the timing of your injection is OK in terms of changing, its only with dose changes that only one should be done at a time, according to DAFNE..

What are your reasons for wanting to inject after the meal? Have you been getting hypos in between meals?!

Thanks for confirming re the timing of injections/dose changes.

The reasons for wanting to inject after the meal is because I thought maybe it might slow things down a bit and help to prevent hypos but then again maybe not. I've not been getting hypos in between meals. Please don't give me any more hypos to contend with lol Laughing

Nov 23, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Hypos

Just a wee example from my diary showing how much easier it can be to see whats going on.......

Nov 23, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Hypos

It would seem you need to continue to drop your background dose.....

Make sure you get your BI time right on the diary too, makes it easier to read......also keep your comments short, again, just because it makes it easier to read...

You seem to be having a lot of hypos though, constantly, you must feel like its never ending......

How do you treat your hypos, and can you put that information into the diary also please.... Wink

I think that the lows your are experiencing are down to dose amount as opposed to timing. With a split dose of Lantus and with Levemir you can consider changing the times of dose to earlier/later in the evening.....but with a single dose, It wont make much difference I would imagine...

Nov 23, 2012

mum2westiesGill 502 posts

Topic: Questions for HCPs / Hypos

"If your Lantus dose is still in question then you shouldn't be changing your QA dose....

That's how I would look at it anyway....

DAFNE teaches to change only one thing at a time in order to keep as little variable in the equation as possible, and that your background dose should be spot on before any meaningful changes are made to QA doses......

So you have decreased your Lantus to stop the hypos coming, yet you have increased your pre dinner insulin ratio.......

One may be cancelling out the other......"

This is exactly what I thought ie one thing at a time.

I know it's my lantus/BI at fault, I'm having to much of it. But now I don't know where the ++++ I'm upto also do I keep on with the decreasing of the lantus/BI and maybe alter the teatime/dinnr dose back to 1:10 instead of 1.5:10?? very Confused

!

Nov 23, 2012

mum2westiesGill 502 posts

Topic: Questions for HCPs / Hypos

"Has your change in Lantus been confirmed as correct and working, ie....overnight tests and carb free meals during the day....."

No

Nov 23, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Hypos

"How is your dose of 32 going then? What have the numbers being saying?"

Evil or Very Mad

also if you look at my comments since Tuesday/Wednesday I've been bringing my lantus/BI an hour earlier each night.

Nov 23, 2012

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Hypos

Has your change in Lantus been confirmed as correct and working, ie....overnight tests and carb free meals during the day.....

If your Lantus dose is still in question then you shouldn't be changing your QA dose....

That's how I would look at it anyway....

DAFNE teaches to change only one thing at a time in order to keep as little variable in the equation as possible, and that your background dose should be spot on before any meaningful changes are made to QA doses......

So you have decreased your Lantus to stop the hypos coming, yet you have increased your pre dinner insulin ratio.......

One may be cancelling out the other......

Ask your DSN how you you are supposed to determine what each of these changes has done to your blood sugar if the changes happen at the same time......

I think the timing of your injection is OK in terms of changing, its only with dose changes that only one should be done at a time, according to DAFNE..

What are your reasons for wanting to inject after the meal? Have you been getting hypos in between meals?

Nov 23, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Insulin Pump approval

You would still inject for any carbs you had in the pre bed snack, but if it was cheese you wouldn't. The cheese does digest and although mostly fat does get converted into glucose. But it happens very slowly. But the theory is your body is aware that there is fuel in the gut being processed and so does not get the pancreas to release glucagon, or at least not as much, therefore keeping the liver from spitting out huge amounts of glucose.

Normally most people have had nothing in there for 7-8 hours so your body needs a kick up the bum to get going........[dawn phenomenon]......

August was a while back, and together with the change in seasons, I would say its time for some background testing again to see if you need to tweak your dose....

Nov 23, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Hypos

If your having scary hypos then you have to be safe and make sure you have treatment with you at all times.....

As you are experiencing them at all times of the day it would definitely be the Lantus you need to look at. There could be some QA changes needed but you will never know the exact extent of that until your Lantus is pinned down....

How is your dose of 32 going then? What have the numbers being saying?

Having something before bed is fine I suppose but the right thing to do when in a period of dose adjustment of your background is not to have anything.....

I think the point Vic made about not being strictly DAFNE is that you shouldn't need to have any carbs before bed provided your doses are right. This has came hard for a lot of people who have always eaten something to avoid a hypo overnight.........but if this is happening, your dose is wrong....

So if you do have a snack that's fine, but you wont be able to record any meaningful BI test results, and therefore delaying you getting the right dose pinned down which will then let you investigate your QA doses....

Nov 23, 2012

Ahmentep 99 posts

Topic: General Discussion / Hypos

Hi,

I ALWAYS have supper! Quite a substantial supper too, sometimes an actual cooked meal. Always have done. Even so, I sometimes have hypos during the night.

I don't see why it is 'anti dafne' to do so. Surely the whole priniple of DAFNE is that you should be able to eat normally, that is what the 'NE' stands for after all.

Kind regards,

Roger

Nov 23, 2012

Ahmentep 99 posts

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

Hi Marke,

I taket it that your explanation refers to the ipad/iphone app. I run the Android app on two devices and neither automatically upload when I make an entry. I have to press the upload button.

Kind regards,

Roger

Nov 22, 2012

marke 686 posts

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

Hi, You don't is the short answer Very Happy

If you have diary upload turned on all you need to do is add a new entry whilst you have data coverage ( this means you can browse to a web site on your phone, where the app is installed) and the app will automatically upload any entries that are not already on the site. Why doesn't it do this automatically anyway ? Well the problem is, it would need to keep checking all the time if it could connect to the site in the background, this would flatten the battery quicker and unnecessarily use up your data allowance. By only doing it when you have added an entry it knows there is at least one entry to upload and so it is worthwhile connecting to the site to do this. Whilst adding the new entry it checks if any others need to be uploaded and uploads them.
If it still doesn't work when you add a new entry then you don't have data coverage or your user account details are wrong but this should cause an error message to appear.

Nov 22, 2012

vic demain 87 posts

Topic: General Discussion / Hypos

Get yourself running around 10 - 12 for a while by reducing Lantus first, then perhaps reducing ratio of QA. Yes it isn't stricktly DAFNE but I always take a couple of biscuits at bed time. Need to get away from the danger of too many hypos.

Nov 22, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Hypos

I'm having them all over the place really ie on waking, during the day/evening & in the early hours. The worst ones have been if I've woken early or in the early hours, especially if it's had to be an assisted one with my hubby ie the whole of my body is twitching and jerking = not very pleasant at all Evil or Very Mad

!!!

What would be the first thing you'd look at doing?
I've decreased my basal/lantus first from 42u to 36u then from 36u to 32u, I only did the latter on Tuesday 20/11/2012.
Since Tuesday I've also started to bring the time of my dose earlier in the evening from11:00pm - done it by an hour each evening.

Also wondering if a bit of supper ie a sandwich might be an answer to get me right through the night.

Humalog/QA - before meals - carb counting
Lantus/BI - evening

Nov 22, 2012

Leigh Gilmore 4 posts

Topic: General Discussion / Insulin Pump approval

I've never heard that about snacking before bed, it sounds an interesting idea. I think I would find it odd to have a snack of more than 1CP without taking insulin though, I'd probably end up injecting out of habit!

I last did background checks through the night (3 and 6) when I did the DAFNE course in August. It was those that highlighted the problem in the first place.

Nov 22, 2012

mum2westiesGill 502 posts

Topic: Questions for HCPs / Hypos

Hypos

I'm currently having lots of hypos ie on waking, during the day/evening, during the night.

Things I've changed and when:
1 - BI dose decreased/Tuesday 20/11/2012 - on advice from my DSN
2. - Evening meal ratio changed from 1:10 to 1.5:10/Tuesday 20/11/2012 - ditto.

Would it be too many changes if I also started to take my Humalog right after eating a meal?
I normally take it 15 mins before to let it start working then just on the very odd occasion have taken it after.

Read this in the leaflet
"Humalog is a rapid-acting insulin. Take Humalog within fifteen minutes before eating or right after eating a meal".

Nov 22, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Insulin Pump approval

It sounds exactly like me to be honest, although recently I have managed to get single figures when I get up at 6:40am.

Have you tried a slowly absorbed snack before bed like cheese or toast and peanut butter. Some say that having these foods digesting in our stomachs right until the morning actually helps hold the liver response back a bit.....

I haven't noticed it making a real difference though......

You have real discipline though getting up at 4am all the time to give insulin, I am quite happy to wake on 10-12, at least on injections anyway.....

When was the last time you collected overnight background test results?

Nov 22, 2012

AnnaConstant... 5 posts

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

i have the dafne app but cannot figure out how to upload my diary entries. i have diary upload switched to on but how do you actually upload the entries?

Nov 21, 2012

Leigh Gilmore 4 posts

Topic: General Discussion / Insulin Pump approval

Bed is somewhere between 10 and 11 so I can get a decent stretch of uninterrupted sleep. No food at 4, just the insulin. I eat and take more insulin when I get up at 6, but obviously without any more corrective QA if my BG is still above target.

Nov 21, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Insulin Pump approval

What time is bed?

Do you eat and take insulin when you get up?

Nov 21, 2012

Leigh Gilmore 4 posts

Topic: General Discussion / Insulin Pump approval

I'm on Levemir so am taking the evening dose immediately before I go to bed. If I get up at 4 and test my BG it comes out at around 6-8 most days. If I don't inject 6 units of Novorapid then by 6am when I get up for work it'll be up to around 13-14 and if I let myself have a lie in until say 8, it'll be closer to 19, and needless to say I'll be feeling pretty rubbish! 6 units holds me level though so I'd rather wake up at 4 and suffer the interrupted sleep, but I'm hoping a pump will put an end to that, even if it is a long way off yet.

Nov 20, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / BG Diary entries

just mark it down as normal

a blood sugar reading with an inulin dose next to it

the before bed test doesnt hve a BI dose next to it

Nov 20, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Lantus - changing time

novorapidboi26 said:
what time are you up at........?

making sure your not running out for waking time is important you see.........

you could maybe try taking it at 8pm with dinner

I'm normally up at about 07:30am - 08:00am ish

I could possibly take it at 8pm with dinner but I thought you had to make the time earlier by just an hour each night.

Nov 20, 2012

mum2westiesGill 502 posts

Topic: General Discussion / BG Diary entries

But if it was you how would you mark this all down in your dafne diary ie having your BI earlier then also doing a test at bedtime?

Nov 20, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Lantus - changing time

what time are you up at........?

making sure your not running out for waking time is important you see.........

you could maybe try taking it at 8pm with dinner

Nov 23, 2012 mum2westiesGill 502 posts	Topic: Questions for HCPs / Hypos "I think the timing of your injection is OK in terms of changing, its only with dose changes that only one should be done at a time, according to DAFNE.. What are your reasons for wanting to inject after the meal? Have you been getting hypos in between meals?! Thanks for confirming re the timing of injections/dose changes. The reasons for wanting to inject after the meal is because I thought maybe it might slow things down a bit and help to prevent hypos but then again maybe not. I've not been getting hypos in between meals. Please don't give me any more hypos to contend with lol

Nov 23, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Hypos Just a wee example from my diary showing how much easier it can be to see whats going on.......

Nov 23, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Hypos It would seem you need to continue to drop your background dose..... Make sure you get your BI time right on the diary too, makes it easier to read......also keep your comments short, again, just because it makes it easier to read... You seem to be having a lot of hypos though, constantly, you must feel like its never ending...... How do you treat your hypos, and can you put that information into the diary also please.... I think that the lows your are experiencing are down to dose amount as opposed to timing. With a split dose of Lantus and with Levemir you can consider changing the times of dose to earlier/later in the evening.....but with a single dose, It wont make much difference I would imagine...

Nov 23, 2012 mum2westiesGill 502 posts	Topic: Questions for HCPs / Hypos "If your Lantus dose is still in question then you shouldn't be changing your QA dose.... That's how I would look at it anyway.... DAFNE teaches to change only one thing at a time in order to keep as little variable in the equation as possible, and that your background dose should be spot on before any meaningful changes are made to QA doses...... So you have decreased your Lantus to stop the hypos coming, yet you have increased your pre dinner insulin ratio....... One may be cancelling out the other......" This is exactly what I thought ie one thing at a time. I know it's my lantus/BI at fault, I'm having to much of it. But now I don't know where the ++++ I'm upto also do I keep on with the decreasing of the lantus/BI and maybe alter the teatime/dinnr dose back to 1:10 instead of 1.5:10?? very !

Nov 23, 2012 mum2westiesGill 502 posts	Topic: Questions for HCPs / Hypos "Has your change in Lantus been confirmed as correct and working, ie....overnight tests and carb free meals during the day....." No

Nov 23, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Hypos "How is your dose of 32 going then? What have the numbers being saying?" also if you look at my comments since Tuesday/Wednesday I've been bringing my lantus/BI an hour earlier each night.

Nov 23, 2012 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Hypos Has your change in Lantus been confirmed as correct and working, ie....overnight tests and carb free meals during the day..... If your Lantus dose is still in question then you shouldn't be changing your QA dose.... That's how I would look at it anyway.... DAFNE teaches to change only one thing at a time in order to keep as little variable in the equation as possible, and that your background dose should be spot on before any meaningful changes are made to QA doses...... So you have decreased your Lantus to stop the hypos coming, yet you have increased your pre dinner insulin ratio....... One may be cancelling out the other...... Ask your DSN how you you are supposed to determine what each of these changes has done to your blood sugar if the changes happen at the same time...... I think the timing of your injection is OK in terms of changing, its only with dose changes that only one should be done at a time, according to DAFNE.. What are your reasons for wanting to inject after the meal? Have you been getting hypos in between meals?

Nov 23, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Insulin Pump approval You would still inject for any carbs you had in the pre bed snack, but if it was cheese you wouldn't. The cheese does digest and although mostly fat does get converted into glucose. But it happens very slowly. But the theory is your body is aware that there is fuel in the gut being processed and so does not get the pancreas to release glucagon, or at least not as much, therefore keeping the liver from spitting out huge amounts of glucose. Normally most people have had nothing in there for 7-8 hours so your body needs a kick up the bum to get going........[dawn phenomenon]...... August was a while back, and together with the change in seasons, I would say its time for some background testing again to see if you need to tweak your dose....

Nov 23, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Hypos If your having scary hypos then you have to be safe and make sure you have treatment with you at all times..... As you are experiencing them at all times of the day it would definitely be the Lantus you need to look at. There could be some QA changes needed but you will never know the exact extent of that until your Lantus is pinned down.... How is your dose of 32 going then? What have the numbers being saying? Having something before bed is fine I suppose but the right thing to do when in a period of dose adjustment of your background is not to have anything..... I think the point Vic made about not being strictly DAFNE is that you shouldn't need to have any carbs before bed provided your doses are right. This has came hard for a lot of people who have always eaten something to avoid a hypo overnight.........but if this is happening, your dose is wrong.... So if you do have a snack that's fine, but you wont be able to record any meaningful BI test results, and therefore delaying you getting the right dose pinned down which will then let you investigate your QA doses....

Nov 23, 2012 Ahmentep 99 posts	Topic: General Discussion / Hypos Hi, I ALWAYS have supper! Quite a substantial supper too, sometimes an actual cooked meal. Always have done. Even so, I sometimes have hypos during the night. I don't see why it is 'anti dafne' to do so. Surely the whole priniple of DAFNE is that you should be able to eat normally, that is what the 'NE' stands for after all. Kind regards, Roger

Nov 23, 2012 Ahmentep 99 posts	Topic: DAFNE Online Mobile / How to upload diary from app to website Hi Marke, I taket it that your explanation refers to the ipad/iphone app. I run the Android app on two devices and neither automatically upload when I make an entry. I have to press the upload button. Kind regards, Roger

Nov 22, 2012 marke 686 posts	Topic: DAFNE Online Mobile / How to upload diary from app to website Hi, You don't is the short answer If you have diary upload turned on all you need to do is add a new entry whilst you have data coverage ( this means you can browse to a web site on your phone, where the app is installed) and the app will automatically upload any entries that are not already on the site. Why doesn't it do this automatically anyway ? Well the problem is, it would need to keep checking all the time if it could connect to the site in the background, this would flatten the battery quicker and unnecessarily use up your data allowance. By only doing it when you have added an entry it knows there is at least one entry to upload and so it is worthwhile connecting to the site to do this. Whilst adding the new entry it checks if any others need to be uploaded and uploads them. If it still doesn't work when you add a new entry then you don't have data coverage or your user account details are wrong but this should cause an error message to appear.

Nov 22, 2012 vic demain 87 posts	Topic: General Discussion / Hypos Get yourself running around 10 - 12 for a while by reducing Lantus first, then perhaps reducing ratio of QA. Yes it isn't stricktly DAFNE but I always take a couple of biscuits at bed time. Need to get away from the danger of too many hypos.

Nov 22, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Hypos I'm having them all over the place really ie on waking, during the day/evening & in the early hours. The worst ones have been if I've woken early or in the early hours, especially if it's had to be an assisted one with my hubby ie the whole of my body is twitching and jerking = not very pleasant at all !!! What would be the first thing you'd look at doing? I've decreased my basal/lantus first from 42u to 36u then from 36u to 32u, I only did the latter on Tuesday 20/11/2012. Since Tuesday I've also started to bring the time of my dose earlier in the evening from11:00pm - done it by an hour each evening. Also wondering if a bit of supper ie a sandwich might be an answer to get me right through the night. Humalog/QA - before meals - carb counting Lantus/BI - evening

Nov 22, 2012 Leigh Gilmore 4 posts	Topic: General Discussion / Insulin Pump approval I've never heard that about snacking before bed, it sounds an interesting idea. I think I would find it odd to have a snack of more than 1CP without taking insulin though, I'd probably end up injecting out of habit! I last did background checks through the night (3 and 6) when I did the DAFNE course in August. It was those that highlighted the problem in the first place.

Nov 22, 2012 mum2westiesGill 502 posts	Topic: Questions for HCPs / Hypos Hypos I'm currently having lots of hypos ie on waking, during the day/evening, during the night. Things I've changed and when: 1 - BI dose decreased/Tuesday 20/11/2012 - on advice from my DSN 2. - Evening meal ratio changed from 1:10 to 1.5:10/Tuesday 20/11/2012 - ditto. Would it be too many changes if I also started to take my Humalog right after eating a meal? I normally take it 15 mins before to let it start working then just on the very odd occasion have taken it after. Read this in the leaflet "Humalog is a rapid-acting insulin. Take Humalog within fifteen minutes before eating or right after eating a meal".

Nov 22, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Insulin Pump approval It sounds exactly like me to be honest, although recently I have managed to get single figures when I get up at 6:40am. Have you tried a slowly absorbed snack before bed like cheese or toast and peanut butter. Some say that having these foods digesting in our stomachs right until the morning actually helps hold the liver response back a bit..... I haven't noticed it making a real difference though...... You have real discipline though getting up at 4am all the time to give insulin, I am quite happy to wake on 10-12, at least on injections anyway..... When was the last time you collected overnight background test results?

Nov 22, 2012 AnnaConstant... 5 posts	Topic: DAFNE Online Mobile / How to upload diary from app to website i have the dafne app but cannot figure out how to upload my diary entries. i have diary upload switched to on but how do you actually upload the entries?

Nov 21, 2012 Leigh Gilmore 4 posts	Topic: General Discussion / Insulin Pump approval Bed is somewhere between 10 and 11 so I can get a decent stretch of uninterrupted sleep. No food at 4, just the insulin. I eat and take more insulin when I get up at 6, but obviously without any more corrective QA if my BG is still above target.

Nov 21, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Insulin Pump approval What time is bed? Do you eat and take insulin when you get up?

Nov 21, 2012 Leigh Gilmore 4 posts	Topic: General Discussion / Insulin Pump approval I'm on Levemir so am taking the evening dose immediately before I go to bed. If I get up at 4 and test my BG it comes out at around 6-8 most days. If I don't inject 6 units of Novorapid then by 6am when I get up for work it'll be up to around 13-14 and if I let myself have a lie in until say 8, it'll be closer to 19, and needless to say I'll be feeling pretty rubbish! 6 units holds me level though so I'd rather wake up at 4 and suffer the interrupted sleep, but I'm hoping a pump will put an end to that, even if it is a long way off yet.

Nov 20, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / BG Diary entries just mark it down as normal a blood sugar reading with an inulin dose next to it the before bed test doesnt hve a BI dose next to it

Nov 20, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Lantus - changing time novorapidboi26 said: what time are you up at........? making sure your not running out for waking time is important you see......... you could maybe try taking it at 8pm with dinner I'm normally up at about 07:30am - 08:00am ish I could possibly take it at 8pm with dinner but I thought you had to make the time earlier by just an hour each night.

Nov 20, 2012 mum2westiesGill 502 posts	Topic: General Discussion / BG Diary entries But if it was you how would you mark this all down in your dafne diary ie having your BI earlier then also doing a test at bedtime?

Nov 20, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Lantus - changing time what time are you up at........? making sure your not running out for waking time is important you see......... you could maybe try taking it at 8pm with dinner