Recent Posts - DAFNE Online

Nov 20, 2012

novorapidboi26 1,818 posts

Well, all targets are specific to each individual, but ultimately we want to be between 4-7 at the before meal occasions and the fasting time........

Fasting target is the range of blood sugar your at when you wake up, most people find they are higher at this time, due to an increased increased insulin resistance [glucagon] and glucose secretion from the liver. These two processes are happening because of the fact you have been fasting and there is no fuel on board......

Nov 20, 2012

novorapidboi26 1,818 posts

Topic: Questions ? / insulin pump

Not an HCP or Pump user yet however I can explain..........

The corrections are programmed into the pump.....

However corrections can change as you know, so in the morning 1 unit could drop you by 3 mmol/l and at night that may go down to 1 mmol/l.....

The pump can accommodate for these varying levels of resistance to corrections at different times of the day.

So by using the information that the user had given it, together with the specified blood sugar targets for that time of the day, its purely a simple arithmetic calculation...

Nov 20, 2012

novorapidboi26 1,818 posts

Topic: Questions ? / exercise query

I think with long periods of light to moderate activity levels you should actually decrease your BI dose, this will deal with a slower dropping blood sugar level and can accommodate for the hours after the activity also....

Now, I am not a great fan of too much exercise so my advice may not be very good, however I would say that option 1 would be good.

Take your normal 1:1 ratio, and also consider increasing the time from injection to actually eating breakfast. This will help you avid hitting the 20+ blood sugar readings.....

As you would have reduced your BI you would find that you may not need extra CPs during or after.........best to test this approach with caution, as you would with any new approach, as we are all different...

Nov 20, 2012

novorapidboi26 1,818 posts

Topic: Questions ? / exercise query

I think with long periods of light to moderate activity levels you should actually decrease your BI dose, this will deal with a slower dropping blood sugar level and can accommodate for the hours after the activity also....

Now, I am not a great fan of too much exercise so my advice may not be very good, however I would say that option 1 would be good.

Take your normal 1:1 ratio, and also consider increasing the time fro injection to actually eating breakfast. This will help you avid hitting the 20+ blood sugar readings.....

As you would have reduced your BI you would find that you may not need extra CPs during or after.........best to test this approach with caution, as you would with any new approach, as we are all different...

Nov 20, 2012

novorapidboi26 1,818 posts

Topic: General Discussion / Insulin Pump approval

Leigh,

Can I ask what kind of numbers you get in the morning......?

I also suffer from this however its not bad enough to get me up out of bed at that time....!!

I assume your on a split dose of BI and your PM one is as late as possible......[before bed]...

Nov 20, 2012

novorapidboi26 1,818 posts

Topic: General Discussion / Levemir

I take it you use actual pens as opposed to disposables?

Nov 20, 2012

novorapidboi26 1,818 posts

Topic: General Discussion / Ratios

You should wait to see what that recent change has done to your blood sugars, even if you think you should of went for more or less.......

Its a good habit to get in to, its methodical and helps.........

Nov 20, 2012

novorapidboi26 1,818 posts

Topic: General Discussion / Lantus - decreasing

If you are confident enough then yeah, add on the additional units and then proceed with the 3 days testing (3 am etc...)........

Have you been ill........?

Any alcohol......?

Nov 20, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Lantus - decreasing

I'm having hypos all over the place ie waking up to them plus having them during the day.
One week ago on Monday evening 12/11/2012 I reduced my lantus (BI) by 6u so from 42u to 36u (on a say so from my DSN). I decreased it again last night by 2u so from 36u to 34u. I can't help thinking I should've maybe reduced it by 4u. I know lantus should be left for 3 / 4 days / 1 week before making any more changes. Is it too late after just 1 night be reducing it once more then stick with this change for the next few days?

Thanks in advance for any replies Smile

Nov 19, 2012

paulj 36 posts

Topic: Questions ? / exercise query

this morning i decided to go for a 5 mile walk after breakfast.
my BG reading when igot up before breakfast was -11.3
i had 7cps for breakfast and had 3.5 units of q/a insulin plus 1.0 correction i.e. total 4.5 q/a units ratio= half to one
i also took my BI of 7 units
before i started my walk an hour later my BG was-20.8
halfway through the walkmy BG level was-9.9
i then ate 2CP'S of carbohydrates and at the end of my walk one and a half hours later my BG level was 5.8

my questions are -
1.should i have taken my normal 1/1 ratio for breakfast and started with a lower BG level and taken on extra cp's as and when needed?
2.with the high BG level i started with should i have tested for KETONES ?

which option in your opinion would be best for me in the future?the goods thing about this for me was i didnt develop a HYPO as i would have normally done starting with a lower BG level and exercising afterwards.
my ulitimate aim for the next three months is to have as few hypo's as possible to develop in the future better awareness of the onset of hypo's

i realise everyone reacts differently to exercise butr i am a little bit confused at the moment as what would have been and will be the best option in the future

your anticipated advice is greatly appreciated

Nov 19, 2012

paulj 36 posts

Topic: Questions ? / FASTING TARGET

what is a FASTING TARGET and what is the difference between this and a BEFORE MEAL TARGET

Nov 19, 2012

Laurenjayne123 1 post

Topic: General Discussion / Insulin Pens for NovoRapid & Lantus

I found the clickstar to be a much better pen and I do believe its more recent. It looks alot nicer and is a similar style to the nova pens. As for the nova echo pen I have one and it's great and I heard they last a long while too.

Nov 18, 2012

SA2010 69 posts

Topic: General Discussion / Ratios

Hi. I believe you wait for indication to show consistency over 2 days before increasing the QA ratio but if dealing with hypos then can change the ratio for the next time you have that meal, be it breakfast, lunch or evening meal.

This assumes that the BI doses are not being changed at the same time. When making a BI change, I normally wait 2-3 days at least before making any further changes

Simon

Nov 18, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Ratios

How often can ratios be changed?

If I was on a 1:10 or 1.5: 10.......ratio do I have to wait for 3 or 4 days before I change it again?

Gill

Nov 18, 2012

tcmonkey80 41 posts

Topic: Questions ? / insulin pump

Hi, how does the insulin pump work out corrections?

Nov 18, 2012

tcmonkey80 41 posts

Topic: General Discussion / Insulin pump

Thanks RichFreed, I do feel better knowing that I am doing things correctly. It feels very strange not having any injections but cant say I really miss them Smile

.
I to am not completely sure how the pump works out corrections, I will have to learn to trust the pump, I don't even trust my sat nav he he

Nov 18, 2012

RichFreed 51 posts

Topic: General Discussion / Insulin pump

Yep doing BG with no carbs will calculate the correction assuming you have all of those relevant variables set in the Bolus wizard setup.

The correction philosophy of the pump calcs don't really make sense to me to tell you the truth. When you enter a lower than target BG it will try to correct you up to the very bottom of your target range & if you are higher than your range it will try to correct down to the top of your range only. I had my range originally set to 5.7-5.7 to get around that issue but it would always warn me I was outside of my target range for any BG other than 5.7 so to compromise I changed to 5.0-5.7.

I've only ever injected/inserted the cannula into my belly, I tried the thigh once but 70units into one spot and feeling the tissue between my fingers expanding was to freaky for me I afraid.

I also purchased their CGM unit - in Australia Medtronic have a deal where you get what they call a starter pack for less that $400au (should be about Â£250 in UK)which gets you the transmitter device + 5 sensors.

Nov 18, 2012

SA2010 69 posts

Topic: General Discussion / Insulin Pens for NovoRapid & Lantus

Just came across the 'NovoPen 'Echo' whilst googling for discussions on memory lapses for taking insulin dose. Could not remember if I took my dose this morning. The echo appears to have memory of the last dose and how long ago it was so will try to get it prescribed to replace my NovoPen 3 Demi pen. The echo copes with half unit doses so should be ok for me. Anyway just thought I would share this bit of information with you all.

Whilst looking into Pens and with previous discussions on the Lantus Solostar pen accuracy of doses (it continues to release insulin after reaching zero), I came across the ClickStar pen for use with Lantus. Has anyone migrated from Solostar to ClickStar? Is it a better pen? Is it more recent ?

Nov 18, 2012

tcmonkey80 41 posts

Topic: General Discussion / Insulin pump

Hi RichFreed, I have the same pump as yourself, I too always use the Bolus wizard.
So if i enter my BG then say 0 carbs the machine will work out the amount i need? so in theroy I just select ACT?
I have also noticed I am having trouble keeping my sugar levels down when my canual is in my thigh, is this something you have experienced?

Nov 18, 2012

RichFreed 51 posts

Topic: General Discussion / Insulin pump

2.5 what?

I use a Medtronic Minimedipad Paradigm I usually use the Bolus wizard which asks 2 key questions.
1. BG (optional - if I have taken a reading)
2. Grams of carbs being taken.

If I ignore question 1 it will calculate insulin with no correction. If I do answer question 1 it will calculate insulting with +|- corrections.

I was high for the first few days while figuring out the Basal Rates. I'm still struggling a little with morning highs but I'm nearly there (struggled with them prior to pumping too)

Nov 17, 2012

Gibsjoh 2 posts

Topic: General Discussion / Levemir

I have been using Novorapid and Levemir for many years, a few months ago I did my morning bg test and could not understand why it was so high, had a day of not eating a lot as bg always high, next morning same again checked Levemir pen and noticed when I removed needle cover it was wet removed the vial and twisted the top which came away in my hand checked another vial and it had a crack in it. This morning bgs high again checked Levemir vial and yes a crack looked at another one it also had a crack in the vial. That has been four faulty Levemir vials in the last six months and no problems with the NovoRapid vials. If you start getting crazy bg readings for no apparent reason check your insulin vials.

Nov 17, 2012

Leigh Gilmore 4 posts

Topic: General Discussion / Insulin Pump approval

Hi, I was recently added to the Lothian waiting list and was told to expect to wait "up to four years" as a worst case scenario, although they are hoping that funding will be increased and so I won't have to wait that long. I'm counting the days already as I too am affected by dawn phenomenon and am hating getting up for a 4am injection every day.

Nov 17, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Injection sites

I inject QA humalog into my stomach in like a smiley face rotation then BI lantus into thighs sometimes left and sometimes right.

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: Questions ? / FASTING TARGET Well, all targets are specific to each individual, but ultimately we want to be between 4-7 at the before meal occasions and the fasting time........ Fasting target is the range of blood sugar your at when you wake up, most people find they are higher at this time, due to an increased increased insulin resistance [glucagon] and glucose secretion from the liver. These two processes are happening because of the fact you have been fasting and there is no fuel on board......

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: Questions ? / insulin pump Not an HCP or Pump user yet however I can explain.......... The corrections are programmed into the pump..... However corrections can change as you know, so in the morning 1 unit could drop you by 3 mmol/l and at night that may go down to 1 mmol/l..... The pump can accommodate for these varying levels of resistance to corrections at different times of the day. So by using the information that the user had given it, together with the specified blood sugar targets for that time of the day, its purely a simple arithmetic calculation...

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: Questions ? / exercise query I think with long periods of light to moderate activity levels you should actually decrease your BI dose, this will deal with a slower dropping blood sugar level and can accommodate for the hours after the activity also.... Now, I am not a great fan of too much exercise so my advice may not be very good, however I would say that option 1 would be good. Take your normal 1:1 ratio, and also consider increasing the time from injection to actually eating breakfast. This will help you avid hitting the 20+ blood sugar readings..... As you would have reduced your BI you would find that you may not need extra CPs during or after.........best to test this approach with caution, as you would with any new approach, as we are all different...

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: Questions ? / exercise query I think with long periods of light to moderate activity levels you should actually decrease your BI dose, this will deal with a slower dropping blood sugar level and can accommodate for the hours after the activity also.... Now, I am not a great fan of too much exercise so my advice may not be very good, however I would say that option 1 would be good. Take your normal 1:1 ratio, and also consider increasing the time fro injection to actually eating breakfast. This will help you avid hitting the 20+ blood sugar readings..... As you would have reduced your BI you would find that you may not need extra CPs during or after.........best to test this approach with caution, as you would with any new approach, as we are all different...

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: General Discussion / Insulin Pump approval Leigh, Can I ask what kind of numbers you get in the morning......? I also suffer from this however its not bad enough to get me up out of bed at that time....!! I assume your on a split dose of BI and your PM one is as late as possible......[before bed]...

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: General Discussion / Levemir I take it you use actual pens as opposed to disposables?

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: General Discussion / Ratios You should wait to see what that recent change has done to your blood sugars, even if you think you should of went for more or less....... Its a good habit to get in to, its methodical and helps.........

Nov 20, 2012 novorapidboi26 1,818 posts	Topic: General Discussion / Lantus - decreasing If you are confident enough then yeah, add on the additional units and then proceed with the 3 days testing (3 am etc...)........ Have you been ill........? Any alcohol......?

Nov 20, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Lantus - decreasing I'm having hypos all over the place ie waking up to them plus having them during the day. One week ago on Monday evening 12/11/2012 I reduced my lantus (BI) by 6u so from 42u to 36u (on a say so from my DSN). I decreased it again last night by 2u so from 36u to 34u. I can't help thinking I should've maybe reduced it by 4u. I know lantus should be left for 3 / 4 days / 1 week before making any more changes. Is it too late after just 1 night be reducing it once more then stick with this change for the next few days? Thanks in advance for any replies

Nov 19, 2012 paulj 36 posts	Topic: Questions ? / exercise query this morning i decided to go for a 5 mile walk after breakfast. my BG reading when igot up before breakfast was -11.3 i had 7cps for breakfast and had 3.5 units of q/a insulin plus 1.0 correction i.e. total 4.5 q/a units ratio= half to one i also took my BI of 7 units before i started my walk an hour later my BG was-20.8 halfway through the walkmy BG level was-9.9 i then ate 2CP'S of carbohydrates and at the end of my walk one and a half hours later my BG level was 5.8 my questions are - 1.should i have taken my normal 1/1 ratio for breakfast and started with a lower BG level and taken on extra cp's as and when needed? 2.with the high BG level i started with should i have tested for KETONES ? which option in your opinion would be best for me in the future?the goods thing about this for me was i didnt develop a HYPO as i would have normally done starting with a lower BG level and exercising afterwards. my ulitimate aim for the next three months is to have as few hypo's as possible to develop in the future better awareness of the onset of hypo's i realise everyone reacts differently to exercise butr i am a little bit confused at the moment as what would have been and will be the best option in the future your anticipated advice is greatly appreciated

Nov 19, 2012 paulj 36 posts	Topic: Questions ? / FASTING TARGET what is a FASTING TARGET and what is the difference between this and a BEFORE MEAL TARGET

Nov 19, 2012 Laurenjayne123 1 post	Topic: General Discussion / Insulin Pens for NovoRapid & Lantus I found the clickstar to be a much better pen and I do believe its more recent. It looks alot nicer and is a similar style to the nova pens. As for the nova echo pen I have one and it's great and I heard they last a long while too.

Nov 18, 2012 SA2010 69 posts	Topic: General Discussion / Ratios Hi. I believe you wait for indication to show consistency over 2 days before increasing the QA ratio but if dealing with hypos then can change the ratio for the next time you have that meal, be it breakfast, lunch or evening meal. This assumes that the BI doses are not being changed at the same time. When making a BI change, I normally wait 2-3 days at least before making any further changes Simon

Nov 18, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Ratios How often can ratios be changed? If I was on a 1:10 or 1.5: 10.......ratio do I have to wait for 3 or 4 days before I change it again? Gill

Nov 18, 2012 tcmonkey80 41 posts	Topic: Questions ? / insulin pump Hi, how does the insulin pump work out corrections?

Nov 18, 2012 tcmonkey80 41 posts	Topic: General Discussion / Insulin pump Thanks RichFreed, I do feel better knowing that I am doing things correctly. It feels very strange not having any injections but cant say I really miss them . I to am not completely sure how the pump works out corrections, I will have to learn to trust the pump, I don't even trust my sat nav he he

Nov 18, 2012 RichFreed 51 posts	Topic: General Discussion / Insulin pump Yep doing BG with no carbs will calculate the correction assuming you have all of those relevant variables set in the Bolus wizard setup. The correction philosophy of the pump calcs don't really make sense to me to tell you the truth. When you enter a lower than target BG it will try to correct you up to the very bottom of your target range & if you are higher than your range it will try to correct down to the top of your range only. I had my range originally set to 5.7-5.7 to get around that issue but it would always warn me I was outside of my target range for any BG other than 5.7 so to compromise I changed to 5.0-5.7. I've only ever injected/inserted the cannula into my belly, I tried the thigh once but 70units into one spot and feeling the tissue between my fingers expanding was to freaky for me I afraid. I also purchased their CGM unit - in Australia Medtronic have a deal where you get what they call a starter pack for less that $400au (should be about Â£250 in UK)which gets you the transmitter device + 5 sensors.

Nov 18, 2012 SA2010 69 posts	Topic: General Discussion / Insulin Pens for NovoRapid & Lantus Just came across the 'NovoPen 'Echo' whilst googling for discussions on memory lapses for taking insulin dose. Could not remember if I took my dose this morning. The echo appears to have memory of the last dose and how long ago it was so will try to get it prescribed to replace my NovoPen 3 Demi pen. The echo copes with half unit doses so should be ok for me. Anyway just thought I would share this bit of information with you all. Whilst looking into Pens and with previous discussions on the Lantus Solostar pen accuracy of doses (it continues to release insulin after reaching zero), I came across the ClickStar pen for use with Lantus. Has anyone migrated from Solostar to ClickStar? Is it a better pen? Is it more recent ?

Nov 18, 2012 tcmonkey80 41 posts	Topic: General Discussion / Insulin pump Hi RichFreed, I have the same pump as yourself, I too always use the Bolus wizard. So if i enter my BG then say 0 carbs the machine will work out the amount i need? so in theroy I just select ACT? I have also noticed I am having trouble keeping my sugar levels down when my canual is in my thigh, is this something you have experienced?

Nov 18, 2012 RichFreed 51 posts	Topic: General Discussion / Insulin pump 2.5 what? I use a Medtronic Minimedipad Paradigm I usually use the Bolus wizard which asks 2 key questions. 1. BG (optional - if I have taken a reading) 2. Grams of carbs being taken. If I ignore question 1 it will calculate insulin with no correction. If I do answer question 1 it will calculate insulting with +\|- corrections. I was high for the first few days while figuring out the Basal Rates. I'm still struggling a little with morning highs but I'm nearly there (struggled with them prior to pumping too)

Nov 17, 2012 Gibsjoh 2 posts	Topic: General Discussion / Levemir I have been using Novorapid and Levemir for many years, a few months ago I did my morning bg test and could not understand why it was so high, had a day of not eating a lot as bg always high, next morning same again checked Levemir pen and noticed when I removed needle cover it was wet removed the vial and twisted the top which came away in my hand checked another vial and it had a crack in it. This morning bgs high again checked Levemir vial and yes a crack looked at another one it also had a crack in the vial. That has been four faulty Levemir vials in the last six months and no problems with the NovoRapid vials. If you start getting crazy bg readings for no apparent reason check your insulin vials.

Nov 17, 2012 Leigh Gilmore 4 posts	Topic: General Discussion / Insulin Pump approval Hi, I was recently added to the Lothian waiting list and was told to expect to wait "up to four years" as a worst case scenario, although they are hoping that funding will be increased and so I won't have to wait that long. I'm counting the days already as I too am affected by dawn phenomenon and am hating getting up for a 4am injection every day.

Nov 17, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Injection sites I inject QA humalog into my stomach in like a smiley face rotation then BI lantus into thighs sometimes left and sometimes right.