Recent Posts - DAFNE Online

Nov 15, 2012

Gemsa 20 posts

Topic: Questions for HCPs / corrections after a hypo

So DAFNE rule is you don't make a correction dose the meal after a hypo even if your bloods are ridiculous.

What if you aren't sure whether it was a night time hypo or not? I've woken up at 22 and feel rough as so really want to correct, but I had a nightime hypo the previous night and although I tested at 2am last night and was fine, the only reason I can see is I must have had a hypo? Therefore shouldn't really correct?

Nov 15, 2012

HelenP 218 posts

Topic: Questions for HCPs / Surgery and insulin

Another consideration is also how long you will be out to it. Helen

Nov 15, 2012

Ahmentep 99 posts

Topic: General Discussion / How many units of insulin?

You shouldn't need to guess. There will be a calculator on your computer, and on your phone.

If you want to work in CPs it is 1.5 times 5 = 7.5 which, as Alan says, should be rounded up to 8. Unless of course, you know that you are likely to swing on the low side after your meal.

Nov 14, 2012

mum2westiesGill 502 posts

Topic: General Discussion / How many units of insulin?

How many units of insulin would you have on
1.5:1 ratio
for 5 CPs / being 52.0g of carbs?

Am i correct in guessing it would be 7u or 8u?

My pen only allows me to dial up in 1 units not half units.

Nov 14, 2012

merstone 3 posts

Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing

Hi novorapidboi26,
I read with interest your fuller description of the above under the Post Readings thread in the General Discussion forum. All I've done in the past is to check that the "spike", as you call it, is preferably under, but not too much over, 10. Apparently no proof of the real benefits of this but somehow it seems right!

Never previously thought of trying to fine tune the spike downwards by adjusting the QA-to-meal delay, although I have noticed that for me the spike tends to be lower when some delay has occurred. In addition to one's personal profile, I suppose we have other variables in the equation such as GI of the meal and the knock-on effect of any earlier exercise.....

Anyway, food for thought, thanks.

Nov 14, 2012

DianeW 115 posts

Topic: Questions for HCPs / Surgery and insulin

I am having an op with a general anaesthetic, I have to go in for 4pm and they have said don't eat from 12 noon. I take my BI at breakfast and bedtime. Should I reduce my BI, and if so at which injection? Should I test before noon and if low, eat something to bring me up to normal BG and if high, correct with QA? Should I time breakfast for about 8am so that there is 4 hours until 12 and if necessary eat something. My actual op will probably be nearer 5pm. Thanks for any advice.

Nov 13, 2012

tallkenny 1 post

Topic: General Discussion / Insulin Pump approval

I went to an IPAG event recently after Doctor suggested a pump would help sort dawn phenomenon. Was sold, now I'm on the list but at current funding rate in West Lothian it's 3 years..... Crying or Very sad

Nov 13, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Ratios / higher number of units of insulin

novorapidboi26 said:
I think there is a slight misunderstanding but remember that whiskysmum has not actually done DAFNE and so does not know the procedure when dose adjusting............you do now though.....

you have probably been seeing people refer to such ratios on diabetessupport, however these people will be on pumps most likely. There will be some who are injecting and this may work for them.........

I am sure I read somewhere that the standard/average carbs processes from 1 unit is 10 for adults and 15 for children, this may now be out of date but DAFNE is based on this.....

That's correct I've never done DAFNE Sad

. My one way of learning / teaching myself is by way of the forum. Now thanks to you lovely people on the forum I'm getting to know all about the dose adjusting - thank you Very Happy

!

Yes I've seen people refering to such ratios on diabetessupport. Another good forum.

Nov 13, 2012

mum2westiesGill 502 posts

Topic: General Discussion / How many units of insulin?

Alan Constable said:
Also: If you don't have a pen that allows you to dial up half a unit of insulin, you should round up 4.5 units to 5 units.

Yeah thanks for that!

Nov 13, 2012

Pauline1 1 post

Topic: General Discussion / High blood sugars

Help!! Low blood sugars for 2 days and feeling good. Today however, high all day and can't get them down. Any help out there? Not sure why. Doing carb free 2night. Also correcting with QA. Anything else?

Nov 13, 2012

novorapidboi26 1,819 posts

Topic: Questions for HCPs / weight loss - risks

WOW, that's a difficult one, i would say I am about 3-4 stone overweight, although you wouldn't guess it........

My belief is that I eat too many calories and dont exercise enough. Any activity I do is too light in terms of heart rate and I do love my grub.....especially at night.......

I am not too worried about my appearance but I am concerned for my health....

Sorry no advice, just thought I would share my story...... Exclamation

Nov 13, 2012

novorapidboi26 1,819 posts

Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing

I regularly do it...............mostly between lunch and dinner, as I am fighting the dawn phenomenon between breakfast and lunch and my BI is running out between dinner and bed....

And all it tells me is whether the timing of my dose, 10, 15, 20, 25, 30 minutes has met the profile of my digestion well, if it has and the meal is unique or rarely eaten I can take note and adopt the same timing next time.......

Nov 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Clickstar Pen - insulin delivery speed

maybe there is a mechanism on it that helps the plunger depress at a more constant rate, however its very likely this is automatic.......

I could be totally wrong though as I have been on disposables for 4 years plus....

Nov 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Insulin Pump approval

see response in other post..... Very Happy

Nov 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Ratios / higher number of units of insulin

I think there is a slight misunderstanding but remember that whiskysmum has not actually done DAFNE and so does not know the procedure when dose adjusting............you do now though..... Wink

you have probably been seeing people refer to such ratios on diabetessupport, however these people will be on pumps most likely. There will be some who are injecting and this may work for them.........

I am sure I read somewhere that the standard/average carbs processes from 1 unit is 10 for adults and 15 for children, this may now be out of date but DAFNE is based on this..... Very Happy

Nov 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / One unit of insulin to ten grams carbs ratio

I think for most DAFNE graduates they will take a incremental approach to dose adjustment.

If 1:1 (1:10) is not enough for you then you would increase that to 1.5:1 (1.5:10), this makes its easier to calculate more achievable insulin dosages, however some people do need to get there ratio to a more accurate number eg 1.25:1, 1.75:1.

Any more precise than that and it becomes difficult to dose properly unless your on a pump.

If several days results show you need more, increase by .5 units to every 10 grams.... Wink

Nov 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / I did it :)

Hey Nick,

I am currently still in the process of getting a pump.........

I was referred to the clinic after my consultants agreed I would benefit from one. It also helped that the pump clinic within my PCT had secured funding for 18 pumps just for the adults alone. Without this I probably wouldn't have even been considered.

I was referred in July/August and I am looking to go on the saline solution test period mid January, so not too long in the grand scheme of things. The length of time it has taken is probably down to the business of the clinic with the normal appointments..

I hope it not too long a wait....... Wink

Nov 13, 2012

Alan 49 284 posts

Topic: General Discussion / How many units of insulin?

Also: If you don't have a pen that allows you to dial up half a unit of insulin, you should round up 4.5 units to 5 units.

Nov 13, 2012

Ahmentep 99 posts

Topic: General Discussion / How many units of insulin?

Hi,

Don't be frightened by this, but this is how it works mathematically.

Insulin units = C/10 x R
Carbs = I/R x10
Ratio = I/C x 10

Where C = Carbohydrate in grams
I = Insulin in units
R = Ratio ( e.g. 1:1)

So, for the values you gave:

C/10 x R (You only use the first figure (or the top figure, depending on how the ratio is written))

30/10 x 1.5 = 4.5

I hope this helps for the future.

Kind regards,

Roger

PS
A ratio, say 1 to 1, can be written as 1 to 1 or as 1:1 or as 1/1

For a ratio of 1 to 10 these would be - 1 to 10, or 1:10 or 1/10

Nov 12, 2012

merstone 3 posts

Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing

Thanks marke.
Signs of some research into the value of occasional post-meal testing were, of course, exactly what I was hoping to find from this thread. However, I guess that anything remotely conclusive in this area is unlikely, bearing in mind the longer term complications aspect would tend to make it as lengthy as the proverbial piece of string.

I therefore wonder by who and on what evidence the post-meal BG targets published in last month's Balance magazine were derived?

Nov 12, 2012

marke 686 posts

Topic: Questions for HCPs / snacking and corrections

Hi Gemsa, sorry bad news you are no longer 'normal'. What happens to 'normal' people no longer applies to you. What Carolin was trying to say was say you eat at 6pm, inject 12 units and have 120carbs ( where you are on 1:1 and 10carbs = 1 unit). If you test 1 hour later your body is still digesting the food and your BG will be higher than normal. If its 14 and you decide to correct and give yourself 3 units to bring you back to 5 ( generalising a lot about the exact
effect of insulin), you now potentially have 15 units working on 12CP's which may be too much and will force you too low. Your QA insulin will generally keep working for upto 5 hours, this is the danger of injecting between meals.
In an ideal world our BG stays within range after meals, but its not an ideal world so we are trying to make the best we can of it. If your BG is back in range before the next meal then generally you are doing ok. You can try to get better control than this but is very difficult. You don't have the feedback mechanism that a normal person has. You cannot secreet insulin at just the right time to balance the sugar in your blood, All you can do is put it into your body fat and let it be absorbed into your system at roughly the rate required. This is not precise but its as good as it gets with technology as it is at the moment. Maybe one day this will change but not in the immediate future.

Nov 12, 2012

marke 686 posts

Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing

I wouldn't say it is completely unnecessary, however I would also say it is not covered in the course because no research has been conducted to prove its benefits. Its nothing to do with test strip economy more to do with the don't tell you stuff that is not backed up by research, Thats the point of DAFNE it is all backed up by research.
You will find loads of discussions on Diabetes sites regarding post-meal highs and their significance. However my personal view is most of it is not backed up by any real research just opinions. Whilst everyones opinion is valid, at the end of the day thats all it is. I have my own personal views but its not for me to tell you what is right or wrong. If there IS some solid research hopefully someone will respond with some links to it.

Nov 12, 2012

mum2westiesGill 502 posts

Topic: General Discussion / How many units of insulin?

Thank you Marian!

Nov 12, 2012

NuMo 28 posts

Topic: General Discussion / How many units of insulin?

41/2 (4.5)

Nov 12, 2012

mum2westiesGill 502 posts

Topic: General Discussion / How many units of insulin?

How many units of insulin would you have on
1.5:1 ratio
for 3 CPs / being 30g of carbs?

Nov 15, 2012 Gemsa 20 posts	Topic: Questions for HCPs / corrections after a hypo So DAFNE rule is you don't make a correction dose the meal after a hypo even if your bloods are ridiculous. What if you aren't sure whether it was a night time hypo or not? I've woken up at 22 and feel rough as so really want to correct, but I had a nightime hypo the previous night and although I tested at 2am last night and was fine, the only reason I can see is I must have had a hypo? Therefore shouldn't really correct?

Nov 15, 2012 HelenP 218 posts	Topic: Questions for HCPs / Surgery and insulin Another consideration is also how long you will be out to it. Helen

Nov 15, 2012 Ahmentep 99 posts	Topic: General Discussion / How many units of insulin? You shouldn't need to guess. There will be a calculator on your computer, and on your phone. If you want to work in CPs it is 1.5 times 5 = 7.5 which, as Alan says, should be rounded up to 8. Unless of course, you know that you are likely to swing on the low side after your meal.

Nov 14, 2012 mum2westiesGill 502 posts	Topic: General Discussion / How many units of insulin? How many units of insulin would you have on 1.5:1 ratio for 5 CPs / being 52.0g of carbs? Am i correct in guessing it would be 7u or 8u? My pen only allows me to dial up in 1 units not half units.

Nov 14, 2012 merstone 3 posts	Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing Hi novorapidboi26, I read with interest your fuller description of the above under the Post Readings thread in the General Discussion forum. All I've done in the past is to check that the "spike", as you call it, is preferably under, but not too much over, 10. Apparently no proof of the real benefits of this but somehow it seems right! Never previously thought of trying to fine tune the spike downwards by adjusting the QA-to-meal delay, although I have noticed that for me the spike tends to be lower when some delay has occurred. In addition to one's personal profile, I suppose we have other variables in the equation such as GI of the meal and the knock-on effect of any earlier exercise..... Anyway, food for thought, thanks.

Nov 14, 2012 DianeW 115 posts	Topic: Questions for HCPs / Surgery and insulin I am having an op with a general anaesthetic, I have to go in for 4pm and they have said don't eat from 12 noon. I take my BI at breakfast and bedtime. Should I reduce my BI, and if so at which injection? Should I test before noon and if low, eat something to bring me up to normal BG and if high, correct with QA? Should I time breakfast for about 8am so that there is 4 hours until 12 and if necessary eat something. My actual op will probably be nearer 5pm. Thanks for any advice.

Nov 13, 2012 tallkenny 1 post	Topic: General Discussion / Insulin Pump approval I went to an IPAG event recently after Doctor suggested a pump would help sort dawn phenomenon. Was sold, now I'm on the list but at current funding rate in West Lothian it's 3 years.....

Nov 13, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Ratios / higher number of units of insulin novorapidboi26 said: I think there is a slight misunderstanding but remember that whiskysmum has not actually done DAFNE and so does not know the procedure when dose adjusting............you do now though..... you have probably been seeing people refer to such ratios on diabetessupport, however these people will be on pumps most likely. There will be some who are injecting and this may work for them......... I am sure I read somewhere that the standard/average carbs processes from 1 unit is 10 for adults and 15 for children, this may now be out of date but DAFNE is based on this..... That's correct I've never done DAFNE . My one way of learning / teaching myself is by way of the forum. Now thanks to you lovely people on the forum I'm getting to know all about the dose adjusting - thank you ! Yes I've seen people refering to such ratios on diabetessupport. Another good forum.

Nov 13, 2012 mum2westiesGill 502 posts	Topic: General Discussion / How many units of insulin? Alan Constable said: Also: If you don't have a pen that allows you to dial up half a unit of insulin, you should round up 4.5 units to 5 units. Yeah thanks for that!

Nov 13, 2012 Pauline1 1 post	Topic: General Discussion / High blood sugars Help!! Low blood sugars for 2 days and feeling good. Today however, high all day and can't get them down. Any help out there? Not sure why. Doing carb free 2night. Also correcting with QA. Anything else?

Nov 13, 2012 novorapidboi26 1,819 posts	Topic: Questions for HCPs / weight loss - risks WOW, that's a difficult one, i would say I am about 3-4 stone overweight, although you wouldn't guess it........ My belief is that I eat too many calories and dont exercise enough. Any activity I do is too light in terms of heart rate and I do love my grub.....especially at night....... I am not too worried about my appearance but I am concerned for my health.... Sorry no advice, just thought I would share my story......

Nov 13, 2012 novorapidboi26 1,819 posts	Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing I regularly do it...............mostly between lunch and dinner, as I am fighting the dawn phenomenon between breakfast and lunch and my BI is running out between dinner and bed.... And all it tells me is whether the timing of my dose, 10, 15, 20, 25, 30 minutes has met the profile of my digestion well, if it has and the meal is unique or rarely eaten I can take note and adopt the same timing next time.......

Nov 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Clickstar Pen - insulin delivery speed maybe there is a mechanism on it that helps the plunger depress at a more constant rate, however its very likely this is automatic....... I could be totally wrong though as I have been on disposables for 4 years plus....

Nov 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Insulin Pump approval see response in other post.....

Nov 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Ratios / higher number of units of insulin I think there is a slight misunderstanding but remember that whiskysmum has not actually done DAFNE and so does not know the procedure when dose adjusting............you do now though..... you have probably been seeing people refer to such ratios on diabetessupport, however these people will be on pumps most likely. There will be some who are injecting and this may work for them......... I am sure I read somewhere that the standard/average carbs processes from 1 unit is 10 for adults and 15 for children, this may now be out of date but DAFNE is based on this.....

Nov 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / One unit of insulin to ten grams carbs ratio I think for most DAFNE graduates they will take a incremental approach to dose adjustment. If 1:1 (1:10) is not enough for you then you would increase that to 1.5:1 (1.5:10), this makes its easier to calculate more achievable insulin dosages, however some people do need to get there ratio to a more accurate number eg 1.25:1, 1.75:1. Any more precise than that and it becomes difficult to dose properly unless your on a pump. If several days results show you need more, increase by .5 units to every 10 grams....

Nov 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / I did it :) Hey Nick, I am currently still in the process of getting a pump......... I was referred to the clinic after my consultants agreed I would benefit from one. It also helped that the pump clinic within my PCT had secured funding for 18 pumps just for the adults alone. Without this I probably wouldn't have even been considered. I was referred in July/August and I am looking to go on the saline solution test period mid January, so not too long in the grand scheme of things. The length of time it has taken is probably down to the business of the clinic with the normal appointments.. I hope it not too long a wait.......

Nov 13, 2012 Alan 49 284 posts	Topic: General Discussion / How many units of insulin? Also: If you don't have a pen that allows you to dial up half a unit of insulin, you should round up 4.5 units to 5 units.

Nov 13, 2012 Ahmentep 99 posts	Topic: General Discussion / How many units of insulin? Hi, Don't be frightened by this, but this is how it works mathematically. Insulin units = C/10 x R Carbs = I/R x10 Ratio = I/C x 10 Where C = Carbohydrate in grams I = Insulin in units R = Ratio ( e.g. 1:1) So, for the values you gave: C/10 x R (You only use the first figure (or the top figure, depending on how the ratio is written)) 30/10 x 1.5 = 4.5 I hope this helps for the future. Kind regards, Roger PS A ratio, say 1 to 1, can be written as 1 to 1 or as 1:1 or as 1/1 For a ratio of 1 to 10 these would be - 1 to 10, or 1:10 or 1/10

Nov 12, 2012 merstone 3 posts	Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing Thanks marke. Signs of some research into the value of occasional post-meal testing were, of course, exactly what I was hoping to find from this thread. However, I guess that anything remotely conclusive in this area is unlikely, bearing in mind the longer term complications aspect would tend to make it as lengthy as the proverbial piece of string. I therefore wonder by who and on what evidence the post-meal BG targets published in last month's Balance magazine were derived?

Nov 12, 2012 marke 686 posts	Topic: Questions for HCPs / snacking and corrections Hi Gemsa, sorry bad news you are no longer 'normal'. What happens to 'normal' people no longer applies to you. What Carolin was trying to say was say you eat at 6pm, inject 12 units and have 120carbs ( where you are on 1:1 and 10carbs = 1 unit). If you test 1 hour later your body is still digesting the food and your BG will be higher than normal. If its 14 and you decide to correct and give yourself 3 units to bring you back to 5 ( generalising a lot about the exact effect of insulin), you now potentially have 15 units working on 12CP's which may be too much and will force you too low. Your QA insulin will generally keep working for upto 5 hours, this is the danger of injecting between meals. In an ideal world our BG stays within range after meals, but its not an ideal world so we are trying to make the best we can of it. If your BG is back in range before the next meal then generally you are doing ok. You can try to get better control than this but is very difficult. You don't have the feedback mechanism that a normal person has. You cannot secreet insulin at just the right time to balance the sugar in your blood, All you can do is put it into your body fat and let it be absorbed into your system at roughly the rate required. This is not precise but its as good as it gets with technology as it is at the moment. Maybe one day this will change but not in the immediate future.

Nov 12, 2012 marke 686 posts	Topic: Questions for HCPs / DAFNE view of Post-meal BG Testing I wouldn't say it is completely unnecessary, however I would also say it is not covered in the course because no research has been conducted to prove its benefits. Its nothing to do with test strip economy more to do with the don't tell you stuff that is not backed up by research, Thats the point of DAFNE it is all backed up by research. You will find loads of discussions on Diabetes sites regarding post-meal highs and their significance. However my personal view is most of it is not backed up by any real research just opinions. Whilst everyones opinion is valid, at the end of the day thats all it is. I have my own personal views but its not for me to tell you what is right or wrong. If there IS some solid research hopefully someone will respond with some links to it.

Nov 12, 2012 mum2westiesGill 502 posts	Topic: General Discussion / How many units of insulin? Thank you Marian!

Nov 12, 2012 NuMo 28 posts	Topic: General Discussion / How many units of insulin? 41/2 (4.5)

Nov 12, 2012 mum2westiesGill 502 posts	Topic: General Discussion / How many units of insulin? How many units of insulin would you have on 1.5:1 ratio for 3 CPs / being 30g of carbs?