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Sep 27, 2012
JayBee
587 posts
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Topic: General Discussion / Result. Today's results! The next plan of action is to put my evening BI down to 15 now I've got solid evidence.
You're welcome. You're helping me too so it's the least I can do. 
It's certainly a good start considering how dangerous the blues can be, and those green will come to you when they're ready, okay? We'll work through this!
Sounds good to me. What are the ratios you've decided to stick with for the 2-3 days?
Haha, this made my day! ^_^ I'm sure if we do a Foxtrot and throw in a Trick of a Tail, we shall reach our new Genesis! Just a Job to Do: best to keep in mind that We Can't Dance for now to save us from the Land of Confusion! ;P Sussudio!
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Sep 27, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Result. For me the benefit of Levemir is not its blood sugar reduction power, as its still a long acting insulin analogue just like Lantus and done the same job for me as Lantus done, its the flexibility of being able to cut your BI requirements in 2, am and pm while being able to make adjustments and see the effects straight away....[although you should always confirm dose change with 2-3 days results.... ].......allows you to concentrate on the overnight requirement and quickly establish the right dose as there are no carbs or QA working, leaving just your daytime dose to work out....Vic, I think your plan to get rid of the lows is a good one.........I have had days of all greens, but they are few and far between, I try to aim for readings less than 10 all day, so less than 10 for mid meal spikes, again, this is hard to achieve most of the time.......you will get above target readings all the time, its just the way it is, if you can accept that, life will be much easier.... |
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Sep 27, 2012
AshleyB
10 posts
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Topic: General Discussion / Result. Ive been on levemir for 36hrs and ive already seen a massive drop in my BG levels. I'm not high before bed and I'm waking up within the DAFNE tragets. I'm very impressed. I would consider "Vic" to change, I instantly feel i'm in control.
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Sep 27, 2012
vic demain
87 posts
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Topic: General Discussion / Result. JWo - Thank you for your considerable input into this thread and to helping me sort out my thoughts and future direction. That I have now done and whilst it doesn't include a pump, I may well ask my doctor about Levemir, next time I see him.I have been aiming for greens across the board, which is unachievable, now I know I need to eredicate all blues as they are the real danger. Will have to cope with reds. My BI is working well at 18 units, so will leave that and try to adjust the other with QA. There has been some Misunderstanding, although I Know What I Like, so I will Follow You will you Follow Me? Los Endos.
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Sep 26, 2012
SteveRowland
10 posts
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Topic: Questions for HCPs / Help Thanks, Nick. I may have misunderstood you but that sounds like the actions on a positive ketone test which I've not had. I'm increasing my BI by 10% and correcting as appropriate. I wonder if we mean the same thing? |
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Sep 26, 2012
JayBee
587 posts
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Topic: Site Development / Quote error. I'm not sure when it started doing it but whenever I go to edit my forum posts, " turn into " and I keep having to re-edit to correct them.If I fail to correct them, and edit again, it doubles up. Hope this issue isn't too difficult to fix... Sorry if it is.  Many thanks in advance! |
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Sep 26, 2012
JayBee
587 posts
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Topic: General Discussion / Result. In all honesty, what insulin you choose to be on, like with the pump, it is entirely up to you. It is your body after all and we won't know the impact like you will. I'm certainly not expecting you to just go on to Levemir just because I said so; it has just had a very positive effect on my control, worthy of a mention in my own opinion especially considering how similar our troubles have been. It is very possible to achieve control with Lantus but how long it takes will depend on how it is approached (Heck, wouldn't it be funny if you ended up split dosing Lantus like I did before!).Sometimes healthcare professionals are not always aware to make the suggestions I suppose but I cannot honestly speak on behalf of your healthcare team. You could ask them what they think of the idea of Levemir if you want their input into your decision. Sadly, money limits do seem to have quite a lot of say in what you're offered - I mean, heck, I was asked to change my blood testing machine, pen needles, finger pricking needles, etc, which I started a discussion about here: http://www.dafneonline.co.uk/forums/1/topics/1815 Hope you're doing okay vic. After you've had your next 48 hours with no changes, if you post your results up, I'll get L to look at the patterns too because he loves a challenge. He often reads my BG diary in a completely different way to me because he's a keen mathematician. ;) Best wishes. |
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Sep 26, 2012
JayBee
587 posts
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Topic: General Discussion / Top 5 Takeaways from DAFNE I was diagnosed age 5, back in 1990. I did DAFNE in May 2009.------ My top 5 significant lessons: 1) I have been given a lot more solid information to give to anyone who wants to help me as a Type 1 Diabetic. Knowledge is a very powerful thing when used right and not generalised. Be it my workplace, GP surgery, a friend or a loved one, having the DAFNE knowledge and guidebook has given me the opportunity and confidence to explain how I care for myself a lot better than ever before - and in turn, more confidence in say, a loved one taking care of me when I'm vulnerable because they are also DAFNE educated and understand my needs to a similar level to me. The best example I can give of this is my fiance. He cares about me very much clearly and I genuinely feel that him also learning the DAFNE rules has strengthen our relationship as a result. It is very common for a loved one, including parents, to be completely frustrated by the fact they don't understand the suffering of someone they love and this is often amplified by fear of the unknown. DAFNE has removed a lot of the frustration from this and has made me as a diabetic person a lot more understandable. He even carb counts for me sometimes! On a related note: A bonus is it is also possible to help a fellow graduate who has lost their way. DAFNE rules give a base to work from and provides information found from at least a decade of research. It makes me quite sad that across the world diabetics have to gain this knowledge alone. Having any kind of course is a very good thing for the majority; though pride can get in the way for some. Speaking of pride, it does get kind of embarrassing how much personal information may need to be disclosed for some situations (like some forms of exercise, for example *cough,cough*)... this can make it awkward to want to ask for help(!). 2) I understand what my body is trying to tell me now. Before DAFNE, I used to correct before giving my body a chance to use up the insulin I took from a meal. I would "boomerang" - where I'd correct, hypo, panic eat, go high, panic correct... etc - frequently and I would never learn from it. I see many others admit doing this and having no patience to let their body use the things they give it. Patience is a very valuable thing. My control is so much better now since DAFNE (as in it's a lot more stable) and I actually understand what the hell is going on as soon as I learnt to work with my body and not resort to self-depreciation because I was high or low. I can use the tool that is insulin a lot more effectively. I can understand what my body is trying to tell me ten fold. DAFNE gave me a lot of confidence back. 3) After 19 years of being diabetic, I was finally introduced to key carb counting information. In the past, I would pull dose numbers "out of my butt" after just looking at food, because I did not know about carb counting AT ALL. It was never even suggested to me, until I did DAFNE. I was told to "work it out myself" pretty much. Shortly before DAFNE I used to say to myself things like "If I'm 12, I'll take 2 units" or "I'm 13, I'll take 3 units". I can see now just how dangerous that logic was but I did not have base knowledge to work with because I was taught about "eating for my insulin" and not the other way around which DAFNE teaches. Adjusting your insulin for what you eat instead of eating for it is so much better for all. It's a shame this was not realised sooner. 4) I don't have to be afraid to live my life. When I was fairly young (early teens, I had been diabetic about 5-8 years by this point), I made a few decisions: 1. I was never going to drive (because it'll be too dangerous due to hypo potential). 2. I was probably never going to be a Mom (because I had no faith in my control, I don't think I could be a good full-time mom and I didn't want to have to have cesarean section due to baby big-ness). 3. I didn't care if I never got married. 4. I was going to live for happiness! Since DAFNE, it's been a bit of a mental rewiring thing: 1. I passed my driving test last year. 2. I'm engaged. 3. .. well how I think has started to change generally. I used to live in fear and having to challenge a lot of my feelings has been an emotional experience. Still no plans to be a mom though, but my reasons aren't exactly the same any more. If I want one, I'll go for it probably now. ;P Shall see! 5) More respect for ketones and a better routine in place for illness. Misunderstood knowledge or taken at face value advice is a very dangerous thing. An education based on opinion is not a good education. There is a very good reason why this site expects you to register your place of doing the course to then allow you access to the online guidelines - some of them can be potentially very dangerous and one of these is the sickday rules. My respect for ketones was very poor pre-DAFNE. I would not take my ketone urine sticks stock too seriously. If my ketone levels were high, it was time to consider a trip to the hospital. Post-DAFNE, I can now prevent myself from going into hospital. I can get those excessive ketone levels down myself using the rules. The last time I went into hospital wasn't because of ketones or my diabetes (my levels were lovely) - it was dehydration alone from not being able to keep fluids down. Definitely would have been a very different story pre-DAFNE. |
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Sep 26, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Top 5 Takeaways from DAFNE Post DAFNE, I have yet to meet an HCP that knows more than me with regards to my control. DAFNE taught me about the different insulins and I made decisions on what I thought I needed.....You don't have to wait for them to tell you to go on it.... I didn't mean to upset though.....DAFNE isn't a fix for anyone directly..., each individual needs to tweak for their own needs.....as you know......the people that teach it don't say it's a quick fix, still requires hard work on our part..... |
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Sep 26, 2012
vic demain
87 posts
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Topic: General Discussion / Top 5 Takeaways from DAFNE Sorry Novorapidboi but you couldn't be further from the truth. Having completed and enjoyed the course some 3 years ago, I have worked tirelessly to try and follow the general principal and thus improve my control. I have tested my blood at least 4 times everyday (would have done more if the doc would prescribe enough strips), weighed out food, done endless calculations to try and fit injections to what I am eating, have regularly attended clinics, been an active member of this site, all of which I still do. So no I have not given up.However DAFNE in my experience is not a one size fits all solution to every type1 diabetic. My Hb1ac has never improved since the course, I have suffered far more hyops than ever before and my control is no better than before the course. If DAFNE were perfect, we would all get green results every time we tested, yet that is not the case for many. In fact in 3 years I have never experienced a completely green day, have you? You are correct in thinking that I am not happy with what has gone on. If Levemir is so much better, why have my diabetic team never mentioned moving over to it? Their job is to help improve my control. I do not believe that my problem is the background as I know that by taking a certain amount, I will be in the right area yet if I increase it by 2 units, I will be hypo all over the place. Sorry to sound negative but your opening sentence sounded like every person I have sat across a desk from who tells me "if you improve your control, you will feel better".  |
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Sep 26, 2012
Nick_G
6 posts
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Topic: Questions for HCPs / Help Hi Steve,Have you applied the sick day rules to your insulin rates? You can increase your previous TDD by 10% initially with a view to increasing to 20% if required. |
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Sep 26, 2012
SteveRowland
10 posts
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Topic: Questions for HCPs / Help I am struggling with a seasonal respiratory chest infection. I've finished a course of antibiotics and am snuffling etc. Over the past week my BG is ridiculously high. I have been correcting robistly but BG keeps rising. I have increased my BI by one. No effect. I am leaving work now to test for knes.. So far all ketone tests have been negative. I'm going to increase BI by 10% and keep correcting. Any comments welcome! |
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Sep 26, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Top 5 Takeaways from DAFNE It sounds as though you have given up on DAFNE Vic!... I believe you are far from getting the best out of DAFNE. You are on a single dose of Lantus, this could be split, you could try Levemir. All these angles need to be explored first before giving up.....but I sense a reluctance.....the background dose as we all know is the foundation of the insulin regime....I think you would agree that your foundation is not structurally sound yet.... For me the top 5 would be: 1. Basic understanding of the carb/insulin relationship. 2. The thirst to learn more about my own condition and others. 3. Sick day rules. 4. A much more structured routine when it comes to eating, testing, which comes easy. 5. Acknowledging that I will never be able to control it perfectly, no one will, but that I should focus on the important things in life and enjoy them, try to balance out controlling blood sugars and living life.... |
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Sep 26, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Result. Vic,I know you stand by Lantus at the moment, however Levemir would suit you much better if you find you need to up BI doses and then down again. The change of dose in Levemire happens immediately...... Also with a pump, here I go again...;), is that you can set what is called temporary basal rates, which allows you to cut or add a percentage of your BI dose, for times when your more or less active, so keeping the same BI dose, just adjusting for non regular events.... |
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Sep 26, 2012
JayBee
587 posts
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Topic: General Discussion / Result.
Based on the diary entries you've posted most recently, you don't exercise the 48 hour rule at all and this works against you. Adjusting things every day does not give your body the chance to use the new dose before you change it again - this is why the 48 rule exists because your body needs that time. http://www.dafneonline.co.uk/hbook_topics/45 (link is to the online DAFNE guidebook on this site - see notes in the third box down on the flow diagram - and fifth "only adjust one insulin at a time"). It is very very easy to panic when things aren't going well but changing things about a lot can make it a lot worse. I know because I have sinned as well in the past (and you saying "I can't afford to hypo" is a personal echo in my ears!). My DSN and L have often told me off for not waiting the 48 hours minimum as taught by DAFNE. When I did, I found things did start making a bit more sense - but you've got to be prepared to find out, be it through the highs or lows. Ask for help if needed if you're extra worried at work.I mean, look at me, I'm high a lot of the time currently but at least I'm consistent and slowly getting to the answer... plus I've explained the changes I've had to go though to get my high BG causing stress levels to go down. I'd love for DAFNE to be a quick fix but sadly it isn't. Our bodies are too complicated for it to be that simple and generalised. Insulin itself is also too complicated a tool to be generalised - for example, Lantus won't work like Levemir; and everyone won't respond the same to either insulins.Edit: Sad to see your response to the 5 takeaways thread. ------------------ **Posts today's results** 13BI in the morning today. Bit of stress yesterday evening so, like overnight, I'm expecting today to be higher than normal today. |
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Sep 26, 2012
vic demain
87 posts
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Topic: General Discussion / Top 5 Takeaways from DAFNE DAFNE gives so much knowleadge. Sick day rules, controlling diabetes by carbohydrate intake calculations, how to cope with exercise and by giving people the confidence to feel that they can contol their condition.The downside is that with the fullness of time, some people find out that they are very different to the norm and DAFNE principals do not cover them and they are back to sorting out their own condition. |
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Sep 26, 2012
AshleyB
10 posts
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Topic: General Discussion / Result. What was your reading before bed, Was there any extra activites before bed You should lower your BI again tonight coz of the hypo!
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Sep 26, 2012
AshleyB
10 posts
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Topic: General Discussion / Result. Its not new here either, I've kept all my BG booklets so far and intend to for some years. I started my Levemir last night, I was 15.6mmol/l before bed as i hypo'd 2hrs after dinner (no correction after a hypo). This morning at 5am i decided to take a reading to see how my Levemir kept me staedy to my suprise i was 15.8mmol/l only 0.2mmol/l change which i'm very impressed with. I take my next dose at 10am. My dossage was 23 for Lanctas so I have gone for a 12u split across 12hrs.I hope i will be stable now without the rise in the afternoon. I agree with JWo :- Try not to change too many things around to quickly otherwise you wont be able to see the effects. |
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Sep 26, 2012
HelenP
218 posts
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Topic: General Discussion / Top 5 Takeaways from DAFNE My top five are to do with the relationships between insulin demand (by your system), insulin demand from the different types of food and the times of action of the different types of insulin. Dafne answered so many questions and gave me a lot of freedom. Previously I had been on 5 injections: two morning and night (6:00am and 6:00pm - long acting) and three linked to meals (6:00am, noon and 6:00pm) and no food in between. Both the long acting were the same number of units and breakfast, lunch and dinner were all the same,,,very rigid!When I first asked my endocrinologist if I could (literally would he refer me) do DAFNE he said that I would not like it as it required a lot of attention to detail. He did not refer me but I managed to talk myself into a course and when I went back and announced that I had learnt a lot he was amused! For the first time I learnt that as far as possible I was in control. Helen |
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Sep 25, 2012
pfordmartin
5 posts
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Topic: General Discussion / Top 5 Takeaways from DAFNE Hi all. I am an American writer working on a piece for JDRF about the DAFNE program. I would love to hear your thoughts about the most important things you learned from attending DAFNE. It could be as broad as "talking to others with diabetes about living with it really helped" or as specific as "I learned how to adjust my insulin dose for pizza." Really, whatever significant learnings you applied to your life after attending the program. I'll be compiling a top 5 list, so feel free to contribute as many or as few as you'd like!I also started a thread asking for "your story" about attending DAFNE. While that piece is fairly complete, you should feel free to visit that as well. And feel free to private message my inbox here if you'd rather share that way. Thanks so much for allowing me to learn more about DAFNE and your experiences! Best, Paula ************************* Paula Ford-Martin www.wordcrafts.com |
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Sep 25, 2012
pfordmartin
5 posts
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Topic: General Discussion / Let's hear your story! Thanks to all who responded! Great input, and it is extremely helpful. :-)I spoke with my editor today who had a few additional requests for this piece, so I'm going to start a new thread called "Top 5 Take Aways from DAFNE." Please stop by and contribute if you have more thoughts! Best, Paula |
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Sep 25, 2012
Alba37
1 post
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iPAG are holding a pump information (bolus advisor monitors and CGM too) afternoon in Glasgow at the Swallow Hotel from 1pm - 4.30pm. 6th Oct, 2012. Everyone welcome. |
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Sep 25, 2012
JayBee
587 posts
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Topic: General Discussion / Result. Has anyone else kept most of their old BG diaries?I'm trying to pin point when I changed on to Lantus exactly and then Levemir... have learnt that I split Lantus little under two months after doing DAFNE though (May 22nd 2009 to be precise - see above! XD). Those afternoon highs are unmistakable... I can't get over the fact that no one picked up on it sooner considering corrections are all over the place in my even older, pre-DAFNE, diaries. It makes me kind of sad... Edit: After some more reading, decided to add my findings to my forum profile
How times change! Edit no.2: Yes, I am a bit of a hoarder I suppose.
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Sep 25, 2012
marke
681 posts
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Topic: General Discussion / Bayer Contour USB meters Hi Nikki, which regulations ? I am just curious to know how they are supposed to be improving the accuracy and what that accuracy should be Obviously mine need to be improved since they show my readings to high all the time You can bet they will cost more though even if it is for regulatory reasons, we are not talking about charities here after all.... |
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Sep 25, 2012
JayBee
587 posts
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Topic: General Discussion / Result. vic, you've really got to try and stop those every day changes to ratios and BI... it's making it impossible to understand your BG patterns. Best to leave it at least two days to make sure that nothing else caused the lows/highs (like I've done the past few days with illness/stress in consideration).If you return to the last day you had the least amount of hypos (if none at all, that's even better) and build from there? You know, bit like I did with the 11/17BI change... it'll help get a stable base again to work with (Day I did it showing above - when to those doses because I'd got evidence of the BIs being correct overnight definitely and during the morning only). How stuff has changed since then... I can't be far off now hopefully (though when I start thinking this, often my body decides to be a sod the next day!). Do really feel for you though. Life was hell when I was adjusting my BI with 1:1 across all meals.
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