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Sep 26, 2012
Nick_G 6 posts

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.
 
Sep 26, 2012
SteveRowland 10 posts

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!
 
Sep 26, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / Top 5 Takeaways from DAFNE

It sounds as though you have given up on DAFNE Vic!... Crying or Very sad

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.... Wink

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....
 
Sep 26, 2012
novorapidboi26 1,819 posts

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....
 
Sep 26, 2012
JayBee 587 posts

Topic: General Discussion / Result.

vic demain said:
JWo - The big problem for me was having a week off work and then returning to perhaps the busiest period of my year. When off the BG's skyrocket so put BI up, at work I have been constanly hypo, so have to bring it down. What I need to do is find one scale for work and another for weekends and time off.



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. Sad 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. Sad 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. Sad

------------------
**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.
 
Sep 26, 2012
vic demain 87 posts

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.
 
Sep 26, 2012
AshleyB 10 posts

Topic: General Discussion / Result.

What was your reading before bed, Was there any extra activites before bed Laughing You should lower your BI again tonight coz of the hypo!
 
Sep 26, 2012
AshleyB 10 posts

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.
 
Sep 26, 2012
HelenP 218 posts

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
 
Sep 25, 2012
pfordmartin 5 posts

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! Smile

Best,
Paula
*************************
Paula Ford-Martin
www.wordcrafts.com
 
Sep 25, 2012
pfordmartin 5 posts

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
 
Sep 25, 2012
Alba37 1 post

Topic: General Discussion / Insulin pumps in Scotland

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.
 
Sep 25, 2012
JayBee 587 posts

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... Sad

Edit: After some more reading, decided to add my findings to my forum profile Smile

I changed from Humalin I to Lantus in 2007.
I first started split dosing on Lantus on 22/05/2009; roughly two months after doing DAFNE.
Changed from Lantus to Levemir on 24/09/2010.
For my QAs, I have been on Humalog for as long as I can remember!


How times change! Very Happy

Edit no.2:
Yes, I am a bit of a hoarder I suppose. Razz
 
Sep 25, 2012
marke 686 posts

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 Smile
Obviously mine need to be improved since they show my readings to high all the time Wink
You can bet they will cost more though even if it is for regulatory reasons, we are not talking about charities here after all....
 
Sep 25, 2012
JayBee 587 posts

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). Sad

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. Sad
 
Sep 25, 2012
novorapidboi26 1,819 posts

Topic: Questions for HCPs / bi

Results would be good as Alan says as ultimately it the results that will tell YOU, and us what you need to do......

In order to change your QA ratios you need to have 2-3 days of high readings at the breakfast, lunch and dinner tests............and this information can only be reliable if your BI dose or doses are right...

Is it/Are they? [confirmed by carb free meals/missing a meal/overnight testing]

Often with large increases in BI comes reductions in QA..........

 
Sep 25, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / Result.

Spread the joy........ Very Happy
 
Sep 25, 2012
Alan 49 284 posts

Topic: Questions for HCPs / bi

Hello Susie
I think it would help us to make a judgement if you included your diary entries in your post - the option is beneath the area where you put your post.

Alan
 
Sep 25, 2012
JayBee 587 posts

Topic: General Discussion / Result.

AshleyB said:
I miss read JWo, I know you didn't think i'm a woman, I've got my morning eye in. Shocked



No worries! Don't you just love the confusion of the internet? ;P

The over night results and today's results so far have been interesting! I'm starting to think that perhaps the illness/stress/whatever the hell it was is easing up now and my "normal" numbers are back... have a lookie above (the diary will also automatically update as I do my blood tests still)!

Based on these numbers (especially if they stay fairly consistent to the past few days) I will be putting my morning BI up tomorrow for sure now. Very Happy

My HbA1c has been around 8.9-9% consistently for the last year or so but it has started dropping (my last one back in June/July was 8.4% which for someone who's not seen a drop for a very long time, after a lot of DAFNE work too, this is a massive achievement - something is now working!). With all the extra personal troubles I've had in the past year or so though, to have numbers so much easier to work with, I could cry with happiness now!

Things can only get better! Smile I'm so glad we can all relate. It's so important to realise that this condition will never been all black and white, and you're only working against yourself if you generalise with the knowledge. DAFNE is a guideline that encourages adjustment through pattern searching - an excellent help to those who need it (which imo should be everyone anyway, especially newly diagnosed!).

Sorry, I'll pipe down now... touched into my "DAFNE advocacy mode" a bit there, lol. XD

AshleyB said:
Any how once ive moved over to levimur i will upload some diary entries so you guys can have a look.
Hopefully i will have pages of Greens readings,



Looking forward to it! Smile

I was another that was on Lantus and then I moved to Levemir. I can't imagine going back. Levemir has been way too helpful. Lantus used to run out shortly after lunch for me and I was like that for years before I did DAFNE. Went split dose after the discovery and after still having problems, I moved to Levemir because "it's an insulin designed for split dosing" I was told. Smile A lot less trouble - it's almost like it's not as "strong" as Lantus so less prone to hypos. Sweet relief!
 
Sep 25, 2012
susieq 19 posts

Topic: Questions for HCPs / bi

having increased my bi by 4u since my dafne course, i was wondering if I ought to decrease my Qa ratios, as I seem to go quite low often during the day. my ratio's at the moment are 1.5:1 should I decrease the ratio or just knock off a unit or two?
 
Sep 25, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / Education

I am confident you will get some good information from there... Smile
 
Sep 25, 2012
jonmac 6 posts

Topic: General Discussion / Education

I'm now signed up for the Bournemouth online course and so far so good. Many thanks for the tip!
 
Sep 25, 2012
AshleyB 10 posts

Topic: General Discussion / Result.

Thanks Vic, On the course it was proven that my lanctus wasn't lasting the full day with me, maybe because of my fast metabolic rate of burning energy.

Any how once ive moved over to levimur i will upload some diary entries so you guys can have a look.

Hopefully i will have pages of Greens readings,

I do tend to eat a lot and not inject when snacking and add the CP's to the next meal. Maybe I should start actually using the priciples of injecting followed by eating.

Razz
 
Sep 25, 2012
AshleyB 10 posts

Topic: General Discussion / Result.

I miss read JWo, I know you didn't think i'm a woman, I've got my morning eye in. Shocked
 
Sep 25, 2012
AshleyB 10 posts

Topic: General Discussion / Result.

Just to let you know, I am a man. Don't want any confussion. I didn't take offence JWo. LOL x

Its really P ing me off at the min as i'm always high and making corrections. I can't wait to get on the levimur to get a steady BI.

Over the last 14 days ive averaged 13mmol/L

Vic what BI do you take, mines Lanctus at the minute.

AshleyB a Bloke lol..