Recent Posts - DAFNE Online

Aug 31, 2012

novorapidboi26 1,819 posts

Do your results show a problem with insulin doses at certain times, or is there no obvious patterns............

I have heard of folk having 'brittle' diabetes and having conditions like gastroparesis where managing sugars is difficult and unpredictable,could be something like that....

Aug 31, 2012

DianeW 115 posts

Topic: General Discussion / Diabetic jokes

Ok here goes

There once was a diabetic called Sally
Who thought she was going doolally
She let out a scream
When her meter said 15
Her CPs and QA did not tally!

Aug 31, 2012

DianeW 115 posts

Topic: General Discussion / morning highs

Although obviously a good thing to eat less carbs/smaller portions at dinner, if you cover the carbs with the right amount of QA then bedtime reading should be ok and it follows if BI is correct then your morning reading shouldn't be that different from your bedtime reading. I had this problem and have had my Lantus split into morning and bedtime, but I find if you don't get the bedtime reading right then no amount of splitting seems to help....I presume you're not going hypo in the night which would make it high in morning?

Aug 31, 2012

Garry 328 posts

Topic: General Discussion / morning highs

If you have the confidence, lift your BI another 2 u and follow progress over the next few days and along with the dreaded 03:00 BG checks see what happens.
No improvement and good 03:00s - add another 2 u.
Wait a few days and see how you go. Once you get it right you may find that BG is within 1 mmol of your before bed result. Things will change over 28 days though.
Regards
Garry

Aug 31, 2012

ruthhutchinson 39 posts

Topic: Carbohydrate Counting / Paris bun/ rock bun

thanks Carolin. I miscalculated anyway and ended up with a BG reading of 1.8 - oops.

Aug 31, 2012

Phil Maskell 194 posts

Topic: Questions for HCPs / new to this!

Hi,

Just thought of another thing, knowledge is power with DAFNE, if you don't know your current BG how can you react, how often do you test a day? With DAFNE its every mealtime, bedtime and any other time you eat or exercise, this might be something you need to get used to if you don't test this often. Check your GP doesn't mind you using this many test strips?

You can then record your BG and try to see patterns etc...

Phil

Aug 31, 2012

Phil Maskell 194 posts

Topic: General Discussion / morning highs

susieq said:
No Carolin, I don't take any CP's for non carb foods, which is great. after my meal I was a pleasant 7.7 before bed, then overnight it rises to 10.7 in the morning, but I am just going to live with it. I've raised my bi and it's now a good week since I did that and it's still 9.9 this morning, so, perhaps it's my lot. daytime levels are good, I just wondered WHY it rises and you can never get a pleasant wake-up reading. But if that's the lease of my worries, then I'll live with it. as Phil says, I'll take option 2. !

Do you not fancy option 1 ? 4am injection sounds sooo appealing

Phil

Aug 31, 2012

Carolin 83 posts

Topic: General Discussion / morning highs

Hi Susieq,

Others who have responded are correct about the Dawn Phenomenon; it's a natural release of hormones (particularly growth hormone) in the early hours of the morning as you wake up that causes your liver to release glucose into your blood stream. If there isn't enough insulin (BI) around at this time your BG will start to rise.

The best way of trying to control this is:
1. take your evening BI as late as possible (bedtime) so it's still got a reasonable level of action by morning time
2. increase the dose of your bedtime BI, but ALWAYS check your 3am BG before and after making increases to BI to ensure you're not dipping too low there (you should be above 4.5mmol/l). If you do start to have night-time hypos, you will need to cut back on your BI again.

Some people just never manage to control morning BG, however if all other BGs and HbA1c is good then it's best to just live with it as you say.

Good luck,

Carolin

Aug 31, 2012

Phil Maskell 194 posts

Topic: Questions for HCPs / new to this!

Hi,

I did a 5 day course and I think this could have been compressed into 2 or 3 days, but there are quite few things that you need to get sorted such as Background and mealtime ratios, sickness rules, exercise etc... The first hour of the day was going through everyones BG diary and working out the best course of action for everyone, by doing this as a group you could see the changes you needed to make in different situations, you might not have a hypo that week, but someone else in the group would so you could discuss how to react to these things.

I would guess not really, support after the course online is perfect, but I think the basics need time.

If you're having control issues now there are a couple of important things from DAFNE that might help. It all becomes alot easier if your Background insulin is holding you at a steady BG, I had to do a weekend carb free to prove this to myself. Don't overcorrect hypos as you go sky high after and are chasing your tail all day (do you correct high BGs, if so don't between meals as this can cause yo-yoing too) then, 20 carbs or 2CP in DAFNE parlance (little carton of Orange Juice is exactly 2CP Very Happy

Chocolate is not a good hypo cure as the fat in it slows the sugar absorbtion Crying or Very sad

) is usually enough to bring you up and if more than an hour before the next meal 2CP of starchy carbs to keep up.

Do you currently carb count? You could look this up online and just get used to estimating carbs per meal as this will be useful.

Hope this helps. These are just hints for now, but I feel you will have to wait for the course though.

Phil

Aug 31, 2012

susieq 19 posts

Topic: General Discussion / morning highs

No Carolin, I don't take any CP's for non carb foods, which is great. after my meal I was a pleasant 7.7 before bed, then overnight it rises to 10.7 in the morning, but I am just going to live with it. I've raised my bi and it's now a good week since I did that and it's still 9.9 this morning, so, perhaps it's my lot. daytime levels are good, I just wondered WHY it rises and you can never get a pleasant wake-up reading. But if that's the lease of my worries, then I'll live with it. as Phil says, I'll take option 2. ! Smile

Aug 31, 2012

Robyn51187 1 post

Topic: Questions for HCPs / new to this!

Hi,
I heard of DAFNE after having an eye exam yesterday, I have been diabetic for 17 years diagnosed at 7. My control has been difficult for about 3 years and this was recommended to me. The waiting list for DAFNE in my area is 18months and i really don't want to wait that long! I was wondering if i can do the change with just online support?
Eagerly awaiting your reply,
Robyn McMurray

Aug 31, 2012

Carolin 83 posts

Topic: Carbohydrate Counting / Paris bun/ rock bun

Hi,

Could be something like an English 'teacake' - see CP listing - which is 3CP for 55g, so you'd be looking at around 8CP for 145g

Hope this helps?

Carolin

Aug 31, 2012

Carolin 83 posts

Topic: General Discussion / morning highs

sjohno said:
susieq - do you take QA for the omelette, bacon and salad?

Unfortunately for me I have to take QA for all non carb foods......if I have an omelette with bacon, mushrooms and tomatoes at lunchtime this for me is 3CP, I am on a 1:1.5 ration so I take 6QA for that omelette. I can eat chicken with salad and still have to take QA

Just a little word of warning for other DAFNE grad's. There is essentially NO carbohydrate in this meal so we wouldn't advise people to count as CPs or inject QA as there is a very high risk of hypos; however clearly with experience and understanding your own diabetes and response to different foods you will leanr exactly what you need.

Often if you find you are needing QA even if not eating carbs it can be an indication of BI not being high enough.

Keep it up! Smile

Carolin

Aug 31, 2012

Carolin 83 posts

Topic: General Discussion / Diabetic jokes

Hi everyone,

Please, please, please keep this going. It's great material for the quarterly DAFNE Newsletter.... we'll try to include 1 or 2 of the best in each issue.

Cheers,

Carolin Laughing

Aug 31, 2012

vic demain 87 posts

Topic: General Discussion / Result.

Thanks for the positive feedback Garry, but this has all become a bit disheartening. Unlike you, I have never been able to achieve largely greens. In fact after 3 yrs, I have never once had a complete day of readings in the green. Was put on a mission to look at a pump a while ago but preferred to stay with the needle, perhaps a mistake. Maybe there is some other factor that we are all missing but much as I enjoyed the DAFNE course and continue to follow the principals, the results have not made a jot of difference for me Crying or Very sad

Aug 30, 2012

mum2westiesGill 502 posts

Topic: General Discussion / What did you have to eat yesterday?

HelenP said:
OK OK I have been reading these with interest and am entertained/even amused by what we consider "normal eating". However, I give up... what is an "mds"?

Helen

"Rnds" is my shortened version of rounds Smile

Aug 30, 2012

HelenP 218 posts

Topic: General Discussion / What did you have to eat yesterday?

Thanks...that makes a whole lot more sense! Here we call them slices! My G'mother used to talk about rounds when referring to bread but apparently there was a period of confusion (20-30 years ago) as to whether a round of sandwiches meant two slices of bread so the term gradually ceased to be used.

I will also have to see about my glasses!
Helen

Aug 30, 2012

meltow 78 posts

Topic: General Discussion / What did you have to eat yesterday?

RNDS not MDS!!!
Rounds Confused

Aug 30, 2012

HelenP 218 posts

Topic: General Discussion / What did you have to eat yesterday?

OK OK I have been reading these with interest and am entertained/even amused by what we consider "normal eating". However, I give up... what is an "mds"?

Helen

Aug 30, 2012

ruthhutchinson 39 posts

Topic: Carbohydrate Counting / Paris bun/ rock bun

Does anyone have any idea what the CPs would be for a rock bun/Paris bun which weighs in at 145g? I'm not sure what these are called in England but they are like a cross between a sweet crusty roll and a fruit bun. Any ideas?

Aug 30, 2012

susieq 19 posts

Topic: General Discussion / morning highs

Sounds like I should be happy with what Ive got....My HbA1c is 7.3 and it's just the morning highs that bug me. I correct at breakfast and the rest of the day is ok. some lows when I am walking or shopping/housework etc. but then I have an excuse to have a biscuit lol. I am happy to read that you think I might be beating myself up about it. I reckon you're right. I worry toooooo much. I suppose 10.7 isn't way too off the scale to not be able to live with it.

I don't want a pump, and I don't really want to go without my usual food. so perhaps this is what it's gonna be... and I certainly don't want to wake up at 3am to inject!!!!!! Mad

Option 2 then. Smile

DAFNE was good, I loved the week, and it did give me confidence to tweak around and not be scared of what I was doing. don't get me wrong. they were great. I suppose I did expect too much in the fact that I wanted to be able to stick at one bi dose and be satisfied that my overnight levels would be stable. But asking that of the dreaded diabetes is asking for pigs to fly!

Aug 30, 2012

Phil Maskell 194 posts

Topic: General Discussion / morning highs

sjohno said:
Since taking the DAFNE course in November 2009 my HbA1c tests have been 6.8,6.1, 6.2,6.2, 6.1.

I have had T1 for 33 years and DAFNE is the best thing that has happened, it's been a bit of a bumpy learning process but I believe I have a good handle on it now

Nice, even with DAFNE I am more 7 than 6 Mad

Aug 30, 2012

Phil Maskell 194 posts

Topic: General Discussion / morning highs

sjohno said:
susieq - do you take QA for the omelette, bacon and salad?

Unfortunately for me I have to take QA for all non carb foods......if I have an omelette with bacon, mushrooms and tomatoes at lunchtime this for me is 3CP, I am on a 1:1.5 ration so I take 6QA for that omelette. I can eat chicken with salad and still have to take QA

For 3CP to 6QA isn't that a ratio of 2:1? 1:1.5 on 3CP would be 2QA?

Just don't want to confuse things (any more than sorting this lot out) Wink

Aug 30, 2012

Garry 328 posts

Topic: General Discussion / morning highs

Many of us find that BI changes can take some days to kick in with an effect.
It may be the same for you, particularly if on Lantus BI.
For me, BI changes take 3 days to show signs of any possible improvement.

I think Confused

I eat a NORMAL diet, which when I look at my diary, averages 23 CPs a day.
We always have lots of unmeasured stuff going on in our blood which is difficult to manage the outcome of.
Take a few days to make any further changes - so you are sure of cause and effect.
Regards
Garry

Aug 30, 2012

Garry 328 posts

Topic: General Discussion / Result.

Cheer up vic. Just look back and review the good advice that you have given others through this forum.
Take heart from that. Smile

We are all in the same boat. Like you, I work hard at achieving a balance and felt like I was doing really well, with a graph largely in the green - but whilst on holiday....the wheels have come off......and 5 days on, I'm still trying to get things back in control. Goodness knows what has gone wrong but I'll keep day-by-day trying to get back on an even keel.

Regards
Garry

Aug 31, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Result. Do your results show a problem with insulin doses at certain times, or is there no obvious patterns............ I have heard of folk having 'brittle' diabetes and having conditions like gastroparesis where managing sugars is difficult and unpredictable,could be something like that....

Aug 31, 2012 DianeW 115 posts	Topic: General Discussion / Diabetic jokes Ok here goes There once was a diabetic called Sally Who thought she was going doolally She let out a scream When her meter said 15 Her CPs and QA did not tally!

Aug 31, 2012 DianeW 115 posts	Topic: General Discussion / morning highs Although obviously a good thing to eat less carbs/smaller portions at dinner, if you cover the carbs with the right amount of QA then bedtime reading should be ok and it follows if BI is correct then your morning reading shouldn't be that different from your bedtime reading. I had this problem and have had my Lantus split into morning and bedtime, but I find if you don't get the bedtime reading right then no amount of splitting seems to help....I presume you're not going hypo in the night which would make it high in morning?

Aug 31, 2012 Garry 328 posts	Topic: General Discussion / morning highs If you have the confidence, lift your BI another 2 u and follow progress over the next few days and along with the dreaded 03:00 BG checks see what happens. No improvement and good 03:00s - add another 2 u. Wait a few days and see how you go. Once you get it right you may find that BG is within 1 mmol of your before bed result. Things will change over 28 days though. Regards Garry

Aug 31, 2012 ruthhutchinson 39 posts	Topic: Carbohydrate Counting / Paris bun/ rock bun thanks Carolin. I miscalculated anyway and ended up with a BG reading of 1.8 - oops.

Aug 31, 2012 Phil Maskell 194 posts	Topic: Questions for HCPs / new to this! Hi, Just thought of another thing, knowledge is power with DAFNE, if you don't know your current BG how can you react, how often do you test a day? With DAFNE its every mealtime, bedtime and any other time you eat or exercise, this might be something you need to get used to if you don't test this often. Check your GP doesn't mind you using this many test strips? You can then record your BG and try to see patterns etc... Phil

Aug 31, 2012 Phil Maskell 194 posts	Topic: General Discussion / morning highs susieq said: No Carolin, I don't take any CP's for non carb foods, which is great. after my meal I was a pleasant 7.7 before bed, then overnight it rises to 10.7 in the morning, but I am just going to live with it. I've raised my bi and it's now a good week since I did that and it's still 9.9 this morning, so, perhaps it's my lot. daytime levels are good, I just wondered WHY it rises and you can never get a pleasant wake-up reading. But if that's the lease of my worries, then I'll live with it. as Phil says, I'll take option 2. ! Do you not fancy option 1 ? 4am injection sounds sooo appealing Phil

Aug 31, 2012 Carolin 83 posts	Topic: General Discussion / morning highs Hi Susieq, Others who have responded are correct about the Dawn Phenomenon; it's a natural release of hormones (particularly growth hormone) in the early hours of the morning as you wake up that causes your liver to release glucose into your blood stream. If there isn't enough insulin (BI) around at this time your BG will start to rise. The best way of trying to control this is: 1. take your evening BI as late as possible (bedtime) so it's still got a reasonable level of action by morning time 2. increase the dose of your bedtime BI, but ALWAYS check your 3am BG before and after making increases to BI to ensure you're not dipping too low there (you should be above 4.5mmol/l). If you do start to have night-time hypos, you will need to cut back on your BI again. Some people just never manage to control morning BG, however if all other BGs and HbA1c is good then it's best to just live with it as you say. Good luck, Carolin

Aug 31, 2012 Phil Maskell 194 posts	Topic: Questions for HCPs / new to this! Hi, I did a 5 day course and I think this could have been compressed into 2 or 3 days, but there are quite few things that you need to get sorted such as Background and mealtime ratios, sickness rules, exercise etc... The first hour of the day was going through everyones BG diary and working out the best course of action for everyone, by doing this as a group you could see the changes you needed to make in different situations, you might not have a hypo that week, but someone else in the group would so you could discuss how to react to these things. I would guess not really, support after the course online is perfect, but I think the basics need time. If you're having control issues now there are a couple of important things from DAFNE that might help. It all becomes alot easier if your Background insulin is holding you at a steady BG, I had to do a weekend carb free to prove this to myself. Don't overcorrect hypos as you go sky high after and are chasing your tail all day (do you correct high BGs, if so don't between meals as this can cause yo-yoing too) then, 20 carbs or 2CP in DAFNE parlance (little carton of Orange Juice is exactly 2CP Chocolate is not a good hypo cure as the fat in it slows the sugar absorbtion ) is usually enough to bring you up and if more than an hour before the next meal 2CP of starchy carbs to keep up. Do you currently carb count? You could look this up online and just get used to estimating carbs per meal as this will be useful. Hope this helps. These are just hints for now, but I feel you will have to wait for the course though. Phil

Aug 31, 2012 susieq 19 posts	Topic: General Discussion / morning highs No Carolin, I don't take any CP's for non carb foods, which is great. after my meal I was a pleasant 7.7 before bed, then overnight it rises to 10.7 in the morning, but I am just going to live with it. I've raised my bi and it's now a good week since I did that and it's still 9.9 this morning, so, perhaps it's my lot. daytime levels are good, I just wondered WHY it rises and you can never get a pleasant wake-up reading. But if that's the lease of my worries, then I'll live with it. as Phil says, I'll take option 2. !

Aug 31, 2012 Robyn51187 1 post	Topic: Questions for HCPs / new to this! Hi, I heard of DAFNE after having an eye exam yesterday, I have been diabetic for 17 years diagnosed at 7. My control has been difficult for about 3 years and this was recommended to me. The waiting list for DAFNE in my area is 18months and i really don't want to wait that long! I was wondering if i can do the change with just online support? Eagerly awaiting your reply, Robyn McMurray

Aug 31, 2012 Carolin 83 posts	Topic: Carbohydrate Counting / Paris bun/ rock bun Hi, Could be something like an English 'teacake' - see CP listing - which is 3CP for 55g, so you'd be looking at around 8CP for 145g Hope this helps? Carolin

Aug 31, 2012 Carolin 83 posts	Topic: General Discussion / morning highs sjohno said: susieq - do you take QA for the omelette, bacon and salad? Unfortunately for me I have to take QA for all non carb foods......if I have an omelette with bacon, mushrooms and tomatoes at lunchtime this for me is 3CP, I am on a 1:1.5 ration so I take 6QA for that omelette. I can eat chicken with salad and still have to take QA Just a little word of warning for other DAFNE grad's. There is essentially NO carbohydrate in this meal so we wouldn't advise people to count as CPs or inject QA as there is a very high risk of hypos; however clearly with experience and understanding your own diabetes and response to different foods you will leanr exactly what you need. Often if you find you are needing QA even if not eating carbs it can be an indication of BI not being high enough. Keep it up! Carolin

Aug 31, 2012 Carolin 83 posts	Topic: General Discussion / Diabetic jokes Hi everyone, Please, please, please keep this going. It's great material for the quarterly DAFNE Newsletter.... we'll try to include 1 or 2 of the best in each issue. Cheers, Carolin

Aug 31, 2012 vic demain 87 posts	Topic: General Discussion / Result. Thanks for the positive feedback Garry, but this has all become a bit disheartening. Unlike you, I have never been able to achieve largely greens. In fact after 3 yrs, I have never once had a complete day of readings in the green. Was put on a mission to look at a pump a while ago but preferred to stay with the needle, perhaps a mistake. Maybe there is some other factor that we are all missing but much as I enjoyed the DAFNE course and continue to follow the principals, the results have not made a jot of difference for me

Aug 30, 2012 mum2westiesGill 502 posts	Topic: General Discussion / What did you have to eat yesterday? HelenP said: OK OK I have been reading these with interest and am entertained/even amused by what we consider "normal eating". However, I give up... what is an "mds"? Helen "Rnds" is my shortened version of rounds

Aug 30, 2012 HelenP 218 posts	Topic: General Discussion / What did you have to eat yesterday? Thanks...that makes a whole lot more sense! Here we call them slices! My G'mother used to talk about rounds when referring to bread but apparently there was a period of confusion (20-30 years ago) as to whether a round of sandwiches meant two slices of bread so the term gradually ceased to be used. I will also have to see about my glasses! Helen

Aug 30, 2012 meltow 78 posts	Topic: General Discussion / What did you have to eat yesterday? RNDS not MDS!!! Rounds

Aug 30, 2012 HelenP 218 posts	Topic: General Discussion / What did you have to eat yesterday? OK OK I have been reading these with interest and am entertained/even amused by what we consider "normal eating". However, I give up... what is an "mds"? Helen

Aug 30, 2012 ruthhutchinson 39 posts	Topic: Carbohydrate Counting / Paris bun/ rock bun Does anyone have any idea what the CPs would be for a rock bun/Paris bun which weighs in at 145g? I'm not sure what these are called in England but they are like a cross between a sweet crusty roll and a fruit bun. Any ideas?

Aug 30, 2012 susieq 19 posts	Topic: General Discussion / morning highs Sounds like I should be happy with what Ive got....My HbA1c is 7.3 and it's just the morning highs that bug me. I correct at breakfast and the rest of the day is ok. some lows when I am walking or shopping/housework etc. but then I have an excuse to have a biscuit lol. I am happy to read that you think I might be beating myself up about it. I reckon you're right. I worry toooooo much. I suppose 10.7 isn't way too off the scale to not be able to live with it. I don't want a pump, and I don't really want to go without my usual food. so perhaps this is what it's gonna be... and I certainly don't want to wake up at 3am to inject!!!!!! Option 2 then. DAFNE was good, I loved the week, and it did give me confidence to tweak around and not be scared of what I was doing. don't get me wrong. they were great. I suppose I did expect too much in the fact that I wanted to be able to stick at one bi dose and be satisfied that my overnight levels would be stable. But asking that of the dreaded diabetes is asking for pigs to fly!

Aug 30, 2012 Phil Maskell 194 posts	Topic: General Discussion / morning highs sjohno said: Since taking the DAFNE course in November 2009 my HbA1c tests have been 6.8,6.1, 6.2,6.2, 6.1. I have had T1 for 33 years and DAFNE is the best thing that has happened, it's been a bit of a bumpy learning process but I believe I have a good handle on it now Nice, even with DAFNE I am more 7 than 6

Aug 30, 2012 Phil Maskell 194 posts	Topic: General Discussion / morning highs sjohno said: susieq - do you take QA for the omelette, bacon and salad? Unfortunately for me I have to take QA for all non carb foods......if I have an omelette with bacon, mushrooms and tomatoes at lunchtime this for me is 3CP, I am on a 1:1.5 ration so I take 6QA for that omelette. I can eat chicken with salad and still have to take QA For 3CP to 6QA isn't that a ratio of 2:1? 1:1.5 on 3CP would be 2QA? Just don't want to confuse things (any more than sorting this lot out)

Aug 30, 2012 Garry 328 posts	Topic: General Discussion / morning highs Many of us find that BI changes can take some days to kick in with an effect. It may be the same for you, particularly if on Lantus BI. For me, BI changes take 3 days to show signs of any possible improvement. I think I eat a NORMAL diet, which when I look at my diary, averages 23 CPs a day. We always have lots of unmeasured stuff going on in our blood which is difficult to manage the outcome of. Take a few days to make any further changes - so you are sure of cause and effect. Regards Garry

Aug 30, 2012 Garry 328 posts	Topic: General Discussion / Result. Cheer up vic. Just look back and review the good advice that you have given others through this forum. Take heart from that. We are all in the same boat. Like you, I work hard at achieving a balance and felt like I was doing really well, with a graph largely in the green - but whilst on holiday....the wheels have come off......and 5 days on, I'm still trying to get things back in control. Goodness knows what has gone wrong but I'll keep day-by-day trying to get back on an even keel. Regards Garry