Recent Posts - DAFNE Online

Aug 1, 2012

Alan 49 284 posts

Topic: General Discussion / Which Olympic athlete are you? -- For fun!

Bradley Wiggins - need I say more?

Aug 1, 2012

RichFreed 51 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Gleaned it from a magazine article early this year. I actually took it up with me to the DAFNE course to confirm. The 'professor' actually knew the author of the article and did not doubt the simple formula would give a reasonable estimate of average.

Aug 1, 2012

ruthhutchinson 39 posts

Topic: General Discussion / changing to levemir- advice please

Thanks Michelle. I have been looking online and the general consensus seems to be that everyone is different so I will just have to give it a go and see what happens.

Aug 1, 2012

michdash 9 posts

Topic: General Discussion / changing to levemir- advice please

Hi Ruth

I currently use levemir: 8.30 am and 8.30 pm, they say that lasts around 16 hrs however tends to taper off at around 12. I found that the 12 hr works for me and if I've accidentally forgot and took later than 8.30 pm then it tends to raise my BGs slightly (not greatly) I was in dafne course last week and this question arose. They said that you can take within an hour of the 12 hr Interval and it shouldn't affect BGs that much. I would just try the 6 pm after dinner and experiment, you may have a little overlap there and then you may find it may be fine. Log your results too see what effect it has over a few days due to the switch off insulin also etc
Michelle

Aug 1, 2012

ruthhutchinson 39 posts

Topic: General Discussion / changing to levemir- advice please

I am shortly going to be changing from Lantus to Levemir. I will be splitting my dose. Can anyone suggest what the best times are to take it? I usually eat breakfast at 8 and my evening meal at 6. I've been told that I should try to keep 12 hours between doses. Does that mean it would not work to take my evening dose along with dinner at 6 - do I need to wait until 8? Or do I have to waken at 6 AM and take the morning dose to fit in with my 6pm dinner? Any advice would be welcome please.

Aug 1, 2012

JayBee 587 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Wow, I had no idea you could do that Rich! Thanks for sharing! Very Happy

Aug 1, 2012

michdash 9 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Wow - Rich!, that's a high one!..but at least it's decreased nicely now Laughing

Thank you, after diagnosis where my hba1c was 125 2 months ago I had another test just before dafne two weeks ago which was 95 that equals around 10.5 as your previous result so it's coming down slowly. Fingers crossed for sept test Very Happy

Cheers Guys

Aug 1, 2012

RichFreed 51 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

If you still get the old % figure (we get both here in AU) I know you can calculate it by taking your HbA1c % double it then minus 6 from the result, will convert it to average BS we read off the meters.

eg me now 6.4hbA1c x 2 -6 = 6.8 - Which equates nicely with my diary.
me last Nov 10.5hbA1c x 2 - 6 =15 - GP kicked my arse, told me to fix myself pronto Embarassed

Jul 31, 2012

JayBee 587 posts

Topic: General Discussion / hungover feeling in the morning (not after drinking)

Can you post some diary results using this site's diary feature?
You may be looking at a dawn phenomenon issue, but it's difficult to tell for sure from what you've described.
Take care.

Jul 31, 2012

michdash 9 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Thanks Garry,

Yes this is indeed a life changing experience, however I am learning more each day. Thanks for the advice

Michelle

Jul 31, 2012

Simon 578 posts

Topic: General Discussion / Which Olympic athlete are you? -- For fun!

Brett Morse, Discuss Thrower a 110kg, 1.9m beefcake Very Happy

Jul 31, 2012

Garry 328 posts

Topic: General Discussion / Which Olympic athlete are you? -- For fun!

I match Winston Gordon who competes for Team GB in 90 kg class at Judo Laughing

Wish I was as fit as him!

Regards
Garry

Jul 31, 2012

Garry 328 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Welcome michdash Smile

As JWO mentions stability counts. Make slow controlled changes and you can understand where improvement comes from.
Stick with it and in 4 or 5 months you'll be at 58 mmol/mol and looking for further gains.

Regards
Garry

Jul 31, 2012

michdash 9 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Oh,

Thank you!, I guess it's just as you say, trying to keep them as stable as possible!. Mind you a y reduction would be fab for myself co sideri g it was 125 mol/mol at diagnosis Crying or Very sad

Jul 31, 2012

JayBee 587 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Not exactly unfortunately.

The averages we see on the diary are those of the results you've inputted on to the diary. Your HbA1c results read the results of how much sugar has been in your blood by reading the red blood cells themselves (they only live for 3 months though), so the diary averages may not be a reliable indication of your HbA1c as a result - especially if you're someone who has irratic control.

Saying that, I've found that when the BG levels are consistantly within a range over a long period on the diary, it has shown up in my HbA1c test to be around the same. I guess that's just a good sign that I do keep myself stable I suppose.

Jul 31, 2012

michdash 9 posts

Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries

Hi all,

I am new here and only been diagnosed 2 months ago. I wondered if anyone knew if the averages displayed in our blood glucose diaries may be an indicator of Hba1c results

Thanks

Michelle

Jul 31, 2012

JayBee 587 posts

Topic: General Discussion / Which Olympic athlete are you? -- For fun!

Click this BBC link to find out! http://www.bbc.co.uk/news/uk-19050139

I got Paloma Schmidt who does Sailing. She competed in "Women's Laser Radial". Very Happy

How about you? Smile

Jul 31, 2012

susanh 20 posts

Topic: Questions for HCPs / QA and BI preferred injection sites

Hi guys,
Catherine, one of our diabetes educators down under has written up a detailed response for you - hope it helps!

Studies show that insulin injected into the abdominal fatty tissue has the fastest and most consistent rate of absorption. The arms and thighs have a slower absorption rate, and the buttocks appear to have the slowest. Evidence shows that rapid acting analogues eg. NovoRapid, Humalog and Apidra can be given at any of the sites mentioned above without too much difference in absorption rates. The same goes with long acting analogues eg. Levemir or Lantus, but be careful not to inject into the muscle for risk of hypo. If youâ€™re using human insulin such as Actrapid the abdomen is preferred due to faster absorption and if using NPH the thigh and buttocks are preferred due to the slower absorption.

Traditionally, the abdomen (avoiding the belly button area), thighs and buttocks have been the preferred site for injections. The arms have been least preferred in the adult population due to the increased risk of injecting into the muscle. Having said that, movement of a muscle speeds up the absorption rate of insulin even when injected into the fatty tissue and therefore you may increase your risk of hypos if you inject into thighs or arms before exercise.

BI (long acting analogue) needs to be injected in a different area from QA so that they do not mix and inadvertently change the profile of either insulin.

Some health professionals advise injecting BI into the same area of the body (whilst rotating sites within that area) mainly so that there is a consistency of absorption from one day to another. This makes sense if weâ€™re saying that different areas of the body have different rates of absorption.

Remember to rotate and inject about 2 cm away from the previous injection so as to avoid causing scar tissue to develop. Also, if using the buttock for instance, make sure to use both buttocks evenly and not prefer one over another simply because it is easier to reach. Keep in mind that needle length, the angle at which the needles are injected and whether the skin requires a pinch up need to be considered to avoid injecting into muscle.

Itâ€™s important that individuals have their injection sites reviewed by their HCP to assess for lipohypertrophy or scarring. Avoiding scarred areas if present is essential as injecting into these may cause erratic insulin absorption hence erratic BGs.
If youâ€™re confused or overwhelmed with the different information and advice that you get remember that everyone is different and people have individual responses in regards to absorption rate of insulin at different sites. If your BGs are not stable consider recording the site of your injection in your diary to see whether it makes a difference to your BGs and then discuss this with your HCP.

Cheers,
Susan & Catherine

Jul 31, 2012

Amackie 1 post

Topic: Carbohydrate Counting / Inject for buckwheat?

Hi Adrienne,

I have done a bit of a search on Kasha, and it is in fact a grain - a staple grain often used to make porridge in Eastern European countries. The nutritional information that I was able to find on the web is American based and in 1 cup of Kasha there is 33.5g of carbohydrate. According to the glycemicindex.com, buckwheat groats are low GI, they have a GI of 47-49, so similar to that of rolled oats....... (note, this is not as low GI as legumes, cherries, grapefruit, barley & fructose powder)... I would advise you to inject for them, based on the amount of carbohydrate calculated in your serve, as you would for oats. However, as everyone is different, monitor your BGLs after eating to determine the effect they have on you.

As for pearl barley, it is one of those super low GI foods (GI of around 22-29) and in DAFNE, we advise you that you may not need to inject at all if only consuming a small amount. If consuming in larger amounts then you may need to inject some QA, but not as much as you normally would for that carbohydrate amount. The only way to determine this is with trial and experimentation.

Quinoa is similar to the Kasha, has a similar GI and is also a grain. As per the advice for the Kasha, inject for Quinoa based on your calculated carbohydrate amount and monitor your BGLs for that individual response.

Hope this helps!

Cheers

Adele (DAFNE dietitian)

Jul 30, 2012

marke 681 posts

Topic: General Discussion / Blood Testing........

I'm afraid meters are just not that accurate, They give you an approximation of your BG and can be affected by a range of factors. If you take a reading from two different points on the body you will most likely get variances in readings. You will definately get variances from different meters. The idea is the meter gives you a guide to your current BG NOT a scientific, laboratory reading. Look at the brightside, not so long ago all you could do was dip a strip in urine and get a colour change that gave you an even more vague reading. Technology moves forward and testing is getting better but its still not and probably never will be an exact science. But then your body is not an exact science, hence the fact it can cope with your BG's fluctuating all over the place without any major problems.
I can't comment on an 'expert' meter since I have never seen one let along used one. I guess they just make suggestions based on a set of parameters and given the 'source' is a variable baseline i.e your body, getting accurate results must be quite a challenge.

Jul 30, 2012

John H 20 posts

Topic: General Discussion / Blood Testing........

Hello to you all, and thanks for your interesting replies to my last question. I also have another question to ask. I was rewarded with an Accuchek Aviva Expert meter system shortly after completing DAFNE course, the settings were decided and entered into the system by the rep, and off I went believing all was ok. I found that on some occasions when things went wrong at bed time, my test results fell by 50% below the minimum threshold decided by the HCP, and entered by the Accuchek Rep. I then entered in to the meter my proposed CP amount to restore BG to the lowest setting as per HCP decision (Of which I have a copy of) to find that the bolus advisor gave me the advice to inject QA to reduce the BG Rise back to the level that was already too low. This sounds like I am babbling on a bit, but hopefully you can follow what I am on about !
This has happened on several occasions, and there was no active insulin at the time because it was all spent. Upon explaining this to the Accuchek Helpline, they requested that I carry out a control test, which was ok, and then advised me to make an appointment with the sales Rep to re-check the settings because nobody wanted the responsibility of giving me the correct information maybe. I was later told that a replacement meter would be sent whilst my Expert system was tested and analysed for issues. After a month wait, I discover that a full analysis can take up to 3 months to complete. So with this experience with Accuchek I now test with 2 meters when I get unusual readings and they are variable to say the least, also after getting 1 sample from 1 hand, another from the other hand there are also some variences. What is the right site to test from if these variences are true & how would you maintain CP to QA inputs? Sorry for a long one this time, but this concerns me, and may do the same to others if they tried it out.
Thanks again Guys and Girls.

Jul 30, 2012

JayBee 587 posts

Topic: General Discussion / Injection sites

I think it varies from person to person considering its up to you where you inject it...
I've usually been advised to inject in the slowest area (the buttocks) but some inject their leg, and I think someone said they injected their stomach as well like you.

Personally, I do as the HCP have told me over the years - I tend to inject BI into my buttocks, swapping sides/cheeks to prevent lipohypertrophy (saying that, if I have to as a last resort, I inject my thigh). To be honest, I'm more comfortable with putting a large dose in my buttocks than say my stomach or my leg simply because of the absorption difference (especially since I'm a fairly active person too).

Edit: Read recently that some people inject their breasts (QA rather than BI I think). I could never do that! D:

Aug 1, 2012 Alan 49 284 posts	Topic: General Discussion / Which Olympic athlete are you? -- For fun! Bradley Wiggins - need I say more?

Aug 1, 2012 RichFreed 51 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Gleaned it from a magazine article early this year. I actually took it up with me to the DAFNE course to confirm. The 'professor' actually knew the author of the article and did not doubt the simple formula would give a reasonable estimate of average.

Aug 1, 2012 ruthhutchinson 39 posts	Topic: General Discussion / changing to levemir- advice please Thanks Michelle. I have been looking online and the general consensus seems to be that everyone is different so I will just have to give it a go and see what happens.

Aug 1, 2012 michdash 9 posts	Topic: General Discussion / changing to levemir- advice please Hi Ruth I currently use levemir: 8.30 am and 8.30 pm, they say that lasts around 16 hrs however tends to taper off at around 12. I found that the 12 hr works for me and if I've accidentally forgot and took later than 8.30 pm then it tends to raise my BGs slightly (not greatly) I was in dafne course last week and this question arose. They said that you can take within an hour of the 12 hr Interval and it shouldn't affect BGs that much. I would just try the 6 pm after dinner and experiment, you may have a little overlap there and then you may find it may be fine. Log your results too see what effect it has over a few days due to the switch off insulin also etc Michelle

Aug 1, 2012 ruthhutchinson 39 posts	Topic: General Discussion / changing to levemir- advice please I am shortly going to be changing from Lantus to Levemir. I will be splitting my dose. Can anyone suggest what the best times are to take it? I usually eat breakfast at 8 and my evening meal at 6. I've been told that I should try to keep 12 hours between doses. Does that mean it would not work to take my evening dose along with dinner at 6 - do I need to wait until 8? Or do I have to waken at 6 AM and take the morning dose to fit in with my 6pm dinner? Any advice would be welcome please.

Aug 1, 2012 JayBee 587 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Wow, I had no idea you could do that Rich! Thanks for sharing!

Aug 1, 2012 michdash 9 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Wow - Rich!, that's a high one!..but at least it's decreased nicely now Thank you, after diagnosis where my hba1c was 125 2 months ago I had another test just before dafne two weeks ago which was 95 that equals around 10.5 as your previous result so it's coming down slowly. Fingers crossed for sept test Cheers Guys

Aug 1, 2012 RichFreed 51 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries If you still get the old % figure (we get both here in AU) I know you can calculate it by taking your HbA1c % double it then minus 6 from the result, will convert it to average BS we read off the meters. eg me now 6.4hbA1c x 2 -6 = 6.8 - Which equates nicely with my diary. me last Nov 10.5hbA1c x 2 - 6 =15 - GP kicked my arse, told me to fix myself pronto

Jul 31, 2012 JayBee 587 posts	Topic: General Discussion / hungover feeling in the morning (not after drinking) Can you post some diary results using this site's diary feature? You may be looking at a dawn phenomenon issue, but it's difficult to tell for sure from what you've described. Take care.

Jul 31, 2012 michdash 9 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Thanks Garry, Yes this is indeed a life changing experience, however I am learning more each day. Thanks for the advice Michelle

Jul 31, 2012 Simon 578 posts	Topic: General Discussion / Which Olympic athlete are you? -- For fun! Brett Morse, Discuss Thrower a 110kg, 1.9m beefcake

Jul 31, 2012 Garry 328 posts	Topic: General Discussion / Which Olympic athlete are you? -- For fun! I match Winston Gordon who competes for Team GB in 90 kg class at Judo Wish I was as fit as him! Regards Garry

Jul 31, 2012 Garry 328 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Welcome michdash As JWO mentions stability counts. Make slow controlled changes and you can understand where improvement comes from. Stick with it and in 4 or 5 months you'll be at 58 mmol/mol and looking for further gains. Regards Garry

Jul 31, 2012 michdash 9 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Oh, Thank you!, I guess it's just as you say, trying to keep them as stable as possible!. Mind you a y reduction would be fab for myself co sideri g it was 125 mol/mol at diagnosis

Jul 31, 2012 JayBee 587 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Not exactly unfortunately. The averages we see on the diary are those of the results you've inputted on to the diary. Your HbA1c results read the results of how much sugar has been in your blood by reading the red blood cells themselves (they only live for 3 months though), so the diary averages may not be a reliable indication of your HbA1c as a result - especially if you're someone who has irratic control. Saying that, I've found that when the BG levels are consistantly within a range over a long period on the diary, it has shown up in my HbA1c test to be around the same. I guess that's just a good sign that I do keep myself stable I suppose.

Jul 31, 2012 michdash 9 posts	Topic: General Discussion / Is Hba1c related to the averages in blood glucose diaries Hi all, I am new here and only been diagnosed 2 months ago. I wondered if anyone knew if the averages displayed in our blood glucose diaries may be an indicator of Hba1c results Thanks Michelle

Jul 31, 2012 JayBee 587 posts	Topic: General Discussion / Which Olympic athlete are you? -- For fun! Click this BBC link to find out! http://www.bbc.co.uk/news/uk-19050139 I got Paloma Schmidt who does Sailing. She competed in "Women's Laser Radial". How about you?

Jul 31, 2012 susanh 20 posts	Topic: Questions for HCPs / QA and BI preferred injection sites Hi guys, Catherine, one of our diabetes educators down under has written up a detailed response for you - hope it helps! Studies show that insulin injected into the abdominal fatty tissue has the fastest and most consistent rate of absorption. The arms and thighs have a slower absorption rate, and the buttocks appear to have the slowest. Evidence shows that rapid acting analogues eg. NovoRapid, Humalog and Apidra can be given at any of the sites mentioned above without too much difference in absorption rates. The same goes with long acting analogues eg. Levemir or Lantus, but be careful not to inject into the muscle for risk of hypo. If youâ€™re using human insulin such as Actrapid the abdomen is preferred due to faster absorption and if using NPH the thigh and buttocks are preferred due to the slower absorption. Traditionally, the abdomen (avoiding the belly button area), thighs and buttocks have been the preferred site for injections. The arms have been least preferred in the adult population due to the increased risk of injecting into the muscle. Having said that, movement of a muscle speeds up the absorption rate of insulin even when injected into the fatty tissue and therefore you may increase your risk of hypos if you inject into thighs or arms before exercise. BI (long acting analogue) needs to be injected in a different area from QA so that they do not mix and inadvertently change the profile of either insulin. Some health professionals advise injecting BI into the same area of the body (whilst rotating sites within that area) mainly so that there is a consistency of absorption from one day to another. This makes sense if weâ€™re saying that different areas of the body have different rates of absorption. Remember to rotate and inject about 2 cm away from the previous injection so as to avoid causing scar tissue to develop. Also, if using the buttock for instance, make sure to use both buttocks evenly and not prefer one over another simply because it is easier to reach. Keep in mind that needle length, the angle at which the needles are injected and whether the skin requires a pinch up need to be considered to avoid injecting into muscle. Itâ€™s important that individuals have their injection sites reviewed by their HCP to assess for lipohypertrophy or scarring. Avoiding scarred areas if present is essential as injecting into these may cause erratic insulin absorption hence erratic BGs. If youâ€™re confused or overwhelmed with the different information and advice that you get remember that everyone is different and people have individual responses in regards to absorption rate of insulin at different sites. If your BGs are not stable consider recording the site of your injection in your diary to see whether it makes a difference to your BGs and then discuss this with your HCP. Cheers, Susan & Catherine

Jul 31, 2012 Amackie 1 post	Topic: Carbohydrate Counting / Inject for buckwheat? Hi Adrienne, I have done a bit of a search on Kasha, and it is in fact a grain - a staple grain often used to make porridge in Eastern European countries. The nutritional information that I was able to find on the web is American based and in 1 cup of Kasha there is 33.5g of carbohydrate. According to the glycemicindex.com, buckwheat groats are low GI, they have a GI of 47-49, so similar to that of rolled oats....... (note, this is not as low GI as legumes, cherries, grapefruit, barley & fructose powder)... I would advise you to inject for them, based on the amount of carbohydrate calculated in your serve, as you would for oats. However, as everyone is different, monitor your BGLs after eating to determine the effect they have on you. As for pearl barley, it is one of those super low GI foods (GI of around 22-29) and in DAFNE, we advise you that you may not need to inject at all if only consuming a small amount. If consuming in larger amounts then you may need to inject some QA, but not as much as you normally would for that carbohydrate amount. The only way to determine this is with trial and experimentation. Quinoa is similar to the Kasha, has a similar GI and is also a grain. As per the advice for the Kasha, inject for Quinoa based on your calculated carbohydrate amount and monitor your BGLs for that individual response. Hope this helps! Cheers Adele (DAFNE dietitian)

Jul 30, 2012 marke 681 posts	Topic: General Discussion / Blood Testing........ I'm afraid meters are just not that accurate, They give you an approximation of your BG and can be affected by a range of factors. If you take a reading from two different points on the body you will most likely get variances in readings. You will definately get variances from different meters. The idea is the meter gives you a guide to your current BG NOT a scientific, laboratory reading. Look at the brightside, not so long ago all you could do was dip a strip in urine and get a colour change that gave you an even more vague reading. Technology moves forward and testing is getting better but its still not and probably never will be an exact science. But then your body is not an exact science, hence the fact it can cope with your BG's fluctuating all over the place without any major problems. I can't comment on an 'expert' meter since I have never seen one let along used one. I guess they just make suggestions based on a set of parameters and given the 'source' is a variable baseline i.e your body, getting accurate results must be quite a challenge.

Jul 30, 2012 John H 20 posts	Topic: General Discussion / Blood Testing........ Hello to you all, and thanks for your interesting replies to my last question. I also have another question to ask. I was rewarded with an Accuchek Aviva Expert meter system shortly after completing DAFNE course, the settings were decided and entered into the system by the rep, and off I went believing all was ok. I found that on some occasions when things went wrong at bed time, my test results fell by 50% below the minimum threshold decided by the HCP, and entered by the Accuchek Rep. I then entered in to the meter my proposed CP amount to restore BG to the lowest setting as per HCP decision (Of which I have a copy of) to find that the bolus advisor gave me the advice to inject QA to reduce the BG Rise back to the level that was already too low. This sounds like I am babbling on a bit, but hopefully you can follow what I am on about ! This has happened on several occasions, and there was no active insulin at the time because it was all spent. Upon explaining this to the Accuchek Helpline, they requested that I carry out a control test, which was ok, and then advised me to make an appointment with the sales Rep to re-check the settings because nobody wanted the responsibility of giving me the correct information maybe. I was later told that a replacement meter would be sent whilst my Expert system was tested and analysed for issues. After a month wait, I discover that a full analysis can take up to 3 months to complete. So with this experience with Accuchek I now test with 2 meters when I get unusual readings and they are variable to say the least, also after getting 1 sample from 1 hand, another from the other hand there are also some variences. What is the right site to test from if these variences are true & how would you maintain CP to QA inputs? Sorry for a long one this time, but this concerns me, and may do the same to others if they tried it out. Thanks again Guys and Girls.

Jul 30, 2012 JayBee 587 posts	Topic: General Discussion / Injection sites I think it varies from person to person considering its up to you where you inject it... I've usually been advised to inject in the slowest area (the buttocks) but some inject their leg, and I think someone said they injected their stomach as well like you. Personally, I do as the HCP have told me over the years - I tend to inject BI into my buttocks, swapping sides/cheeks to prevent lipohypertrophy (saying that, if I have to as a last resort, I inject my thigh). To be honest, I'm more comfortable with putting a large dose in my buttocks than say my stomach or my leg simply because of the absorption difference (especially since I'm a fairly active person too). Edit: Read recently that some people inject their breasts (QA rather than BI I think). I could never do that! D: