Recent Posts - DAFNE Online

Jul 14, 2012

HelenP 218 posts

Topic: Questions for HCPs / Background insulin for surgery

I have just had carpal tunnel surgery (scheduled for 8:00am) and the anaesthetist said that it did not matter what I did she was going to give me 4% glucose. Went under on 10.0 out on 14.2!

After the surgery the BG's were higher than usual for a couple of days...pain? Trauma?

How long will you be "under" and how long will it be before you can drink/eat?

I was only "out" for an hour and then I was able to drink and once I had proven I could keep the water down I was allowed to eat. I then had breakfast (that I had brought from home) and corrected. You also know your response to taking background an hour or two late. ATB, Helen.

Jul 14, 2012

HelenP 218 posts

Topic: General Discussion / Carpal Tunnel v's Neuropathy

The R hand is fine (difficulty lifting heavy objects) so have bitten the bullet and will have the L done next Friday (20th). Patience?

Helen

Jul 13, 2012

Andy-Redditch 1 post

Topic: General Discussion / Levemir clogging needles

Try swapping cartridges in the pens then if the QA seems to have same problem there is definately a problem with the pen itself? I also use Levimir and have never had this type of problem.
Regards Andy.

Jul 13, 2012

Fozia 2 posts

Topic: Questions for HCPs / Background insulin for surgery

Im having a cataract opp soon and it'schduled for 7:30am and I'm not allowed to eat or drink (except water) from midnight the night before. I spilt my background insulin and take half before breakfast and the other half before dinner.

My issue is the eye hospital has top me NOT to take my background insulin in the morning, but I don't want to do that - what should I do?

Thanks

Jul 13, 2012

Carolin 83 posts

Topic: General Discussion / Just for a Laugh!

I previously had a laugh when I followed a link from this forum to an Australian website (www.realitycheck.org.au) that contained the 'Official Dictionary of Diabetes Slang', with such definitions as:

"Hi" - Friendly greeting your blood glucose meter gives you when you've eaten way too
much cake
"Dryâ€spiking" - Not being able to get a single, freaking, miserable little drop of blood out
of your fingertips.

As Editors of the quarterly 'DAFNEws', MarkE & I would love some similar puns / witticisms, etc to liven up the newsletter (to which anyone can subscribe through the official DAFNE website - http://www.dafne.uk.com/dafne_news_subscribe-I460.html). We'll choose 1 or 2 of the best to feature in each issue of DAFNEws

Can't wait to see what you all come up with!

Very Happy

Carolin

Jul 13, 2012

Carolin 83 posts

Topic: General Discussion / Ratios & Honeymoon Period.

Phil Maskell said:
Nighttime hypos due to being over active

Nice one Phil! Very Happy

If anyone else has any similar diabetes-related puns & witticisms we'd love to have them for inclusion in the quarterly DAFNE Newsletter!!

Carolin (Editor of DAFNEws)

Jul 13, 2012

Carolin 83 posts

Topic: Site Development / Targets range

Hi All,

Just a reminder that we recommend the lower end of targets at any time of the day is 4.5mmol/l (not 4); this is important in maintaining good hypo awareness.

Current guidelines:
BG below 3.5mmol/l (hypo) you should TREAT with 1.5 - 2 CPs rapid-acting carbs
BG 3.5 - 4.5mmol/l (below target) you should EAT 1 CP (or if a mealtime, reduce QA dose by 1u) to get back into safe target range

Carolin

Jul 12, 2012

Alan 49 280 posts

Topic: General Discussion / Levemir clogging needles

Yes, I'll try my spare Novopen tonight.

Jul 11, 2012

novorapidboi26 1,816 posts

Topic: General Discussion / Levemir clogging needles

Any developments?

I usually do about 4 units, sometimes more, when priming.......

I would still suspect a faulty pen, as you say it keeps happening, even if it works with a new needle the first time............

you could try and test the same batch of needles with a spare pen...(which you should have, however not everyone does, tut tut....).......

for complete peace mind new pen and needles wouldn't hurt..... Very Happy

Jul 11, 2012

Andrew Alexa... 1 post

Topic: General Discussion / Weight loss ?

Hi,

Yes I also suffered from quite rapid considerable weight loss when I was first moved over to NovoRapid/Levermir Insulin and for a while after taking the DAFNE course - I wasn't overwight before although my control had started to go out of whack a bit and I had started putting on a little bit of weight. I hadn't changed my diet in any considerable way.

Weight loss can be a sign of high blood sugars I think - and this was certainly the case for me - I had been on Mixtard insulin for a long time and it has taken me quite a while to find the right doses and ratios under the DAFNE system. During this period my HbA1C went up quite a bit from how it had been. Now that I am finding the right doses and the control is getting better again things seem to have settled and I'm not losing any more weight (it's just cost me a bit in new trousers!!!).

I'd definitely mention it to your doctor/diabetes nusre though especially as they'll probably be able to recommend the best way to put weight back on sensibly and just in case it's anything else.

Jul 11, 2012

Alan 49 280 posts

Topic: General Discussion / Levemir clogging needles

I don't think it's a problem with my Novopen 4, because it always works fine with a new needle.
I usually dial up 2 units when I prime my pens (I think this is the recommendation). Last night I tried the morning needle, but primed it with 4 units and this worked fine. I'll try this again this evening and see if I've cracked the problem.

Thanks for all your suggestions.

Jul 9, 2012

marke 646 posts

Topic: General Discussion / DAFNE Collaborative 2012

You can find a report on the DAFNE Collaborative 2012 here : collab report
Be warned it contains a 'shocking' revelation about night time hypo's. I know I shouldn't cross post between forums but the bit on night time hypo's is very interesting and likely to cause a 'degree of discussion' Wink

so I wanted to make sure people didn't miss it !!

Jul 9, 2012

marke 646 posts

Topic: General Discussion / Levemir clogging needles

as this is a confession thread, forgive me I have sinned. I also re-use needles and have never had an issue, certainly never had a problem like Alan. I have to say basic physics suggests the pressure exerted by the plunger on the needle to expel insulin should be such that when priming it should be pretty difficult for it to clog, any crystalised Levemir would be pushed out of the needle. This all suggests that it is the pen and not the needle that is the root cause of the problem.

Jul 9, 2012

Phil Maskell 194 posts

Topic: General Discussion / Levemir clogging needles

Alan,

Strange that novorapidboi26 and I don't seem to get this issue and he is on the diposable pens and mine the NovoPen 3 so that rules out the pen. Unless your pen is broken/faulty?

Have you spoken to anyone at the hospital about this? Just seems odd.

Phil

Jul 9, 2012

Alan 49 280 posts

Topic: General Discussion / Levemir clogging needles

I can't even prime the pen - nothing comes through at all, even after several attempts - this happens 9 times out of ten, so I don't even try the old needle for my second Levemir injection now.
When I has first put on Levemir, the Consultant told me that when you inject it, it crystalises - thus contributing to its prolonged effect. I wonder whether it does this if left in the needle after the first injection.

Jul 9, 2012

Phil Maskell 194 posts

Topic: Site Development / Targets range

Annette Bell said:
Thanks both - targets online duly amended! My graphs look much better now

You're not cheating and setting 2 to 15 as target are you? Wink

That's my trick

Phil

Jul 9, 2012

novorapidboi26 1,816 posts

Topic: General Discussion / Weight loss ?

I agree with Phil...

Jul 9, 2012

Annette Bell 58 posts

Topic: Site Development / Targets range

Thanks both - targets online duly amended! My graphs look much better now Wink

Jul 9, 2012

novorapidboi26 1,816 posts

Topic: General Discussion / Levemir clogging needles

I will be honest and say that I only use one needle per disposable pen.......so far my control has not been effected and there have been no lumps etc...........

I also take 2 doses of levemir like you and just use 1 needle per pen......

What do you mean when you say its blocked. I assume you prime before each injection, this would/should clear any blockages.......no?

Jul 9, 2012

Phil Maskell 194 posts

Topic: General Discussion / Levemir clogging needles

Hi,

Are you guys talking about the old syringe type needles or the screw on pen type? I reuse my pen needles until the insulin runs out (about a week), change the cartridge and the needle.

Never had any issues, what sort of complications are you expecting from this? Interested / worried!

Phil

Jul 9, 2012

Phil Maskell 194 posts

Topic: General Discussion / Ratios & Honeymoon Period.

Sadie said:
Hey, just been looking through some old posts for tips and advice. Would you mind explaining what the honeymoon period is? I've never heard of this!
Thanks
Sadie

Nighttime hypos due to being over active Very Happy

Jul 8, 2012

colinlennon 1 post

Topic: General Discussion / macular edema

Just to add that I just had this for the first time last week and honestly, it's really not that bad. I think it's fairly common to need a few of these jags, but now, having had one of them, I'm completely relaxed about the prospect of maybe needing a few more. And I'm not exactly the bravest when it comes to this kind of thing! Laughing

Jul 8, 2012

Garry 328 posts

Topic: General Discussion / Ratios & Honeymoon Period.

Most type 1 diabetics initially have some natural insulin production left as the remaining islets of Langerhans cells in your pancreas continue working...but as time goes on these can stop producing too and we become totally dependant on injected insulin.
As others have said this can last months to years.
My consultant talked about 'a honeymoon period' back in 1979 when I was diagnosed and put me on glibenclamides....I promptly lost 20 pounds....so it's unlikely that I had any honeymoon time.
Glibenclamide replaced with porcine insulin within 10 months. Who knows what my BGs were in those times...back then it was still urinalysis testing.

Regards
Garry

Jul 8, 2012

Stew B 123 posts

Topic: General Discussion / Levemir clogging needles

Totally agree with Roger. When I did DAFNE in Feb 2007 the educators checked my injection sites and pointed out lipos (lumps) on my thighs where I had been injecting lantus using needles multiple times. The "blunter" needles were a significant contributer to this, and of course as well as not being a good thing in its own right, it was having an adverse impact on insulin absorption rates. If we're into costs, I'd suggest that the costs to the NHS resulting from diabetes complications will far outweigh costs of single needle use, but what is it with diabetics and guilt (me included)?

Stew

Jul 14, 2012 HelenP 218 posts	Topic: Questions for HCPs / Background insulin for surgery I have just had carpal tunnel surgery (scheduled for 8:00am) and the anaesthetist said that it did not matter what I did she was going to give me 4% glucose. Went under on 10.0 out on 14.2! After the surgery the BG's were higher than usual for a couple of days...pain? Trauma? How long will you be "under" and how long will it be before you can drink/eat? I was only "out" for an hour and then I was able to drink and once I had proven I could keep the water down I was allowed to eat. I then had breakfast (that I had brought from home) and corrected. You also know your response to taking background an hour or two late. ATB, Helen.

Jul 14, 2012 HelenP 218 posts	Topic: General Discussion / Carpal Tunnel v's Neuropathy The R hand is fine (difficulty lifting heavy objects) so have bitten the bullet and will have the L done next Friday (20th). Patience? Helen

Jul 13, 2012 Andy-Redditch 1 post	Topic: General Discussion / Levemir clogging needles Try swapping cartridges in the pens then if the QA seems to have same problem there is definately a problem with the pen itself? I also use Levimir and have never had this type of problem. Regards Andy.

Jul 13, 2012 Fozia 2 posts	Topic: Questions for HCPs / Background insulin for surgery Im having a cataract opp soon and it'schduled for 7:30am and I'm not allowed to eat or drink (except water) from midnight the night before. I spilt my background insulin and take half before breakfast and the other half before dinner. My issue is the eye hospital has top me NOT to take my background insulin in the morning, but I don't want to do that - what should I do? Thanks

Jul 13, 2012 Carolin 83 posts	Topic: General Discussion / Just for a Laugh! I previously had a laugh when I followed a link from this forum to an Australian website (www.realitycheck.org.au) that contained the 'Official Dictionary of Diabetes Slang', with such definitions as: "Hi" - Friendly greeting your blood glucose meter gives you when you've eaten way too much cake "Dryâ€spiking" - Not being able to get a single, freaking, miserable little drop of blood out of your fingertips. As Editors of the quarterly 'DAFNEws', MarkE & I would love some similar puns / witticisms, etc to liven up the newsletter (to which anyone can subscribe through the official DAFNE website - http://www.dafne.uk.com/dafne_news_subscribe-I460.html). We'll choose 1 or 2 of the best to feature in each issue of DAFNEws Can't wait to see what you all come up with! Carolin

Jul 13, 2012 Carolin 83 posts	Topic: General Discussion / Ratios & Honeymoon Period. Phil Maskell said: Nighttime hypos due to being over active Nice one Phil! If anyone else has any similar diabetes-related puns & witticisms we'd love to have them for inclusion in the quarterly DAFNE Newsletter!! Carolin (Editor of DAFNEws)

Jul 13, 2012 Carolin 83 posts	Topic: Site Development / Targets range Hi All, Just a reminder that we recommend the lower end of targets at any time of the day is 4.5mmol/l (not 4); this is important in maintaining good hypo awareness. Current guidelines: BG below 3.5mmol/l (hypo) you should TREAT with 1.5 - 2 CPs rapid-acting carbs BG 3.5 - 4.5mmol/l (below target) you should EAT 1 CP (or if a mealtime, reduce QA dose by 1u) to get back into safe target range Carolin

Jul 12, 2012 Alan 49 280 posts	Topic: General Discussion / Levemir clogging needles Yes, I'll try my spare Novopen tonight.

Jul 11, 2012 novorapidboi26 1,816 posts	Topic: General Discussion / Levemir clogging needles Any developments? I usually do about 4 units, sometimes more, when priming....... I would still suspect a faulty pen, as you say it keeps happening, even if it works with a new needle the first time............ you could try and test the same batch of needles with a spare pen...(which you should have, however not everyone does, tut tut....)....... for complete peace mind new pen and needles wouldn't hurt.....

Jul 11, 2012 Andrew Alexa... 1 post	Topic: General Discussion / Weight loss ? Hi, Yes I also suffered from quite rapid considerable weight loss when I was first moved over to NovoRapid/Levermir Insulin and for a while after taking the DAFNE course - I wasn't overwight before although my control had started to go out of whack a bit and I had started putting on a little bit of weight. I hadn't changed my diet in any considerable way. Weight loss can be a sign of high blood sugars I think - and this was certainly the case for me - I had been on Mixtard insulin for a long time and it has taken me quite a while to find the right doses and ratios under the DAFNE system. During this period my HbA1C went up quite a bit from how it had been. Now that I am finding the right doses and the control is getting better again things seem to have settled and I'm not losing any more weight (it's just cost me a bit in new trousers!!!). I'd definitely mention it to your doctor/diabetes nusre though especially as they'll probably be able to recommend the best way to put weight back on sensibly and just in case it's anything else.

Jul 11, 2012 Alan 49 280 posts	Topic: General Discussion / Levemir clogging needles I don't think it's a problem with my Novopen 4, because it always works fine with a new needle. I usually dial up 2 units when I prime my pens (I think this is the recommendation). Last night I tried the morning needle, but primed it with 4 units and this worked fine. I'll try this again this evening and see if I've cracked the problem. Thanks for all your suggestions.

Jul 9, 2012 marke 646 posts	Topic: General Discussion / DAFNE Collaborative 2012 You can find a report on the DAFNE Collaborative 2012 here : collab report Be warned it contains a 'shocking' revelation about night time hypo's. I know I shouldn't cross post between forums but the bit on night time hypo's is very interesting and likely to cause a 'degree of discussion' so I wanted to make sure people didn't miss it !!

Jul 9, 2012 marke 646 posts	Topic: General Discussion / Levemir clogging needles as this is a confession thread, forgive me I have sinned. I also re-use needles and have never had an issue, certainly never had a problem like Alan. I have to say basic physics suggests the pressure exerted by the plunger on the needle to expel insulin should be such that when priming it should be pretty difficult for it to clog, any crystalised Levemir would be pushed out of the needle. This all suggests that it is the pen and not the needle that is the root cause of the problem.

Jul 9, 2012 Phil Maskell 194 posts	Topic: General Discussion / Levemir clogging needles Alan, Strange that novorapidboi26 and I don't seem to get this issue and he is on the diposable pens and mine the NovoPen 3 so that rules out the pen. Unless your pen is broken/faulty? Have you spoken to anyone at the hospital about this? Just seems odd. Phil

Jul 9, 2012 Alan 49 280 posts	Topic: General Discussion / Levemir clogging needles I can't even prime the pen - nothing comes through at all, even after several attempts - this happens 9 times out of ten, so I don't even try the old needle for my second Levemir injection now. When I has first put on Levemir, the Consultant told me that when you inject it, it crystalises - thus contributing to its prolonged effect. I wonder whether it does this if left in the needle after the first injection.

Jul 9, 2012 Phil Maskell 194 posts	Topic: Site Development / Targets range Annette Bell said: Thanks both - targets online duly amended! My graphs look much better now You're not cheating and setting 2 to 15 as target are you? That's my trick Phil

Jul 9, 2012 novorapidboi26 1,816 posts	Topic: General Discussion / Weight loss ? I agree with Phil...

Jul 9, 2012 Annette Bell 58 posts	Topic: Site Development / Targets range Thanks both - targets online duly amended! My graphs look much better now

Jul 9, 2012 novorapidboi26 1,816 posts	Topic: General Discussion / Levemir clogging needles I will be honest and say that I only use one needle per disposable pen.......so far my control has not been effected and there have been no lumps etc........... I also take 2 doses of levemir like you and just use 1 needle per pen...... What do you mean when you say its blocked. I assume you prime before each injection, this would/should clear any blockages.......no?

Jul 9, 2012 Phil Maskell 194 posts	Topic: General Discussion / Levemir clogging needles Hi, Are you guys talking about the old syringe type needles or the screw on pen type? I reuse my pen needles until the insulin runs out (about a week), change the cartridge and the needle. Never had any issues, what sort of complications are you expecting from this? Interested / worried! Phil

Jul 9, 2012 Phil Maskell 194 posts	Topic: General Discussion / Ratios & Honeymoon Period. Sadie said: Hey, just been looking through some old posts for tips and advice. Would you mind explaining what the honeymoon period is? I've never heard of this! Thanks Sadie Nighttime hypos due to being over active

Jul 8, 2012 colinlennon 1 post	Topic: General Discussion / macular edema Just to add that I just had this for the first time last week and honestly, it's really not that bad. I think it's fairly common to need a few of these jags, but now, having had one of them, I'm completely relaxed about the prospect of maybe needing a few more. And I'm not exactly the bravest when it comes to this kind of thing!

Jul 8, 2012 Garry 328 posts	Topic: General Discussion / Ratios & Honeymoon Period. Most type 1 diabetics initially have some natural insulin production left as the remaining islets of Langerhans cells in your pancreas continue working...but as time goes on these can stop producing too and we become totally dependant on injected insulin. As others have said this can last months to years. My consultant talked about 'a honeymoon period' back in 1979 when I was diagnosed and put me on glibenclamides....I promptly lost 20 pounds....so it's unlikely that I had any honeymoon time. Glibenclamide replaced with porcine insulin within 10 months. Who knows what my BGs were in those times...back then it was still urinalysis testing. Regards Garry

Jul 8, 2012 Stew B 123 posts	Topic: General Discussion / Levemir clogging needles Totally agree with Roger. When I did DAFNE in Feb 2007 the educators checked my injection sites and pointed out lipos (lumps) on my thighs where I had been injecting lantus using needles multiple times. The "blunter" needles were a significant contributer to this, and of course as well as not being a good thing in its own right, it was having an adverse impact on insulin absorption rates. If we're into costs, I'd suggest that the costs to the NHS resulting from diabetes complications will far outweigh costs of single needle use, but what is it with diabetics and guilt (me included)? Stew