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Jul 12, 2012
Alan 49
284 posts
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Yes, I'll try my spare Novopen tonight. |
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Jul 11, 2012
novorapidboi26
1,819 posts
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Topic: DAFNE Graduate Group (DGG) / DAFNE Collaborative 2012 interesting read..................can I paste this on diabetessupport.co.uk? |
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Jul 11, 2012
novorapidboi26
1,819 posts
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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..... 
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Jul 11, 2012
Andrew Alexa...
1 post
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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. |
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Jul 11, 2012
Alan 49
284 posts
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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. |
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Jul 10, 2012
Anele46
109 posts
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Topic: DAFNE Graduate Group (DGG) / DAFNE Collaborative 2012 Very Interesting Marke.Thanks very much for the update and typing this all out  Cheers, Anele. |
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Jul 9, 2012
marke
686 posts
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Topic: General Discussion / DAFNE Collaborative 2012 You can find a report on the DAFNE Collaborative 2012 here : collab reportBe 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 !! |
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Jul 9, 2012
marke
686 posts
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Topic: DAFNE Graduate Group (DGG) / DAFNE Collaborative 2012 (disclaimer: this report has been proof read by HCP's so is slightly more 'technical' than I would have written in places )Once again the DAFNEOnline team was present at the DAFNE Collaborative to bring you all the news and views of what is going on in the DAFNE Programme. For those that don’t know what it is, the DAFNE Collaborative is the annual event at which representatives of all DAFNE Centres, the DAFNE Executive, the DAFNE Programme team and the DAFNE User Action Group (DUAG) gather to receive presentations and attend workshops related to what is happening in the DAFNE Programme. The last of the groups mentioned in that list the DUAG is the user representative body on the DAFNE programme. So what happened this year ? Well the day ‘kicked off’ with a presentation about ‘KICk -OFF’ ( pun intended !). This is a programme that I know will be of great interest to some since it is the juvenile equivalent of DAFNE for 11-16 year olds. At this stage it is still in the trial stage and is scheduled to report results in Spring 2013. Presuming that the results do show sufficient benefits to enable it to be rolled out there are still some challenges to be overcome. However things do look positive and a programme of this kind would provide major benefits to many. Of course it is slightly different to the adult DAFNE Course, mainly because teaching/engaging teenagers is obviously not the same as teaching a group of adults and their approach to their diabetes is different. However listening to some of the quotes given by those that took part in the pilot courses, there is a distinct feeling of déjà vu. One example “I liked watching everyone share their thoughts about diabetes†could just as easily be about a DAFNE Course. I did ask about a link-up to DAFNEOnline for Kick-Off however it seems teenagers don’t like talking about their diabetes and while they continue to talk to other attendees it’s not about diabetes, so maybe something to consider in future. The next presentation was on something that I am sure will provoke discussion. It concerned what happens to blood glucose overnight and if rebound hypo’s ( the somogyi effect) exist i.e high BGs in the morning caused by night time hypos. The overall conclusion was that high fasting readings due to rebound form overnight hypoglycaemia was very rare - if it happened at all and that the cause of high morning BGs was a lot more complex. The conclusions were drawn from a number of surveys including a dawn phenomenon survey of 100 patients. however a A number of the results used to demonstrate conclusions were based on Continuous Glucose monitoring traces to try to give a better understanding to what is actually happening. It was shown that although night time hypos do occur regularly - when asleep the body produces a much weaker hormone response and much smaller sugar / glucagon response. Therefore another cause is more likely to be the source of high morning BG’s. This is where it was shown that you need to see the high BG in context with BG readings over previous days. This suggests that other factors or a combination of other factors are likely to be the cause rather than possibility of overnight hypo. The main problem with all of this is most of us were told to do a 3am test to rule out hypos causing high morning BGs and now we and educators need to take on board that things are not as clear cut as that. I’m sure there will be a lot of further discussion on this subject. There then followed a workshop that was not attended by your correspondent due to their being a DUAG sub-meeting so my report resumes post lunch with the afternoon session. The first afternoon session was co-ordinated by Prof. Simon Heller and featured a number of presentations on various research programmes that have been ongoing. The first was on a psychosocial study on DAFNE that asked graduates and educators to complete a series of questionnaires and interviews before, during and after the DAFNE Course. The second and third studies were on qualative work and the DAFNE database respectively. Not much of this is sharable publically at this time. The fourth study was on how the length of time someone has been Type 1 affects how successful DAFNE is. The conclusion was that DAFNE is just as effective with long term diabetics as it is with newly diagnosed diabetes. There was also an update on the 5 x 1 day DAFNE Course at the end of this presentation, although final results from this trial are not yet available. The last presentation in this session concerned the cost effectiveness of DAFNE and was given by Prof. Alan Brennan from ScHARR who also work with NICE to determine the cost effectiveness of treatments. The work they have done involves developing health econoimic modelling and is similar to previous work to assess if DAFNE is cost effective. Preliminary results suggest it is cost effective however these are just preliminary results. The day finished with a workshop and the one I attended was related to the presentation given in the morning about rebound hypos. A lot of discussion centred around how to get the message out to educators let alone graduates that rebound hypos and 3am checks were not as clear cut as previously believed. This was a very interesting discussion and a number of other issues were covered, including post meal injections ( not a good idea since profiles of insulin and food don’t match) and advice from non-DAFNE Health Care Professionals conflicting with DAFNE educators ( generally not accepted unless backed up by Educator). Overall an interesting and informative day and for those interested the presentations are on the DAFNE website ( www.dafne.uk.com ) by clicking on the DAFNE Collaborative 2012 section on the front page. |
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Jul 9, 2012
marke
686 posts
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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. |
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Jul 9, 2012
Phil Maskell
194 posts
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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 |
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Jul 9, 2012
Alan 49
284 posts
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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. |
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Jul 9, 2012
Phil Maskell
194 posts
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Topic: Site Development / Targets range
You're not cheating and setting 2 to 15 as target are you? That's my trickPhil |
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Jul 9, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Weight loss ? I agree with Phil... |
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Jul 9, 2012
Annette Bell
72 posts
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Topic: Site Development / Targets range Thanks both - targets online duly amended! My graphs look much better now
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Jul 9, 2012
novorapidboi26
1,819 posts
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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? |
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Jul 9, 2012
Phil Maskell
194 posts
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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 |
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Jul 9, 2012
Phil Maskell
194 posts
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Topic: General Discussion / Ratios & Honeymoon Period.
Nighttime hypos due to being over active
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Jul 8, 2012
colinlennon
1 post
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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!
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Jul 8, 2012
Garry
328 posts
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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 |
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Jul 8, 2012
Stew B
125 posts
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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 |
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Jul 7, 2012
Sadie
1 post
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Topic: General Discussion / Ratios & Honeymoon Period. 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 |
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Jul 7, 2012
Ahmentep
99 posts
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Topic: General Discussion / Levemir clogging needles Hi Alan,I use Levemir twice a day but cannot comment on your problem as I use needles once only, as you are supposed to do. If you had read the articles that I read about needle use you might be more concerned with your own health than economising on needles. Compared with the amount of money wasted by the NHS the amount such economies can save would not even register. If you re-use needles then the needle is open to the pollutants in the air for the hours between each use (the cap is not a reliable seal, and of course contains air when you replace it). If the needle remains attached to the pen then any contamination entering the needle can prgress to the phial in the pen. The thing that really got me though, in the article, was the description, backed up by highly magnified photographs, of the burrs that are created at the end of the needle each time it is used and the damage these burrs do to your tissue. This leads to increasing difficulty with injection sites over time. Kind regards. Roger |
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Jul 6, 2012
HelenP
218 posts
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Topic: General Discussion / Carpal Tunnel v's Neuropathy Thanks Garry and Lyn,I went and saw the surgeon yesterday (3 days post surgery) and he is talking waiting 2-3 weeks before having the other hand done! This makes sense as I will have my daughter here and she can do the to and froing for me until I get back to it all. The palm of my hand is quite bruised and the wrist is painful...limited driving,,,no lifting etc. I am also the least patient person I know! The wrist is probably as painful as the wrist was presurgery! Helen |
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Jul 6, 2012
lynste2
1 post
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Topic: General Discussion / Carpal Tunnel v's Neuropathy Hi i had CTS surgery about 4 yrs ago, since i would wake during the night in pain or with pins and needles. Apart from the fact that the nurse put the sling support to high which caused some for pain for the first 48hr it was the right decision for me, if or when my left hand starts to become problematic i will opt for surgery again.Rgards Lyn |