Recent Posts - DAFNE Online

Jun 27, 2012

jax8008 5 posts

Topic: General Discussion / Any help please?

Hi

I didn't take offence, I was just explaining the reasons why I'm testing so frequently......can I ask if you feel 'normal' most of the time? This is what gets me, there were only a couple of other people on the DAFNE course and none of them felt as I do so I'm just curious to know how other diabetics 'feel'.

I was diagnosed 3 and a half years ago, at the age of 46! I've carb counted from day one and quite ocd about it, also with correcting I wont correct until after the 2 hours or longer if necessary. Sorry about the erratic input, as I said earlier I didn't fill all the carbs in as I was in a bit of a rush to get the blood test results down to show at my opa. I saw the registrar today, gonna see the Consultant next time, 3 months time! Yeah I seem to need to eat little and often and feel very rubbish if I dont. When you say that I'm sensitive to insulin what do you mean by that?

I do thank you for your replies as its good to hear from someone who is also diabetic, rather than professionals who don't know everything about the day-to-day living with diabetes.

Jun 27, 2012

marke 686 posts

Topic: General Discussion / Any help please?

hi, sorry I didn't mean to suggest that you shouldn't test OR record the tests. Better to much than to little ! I was just pointing out they you shouldn't do something like apply a correction dose for one of these readings, that was all. Looking at your diary it seems that you are sensitve to insulin, have you been a diabetic for a while ? Have you always been this sensitve to insulin, It also seems unless you have missed out data there are a number of days where you didn't eat any carbs, is this normal ? Personally would feel pretty rubbish if I didn't eat anything but thats just me Very Happy

One last thing, if you don't see a consultant at the hospital who do you see ? I always see a consultant so I'm curious

Jun 27, 2012

jax8008 5 posts

Topic: General Discussion / Any help please?

Hi

Thanks for your reply and your comments. The reason that I missed the BI out is that I rushed to input info before I went to hospital.....I always have my BI around 11 at night, 9 units of Levemir. I test a lot because I'm always feeling 'not right' (am I going high or low? symptoms are very similar) so want to know why, although I do have to test before driving which is usually 6 times a day, maybe I shouldn't add them to my DAFNE ones and stick to just noting the ones prior to eating and 2 hours after, would you say that would be better? I understand that its not an exact science with food,their GI and timing of insulin injection but surely I shouldn't be feeling like I'm having diabetic warning signs for 6 hours of a waking day?

I've not long since got home after my ordeal at my OPA. My Hba1c is 46% which I thought was good but the doc says that it shows I'm running at the low end. She had no answers to what I was asking, until she walked out to get a blood form and I was in tears when she came back in......she then listened to me, basically admitting that I shouldn't be feeling like I do but has no idea why I'm feeling like it. Advised me for further blood tests and to seek further advice from Diabetic Specialist Nurse......then to see the Consultant in 3 months!! I shall have to make more of an effort to go back to making a complete and full diary of foodstuffs I'm eating exactly.

Jun 27, 2012

marke 686 posts

Topic: General Discussion / Any help please?

There are a few things to say aboutthese results. The most important being you don't reecord your BI insulin most of the time. This is important and it is important that you take it at around the same time every day. What type of BI is it , latus or Levemir maybe ? The second is you test an awful lot quite often with 2 hours of eating. This is not necessarily a good idea since high readings at this point could be down to the timing of your injection ( before or after food) and the GI of the food. That is why it is recommended that you test before meals generally 4 times a day. I'm not criticising you for testing so much its just that high readings can cause oyu to get stressed which will compound the high readings.
Is your reduced level of warning signs what is causing you to test so much ? If you want to help restore your warning signs you should run a bit high for a few days maybe a bit longer to help restore them.
These are just initial impressions, hopefully I and others can look at the readings in more detail and come up with some suggestions

Jun 27, 2012

mark1882 1 post

Topic: General Discussion / High morning readings

Hi I have had high morning reading that seem to vary wildly (11-1 Cool

Cant seem to get a correlation between my night time long term Levemir + Novarapid adjustments

Anyone have similar problems

I can control the other times reasonably well as long as I'm aware of carb value of what I'm eating

Jun 27, 2012

jax8008 5 posts

Topic: General Discussion / Any help please?

I've attached 10 days worth of results.....I'm thorough and a bit ocd with my carb counting so I haven't added all my carb:insulin ratios. I am at a complete loss as to why I'm having all these hypos and also feeling very tired. Last night I even had a carb-free meal of 3xegg omelette with fresh tomatoes although I did have a glass of milk so had 1 unit of insulin to cover that..... my bg went from 6.4 before eating to 10.3 in 30 minutes after eating and was still 10.4 before bed and I hadn't even eaten or drank anything else.

I've actually got OPA this afternoon and its because of inputting my results that I have noticed the hypos, which the night time ones are of particular concern as I luckily woke up with them. The others I didn't get any warning signs at all until it was too late. I'm feeling really down at the minute because of it all.....I'm feeling drained all the time, my little girl is getting a bum deal as I'm constantly tired and irritable I feel like its really getting on top of me now and don't know what to do. I keep getting told by professionals that I've got good control but I still feel like poo..... Crying or Very sad

I hope someone can shed some light.

Thanks

Jackie

Jun 26, 2012

Margaret 2 posts

Topic: General Discussion / Pump life advice!

Thank you Helen, for sharing your experiences with us, you gave me very interesting points to think about.

Jun 25, 2012

Alan 49 284 posts

Topic: Site Development / Targets range

Hello Annette
I think the graphs use the DAFNE Online targets which are autoomatically set to the DAFNE recommended targets. You can amend these targets by going to the BG Diary and then scrolling down and clicking on Edit Diary Settings (or something similar to this). You can then amend whatever Target you like.

Jun 25, 2012

Annette Bell 72 posts

Topic: Site Development / Targets range

Hi!
I was printing off my graphs for my diabetic clinic check today and realised that the BG targets on them don't actually reflect the targets I have entered on my iPod app. My upper target is 8 at all times of the day and my lower is 4 (apart from driving) as this seems to suit me best for correctional purposes. The target bands on the graph, however, vary through the day and tend to be lower than 8. This makes my results look a lot worse than they are, when my HbA1c is 6.2. Is there a way of personalising the target bands in the graphs?

Jun 25, 2012

Annette Bell 72 posts

Topic: Site Development / Injection site list

JennyNZ said:
Hi there. I've just started using the on line diary, too and think its great but was going to ask the same question - being able to record 2 different injection sites. I think the graphs are great - I always thought I was great at site rotation until I started using your programme and realised how much I was favouring sites. one thing - you only have one &quot;buttocks&quot; could you make that &quot;left&quot; and &quot;right&quot; as well? thanks

Yes! I have been thinking exactly the same as you for some time now. There should be left & right buttocks just as there are left & right thighs etc. Also, I too use 2 different areas when giving BI & QA at the same time so 2 injection site boxes would be much better. (I enter my results on my iPod app)

Jun 25, 2012

Podarcis 14 posts

Topic: Site Development / Auto calculate QA from BG - let's get it right

Yes, it was me who asked, and this discontinuity issue is exactly what I was investigating when I asked. Let me explain. We will be using an equation to compute the QA correction we need for any given BG level. In mathematics, a discontinuity is when the result of applying an equation to values that are a small distance either side of some particular value results in a large jump in the result of the equation.

As I showed above, there is a discontinuity at BG 17 (also at 13 and 10). BG 16.9 gives +7.6 while BG 17.1 gives +11.6. So if you have a BG of close to 17 (say 17.5, or 16.5, perhaps), your QA correction will be either +7 or +11, approx. Now, clearly, both of these cannot be the right corrective dose to use. If +7 is right for a BG of 16.5, then +11 is clearly way too much for a BG of 17.5.

What my previous post says is that we can avoid this discontinuity problem by applying the corrective factors only within the bands they apply to. This will assist in obtaning good and consistent corrective adjustment values, and will help the app users to achieve better BG control.

No doubt some personal tuning by trial and error will be needed to arrive at the QA:BG ratios for each band. But I believe it will be a simpler task to arrive at these ratios if we use this banded application, in spite of the method being harder to understand. It will be safer, too: the discontinuity issue would have the potential to cause unexpected and unanticipated overcorrections.

Jun 25, 2012

RichFreed 51 posts

Topic: Site Development / Auto calculate QA from BG - let's get it right

I'm the same as Novorapidboi26. Since beginning DAFNE I've identified 2 bands so far, when I'm in the higher band my correction was being calculated at 1QA for each mmol so with a 15 reading I'd be taking 15QA. No consideration enters into it from the reduced correction of the lower band.

Jun 25, 2012

novorapidboi26 1,819 posts

Topic: Site Development / Auto calculate QA from BG - let's get it right

I think I remember you or someone else asking me if I used all the bands of blood sugars when correcting, as obviously, my blood sugars would be dropping and therefore would need less.......

But for me, the method I use, which is just to use one band, has worked perfectly, and its simple, however this could just be specific to me.........its all about insulin resistance, hence the varying effectiveness of 1 unit....

My theory is that if I am above 17mmol/l then the cells of my body have a higher resistance to insulin than I would at lower levels, but its likely my blood sugar levels would drop quicker than that of my resistance and therefore trying to calculate a correction by using all the bands wouldn't really apply.....

I conclude this from my own personal experience and blood sugar results, quite simply, I am on target by the next meal time......

Its interesting though and I would be interested to see someone testing this method...

What do you mean when you say discontinuity? If I was 16.9, I would treat that as if it was 17 or above, not an exact science by any means........... Smile

Jun 25, 2012

Alan 49 284 posts

Topic: General Discussion / Targets

Thanks very much JWo

Jun 24, 2012

JayBee 587 posts

Topic: General Discussion / Targets

You access it from the BG Diary page (it's near the bottom of the page). Here's the address to the page you're looking for:

http://www.dafneonline.co.uk/diary/settings

Jun 24, 2012

Alan 49 284 posts

Topic: General Discussion / Targets

Can someone please remind me how I can amend my BG Targets.

Jun 23, 2012

Podarcis 14 posts

Topic: Site Development / Auto calculate QA from BG - let's get it right

There is a danger of a discontinuity here...

BG is 16.9, corr is (16.9-5.5)/1.5 = +7.6
BG is 17.1, corr is (17.1-5.5)/1.0 = +11.6

Logically the different corrective ratios should be applied separately to each band and accumulated, but nobody will already be doing that in their head. A computer can do it, though. And that will avoid the discontinuity problem.

Eg:
BG is 17.1, need (17.1-17)/1.0 = 0.1 to get to 17,
plus (17-13)/1.5 = 2.7 to get to 13,
plus (13-10)/2.0 = 1.5 to get to 10,
plus (10-5.5)/2.5 = 1.8 to get to 5.5.
So corr = 0.1+2.7+1.5+1.8 = 6.1.

This is lower than novorapid would want, I suspect, but that's due to the corrective ratios being applied to each band. By using slightly different ratios the desired correction can be made in all cases without any discontinuity problem.

I recommend that we should use this calculation method, since it will give reliable results.

Jun 23, 2012

HelenP 218 posts

Topic: General Discussion / Pump life advice!

Ruth..being generous i have no idea what the Korean hostess told the passenger as I don't know Korean and I do not know whether the Korean hostess' English was good enough for "insulin pump!". Lost in translation!

Helen

Jun 27, 2012 jax8008 5 posts	Topic: General Discussion / Any help please? Hi I didn't take offence, I was just explaining the reasons why I'm testing so frequently......can I ask if you feel 'normal' most of the time? This is what gets me, there were only a couple of other people on the DAFNE course and none of them felt as I do so I'm just curious to know how other diabetics 'feel'. I was diagnosed 3 and a half years ago, at the age of 46! I've carb counted from day one and quite ocd about it, also with correcting I wont correct until after the 2 hours or longer if necessary. Sorry about the erratic input, as I said earlier I didn't fill all the carbs in as I was in a bit of a rush to get the blood test results down to show at my opa. I saw the registrar today, gonna see the Consultant next time, 3 months time! Yeah I seem to need to eat little and often and feel very rubbish if I dont. When you say that I'm sensitive to insulin what do you mean by that? I do thank you for your replies as its good to hear from someone who is also diabetic, rather than professionals who don't know everything about the day-to-day living with diabetes.

Jun 27, 2012 marke 686 posts	Topic: General Discussion / Any help please? hi, sorry I didn't mean to suggest that you shouldn't test OR record the tests. Better to much than to little ! I was just pointing out they you shouldn't do something like apply a correction dose for one of these readings, that was all. Looking at your diary it seems that you are sensitve to insulin, have you been a diabetic for a while ? Have you always been this sensitve to insulin, It also seems unless you have missed out data there are a number of days where you didn't eat any carbs, is this normal ? Personally would feel pretty rubbish if I didn't eat anything but thats just me One last thing, if you don't see a consultant at the hospital who do you see ? I always see a consultant so I'm curious

Jun 27, 2012 jax8008 5 posts	Topic: General Discussion / Any help please? Hi Thanks for your reply and your comments. The reason that I missed the BI out is that I rushed to input info before I went to hospital.....I always have my BI around 11 at night, 9 units of Levemir. I test a lot because I'm always feeling 'not right' (am I going high or low? symptoms are very similar) so want to know why, although I do have to test before driving which is usually 6 times a day, maybe I shouldn't add them to my DAFNE ones and stick to just noting the ones prior to eating and 2 hours after, would you say that would be better? I understand that its not an exact science with food,their GI and timing of insulin injection but surely I shouldn't be feeling like I'm having diabetic warning signs for 6 hours of a waking day? I've not long since got home after my ordeal at my OPA. My Hba1c is 46% which I thought was good but the doc says that it shows I'm running at the low end. She had no answers to what I was asking, until she walked out to get a blood form and I was in tears when she came back in......she then listened to me, basically admitting that I shouldn't be feeling like I do but has no idea why I'm feeling like it. Advised me for further blood tests and to seek further advice from Diabetic Specialist Nurse......then to see the Consultant in 3 months!! I shall have to make more of an effort to go back to making a complete and full diary of foodstuffs I'm eating exactly.

Jun 27, 2012 marke 686 posts	Topic: General Discussion / Any help please? There are a few things to say aboutthese results. The most important being you don't reecord your BI insulin most of the time. This is important and it is important that you take it at around the same time every day. What type of BI is it , latus or Levemir maybe ? The second is you test an awful lot quite often with 2 hours of eating. This is not necessarily a good idea since high readings at this point could be down to the timing of your injection ( before or after food) and the GI of the food. That is why it is recommended that you test before meals generally 4 times a day. I'm not criticising you for testing so much its just that high readings can cause oyu to get stressed which will compound the high readings. Is your reduced level of warning signs what is causing you to test so much ? If you want to help restore your warning signs you should run a bit high for a few days maybe a bit longer to help restore them. These are just initial impressions, hopefully I and others can look at the readings in more detail and come up with some suggestions

Jun 27, 2012 mark1882 1 post	Topic: General Discussion / High morning readings Hi I have had high morning reading that seem to vary wildly (11-1 Cant seem to get a correlation between my night time long term Levemir + Novarapid adjustments Anyone have similar problems I can control the other times reasonably well as long as I'm aware of carb value of what I'm eating

Jun 27, 2012 jax8008 5 posts	Topic: General Discussion / Any help please? I've attached 10 days worth of results.....I'm thorough and a bit ocd with my carb counting so I haven't added all my carb:insulin ratios. I am at a complete loss as to why I'm having all these hypos and also feeling very tired. Last night I even had a carb-free meal of 3xegg omelette with fresh tomatoes although I did have a glass of milk so had 1 unit of insulin to cover that..... my bg went from 6.4 before eating to 10.3 in 30 minutes after eating and was still 10.4 before bed and I hadn't even eaten or drank anything else. I've actually got OPA this afternoon and its because of inputting my results that I have noticed the hypos, which the night time ones are of particular concern as I luckily woke up with them. The others I didn't get any warning signs at all until it was too late. I'm feeling really down at the minute because of it all.....I'm feeling drained all the time, my little girl is getting a bum deal as I'm constantly tired and irritable I feel like its really getting on top of me now and don't know what to do. I keep getting told by professionals that I've got good control but I still feel like poo..... Crying or Very sad I hope someone can shed some light. Thanks Jackie

Jun 26, 2012 Margaret 2 posts	Topic: General Discussion / Pump life advice! Thank you Helen, for sharing your experiences with us, you gave me very interesting points to think about.

Jun 25, 2012 Alan 49 284 posts	Topic: Site Development / Targets range Hello Annette I think the graphs use the DAFNE Online targets which are autoomatically set to the DAFNE recommended targets. You can amend these targets by going to the BG Diary and then scrolling down and clicking on Edit Diary Settings (or something similar to this). You can then amend whatever Target you like.

Jun 25, 2012 Annette Bell 72 posts	Topic: Site Development / Targets range Hi! I was printing off my graphs for my diabetic clinic check today and realised that the BG targets on them don't actually reflect the targets I have entered on my iPod app. My upper target is 8 at all times of the day and my lower is 4 (apart from driving) as this seems to suit me best for correctional purposes. The target bands on the graph, however, vary through the day and tend to be lower than 8. This makes my results look a lot worse than they are, when my HbA1c is 6.2. Is there a way of personalising the target bands in the graphs?

Jun 25, 2012 Annette Bell 72 posts	Topic: Site Development / Injection site list JennyNZ said: Hi there. I've just started using the on line diary, too and think its great but was going to ask the same question - being able to record 2 different injection sites. I think the graphs are great - I always thought I was great at site rotation until I started using your programme and realised how much I was favouring sites. one thing - you only have one &quot;buttocks&quot; could you make that &quot;left&quot; and &quot;right&quot; as well? thanks Yes! I have been thinking exactly the same as you for some time now. There should be left & right buttocks just as there are left & right thighs etc. Also, I too use 2 different areas when giving BI & QA at the same time so 2 injection site boxes would be much better. (I enter my results on my iPod app)

Jun 25, 2012 Podarcis 14 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right Yes, it was me who asked, and this discontinuity issue is exactly what I was investigating when I asked. Let me explain. We will be using an equation to compute the QA correction we need for any given BG level. In mathematics, a discontinuity is when the result of applying an equation to values that are a small distance either side of some particular value results in a large jump in the result of the equation. As I showed above, there is a discontinuity at BG 17 (also at 13 and 10). BG 16.9 gives +7.6 while BG 17.1 gives +11.6. So if you have a BG of close to 17 (say 17.5, or 16.5, perhaps), your QA correction will be either +7 or +11, approx. Now, clearly, both of these cannot be the right corrective dose to use. If +7 is right for a BG of 16.5, then +11 is clearly way too much for a BG of 17.5. What my previous post says is that we can avoid this discontinuity problem by applying the corrective factors only within the bands they apply to. This will assist in obtaning good and consistent corrective adjustment values, and will help the app users to achieve better BG control. No doubt some personal tuning by trial and error will be needed to arrive at the QA:BG ratios for each band. But I believe it will be a simpler task to arrive at these ratios if we use this banded application, in spite of the method being harder to understand. It will be safer, too: the discontinuity issue would have the potential to cause unexpected and unanticipated overcorrections.

Jun 25, 2012 RichFreed 51 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right I'm the same as Novorapidboi26. Since beginning DAFNE I've identified 2 bands so far, when I'm in the higher band my correction was being calculated at 1QA for each mmol so with a 15 reading I'd be taking 15QA. No consideration enters into it from the reduced correction of the lower band.

Jun 25, 2012 novorapidboi26 1,819 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right I think I remember you or someone else asking me if I used all the bands of blood sugars when correcting, as obviously, my blood sugars would be dropping and therefore would need less....... But for me, the method I use, which is just to use one band, has worked perfectly, and its simple, however this could just be specific to me.........its all about insulin resistance, hence the varying effectiveness of 1 unit.... My theory is that if I am above 17mmol/l then the cells of my body have a higher resistance to insulin than I would at lower levels, but its likely my blood sugar levels would drop quicker than that of my resistance and therefore trying to calculate a correction by using all the bands wouldn't really apply..... I conclude this from my own personal experience and blood sugar results, quite simply, I am on target by the next meal time...... Its interesting though and I would be interested to see someone testing this method... What do you mean when you say discontinuity? If I was 16.9, I would treat that as if it was 17 or above, not an exact science by any means...........

Jun 25, 2012 Alan 49 284 posts	Topic: General Discussion / Targets Thanks very much JWo

Jun 24, 2012 JayBee 587 posts	Topic: General Discussion / Targets You access it from the BG Diary page (it's near the bottom of the page). Here's the address to the page you're looking for: http://www.dafneonline.co.uk/diary/settings

Jun 24, 2012 Alan 49 284 posts	Topic: General Discussion / Targets Can someone please remind me how I can amend my BG Targets.

Jun 23, 2012 Podarcis 14 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right There is a danger of a discontinuity here... BG is 16.9, corr is (16.9-5.5)/1.5 = +7.6 BG is 17.1, corr is (17.1-5.5)/1.0 = +11.6 Logically the different corrective ratios should be applied separately to each band and accumulated, but nobody will already be doing that in their head. A computer can do it, though. And that will avoid the discontinuity problem. Eg: BG is 17.1, need (17.1-17)/1.0 = 0.1 to get to 17, plus (17-13)/1.5 = 2.7 to get to 13, plus (13-10)/2.0 = 1.5 to get to 10, plus (10-5.5)/2.5 = 1.8 to get to 5.5. So corr = 0.1+2.7+1.5+1.8 = 6.1. This is lower than novorapid would want, I suspect, but that's due to the corrective ratios being applied to each band. By using slightly different ratios the desired correction can be made in all cases without any discontinuity problem. I recommend that we should use this calculation method, since it will give reliable results.

Jun 23, 2012 HelenP 218 posts	Topic: General Discussion / Pump life advice! Ruth..being generous i have no idea what the Korean hostess told the passenger as I don't know Korean and I do not know whether the Korean hostess' English was good enough for "insulin pump!". Lost in translation! Helen