Recent Posts - DAFNE Online

May 29, 2012

Charlie C 2 posts

Topic: General Discussion / High BG at Lunch

Mike, if it goes up but you havent had any breakfast or any quick acting insulin then i'd be looking at your slow acting (basal) insulin. However if it goes up after breakfast (which it should a little) then maybe you need to check you've counted your carbs correctly.

Hope this helps.

C

May 29, 2012

Anele46 109 posts

Topic: General Discussion / Hypo Awareness

Thanks Marke, I remember reading in the forums in the past of people saying they developed Ketones when having too many carb free meals, must have read it wrong, sorry Sad

Thanks,
Anele.

May 29, 2012

Mike_Holland 1 post

Topic: General Discussion / High BG at Lunch

My BG reading is perfect at breakfast but by lunch has gone very high. The same thing happens if I eat breakfast or not. Which insulin should I increase?! Any help very gratefully taken......

May 29, 2012

slb23 5 posts

Topic: General Discussion / Exercise and high BG

This is the most bizarre thing ever - glad I'm not the only one!
I've recently started to go to the gym in the morning (30 minute run before breakfast); I'm usually 6-8 when I wake, and end up ~15 an hour after. So I do a few units (1 unit takes me down 2 mmol) to correct, as well as my breakfast units, but it continues to rise! Sometimes up to 17 two hours after.
The idea of injecting before is scary, but think I'm going to have to try it. Will let you know!
What's more bizarre is that when I was diagnosed over 10 years ago, I was always told to eat something (at that stage, a mini mars bar a day Confused

!) before PE classes, to stop me going low! Is that just because I used to do 2 mixed injections per day rather than DAFNE, or how did I not notice I was always high.
Very odd, but so glad I found this!

May 29, 2012

GordyP 9 posts

Topic: General Discussion / TDD (Total daily dose)

Hi, could anyone confirm that when Calculating TDD, that includes all insulin taken in that day including corrections. Speaking and researching this is giving me conflicting information on wether to include corrections or not. Any help much appreciated.....

Regards,
Gordy

May 28, 2012

marke 686 posts

Topic: General Discussion / Hypo Awareness

Hi, as far as I am aware Ketones are caused by the abscence of insulin to transport blood sugar into cells resulting in 'fat' being used for energy. Therefore a carb free meal cannot result in ketones, it can result in a hypo if you BI is too high which is exactly what you are trying to establish. If you do have a carb free meal to test your BI its a good idea to test a bit more regularly just to ensure what IS happening to your BG.

May 28, 2012

Anele46 109 posts

Topic: General Discussion / Hypo Treatment

I find 3 jelly babies works a treat followed by some toast.
Helps avoid over-compensating.
I also find 3 dextrose tablets is enough (for me anyway).

Cheers,
Anele.

May 28, 2012

Phil Maskell 194 posts

Topic: General Discussion / Hypo Treatment

Hi,

As mentioned on the DAFNE course, a small carton of Apple or Orange is about 2CP, perfect amount for a hypo, more bulky than Dextrose to carry round though.

Phil

May 28, 2012

Moris 9 posts

Topic: General Discussion / Hypo Treatment

Hi,
I use one or two 25g tubes of Gluco Gel, (persciption) or a few Gluco Tabs followed by toast to back it up. The Gel tastes bad, but it works well.

Moris.

May 28, 2012

Anele46 109 posts

Topic: General Discussion / Hypo Awareness

The only thing to watch out is I've heard of people that often have carb free meals can develop ketones so just a wee minder Smile

Cheers,
Anele.

May 28, 2012

Phil Maskell 194 posts

Topic: General Discussion / Hypo Awareness

Thanks

Might loose weight too as thats Atkins Very Happy

Phil

May 28, 2012

Anele46 109 posts

Topic: General Discussion / Hypo Awareness

Hi Phil,
I tend not have any carb free meals though if I were to I would have either some sort of salad with meat/ tuna/fish/cheese without any dressings that contain carbs. If it's breakfast or lunch then a fried/poached egg(s) with grilled bacon, sausages (although be careful as the cheaper sausages tend to contain carbs - steak ones should be ok), tomotoes, mushrooms.

Also, any meat or fish with steamed veg isa good option too.

Hope this helps Smile

Cheers,
Anele.

May 28, 2012

Phil Maskell 194 posts

Topic: General Discussion / Hypo Awareness

Thanks,

It might be my background, what I will probably do over the weekend is have carb free meals and keep testing.

What are good carb free meals, I was thinking salad, but tomatoes though I don't count them do have some.

Phil

May 28, 2012

Anele46 109 posts

Topic: General Discussion / Hypo Awareness

Hi Phil,
I have never had "great" Hypo awareness and find that if I am busy at work I often miss the signs until it's time for me to check my blood before I eat (I'm generally always at my lowest at lunch time).
My DSN advised that I was on too much BI (Lantus) and have reduced this and this helped.
She also advised me to run my BGs a bit higher (1 or 2 mmol higher than my targets) and this definitely brought back the warning signs.
However, now that I am pregnant I am having to run my BGs as low as possible and am starting to have Hypos as I strive to keep a tighter control for the baby. Having said that, my Hypos aren't as frequent as yours. Have you thought about checking your BI as it may be a little too much? A Carb free meal and a 3AM test would help check this out.

Good luck, I would keep in touch with your DSN and keep writing everything down in your diary (I know it can be very time consuming) but it's the only way to see trends and make the best/safest adjustments Very Happy

Hope this helps in some way.

All the best,
Anele.

May 28, 2012

vic demain 87 posts

Topic: General Discussion / Night time cycle ride.

Hi Jenny, was all geared uo for the long training ride Saturday, before slowing down the training, all going well when 13kms in I had a blow out. No spares, so call back up and that was the end of that! Having said that, training has gone really well and the fundraising support has been brilliant.
You're going to think me really fussy but creamed rice I hate, reminds me of school dinners. Going for jacket potato with beans and cheese. Background insulin has been nearly halved and think I will miss it out altogether on the night.
Think the team you refer to are local to me in High Wycombe and are linked to Sir Stephen Redgrave, the rower and Olympian. My diabetic nurse pointed me in their direction, although I found it very scientific.
Thanks for your interest and good wishes.

May 28, 2012

Phil Maskell 194 posts

Topic: General Discussion / Hypo Awareness

Hi,

Never had the best control, but recently I have made a concerted effort to lower my hba1c, just had blood test so we will see!

Problem is in tighter control I have been going hypo alot, I mean 4 or 5 times a day Sad

Yesterday and today I have a couple of 2.9s without any knowledge of them, no symptoms or anything, this worries me, I have never not had awareness!

If I loosening my grip on control will awareness come back?

How do others feel about this? Lower hba1c or awareness?

Phil

May 28, 2012

GordyP 9 posts

Topic: Questions for HCPs / Morning High

I was going to increase my basal by 10-20%, so from 22 to 24 for few days to see what effect that has. Would anyone agree/disagree Question

May 28, 2012

JennyNZ 29 posts

Topic: General Discussion / Night time cycle ride.

hi Vic - hope all your training is going well and you've got your nutrition sorted. If you're not a fan of pasta, creamed rice is an absolutely yummy way to get carbs regularly. I'm sure this close to the ride things will be coming together a lot more. I saw an article on "runsweet" (I think) about a medical team in England who specialise in diabetics and sport - sounds good.
All the best.

May 28, 2012

GordyP 9 posts

Topic: Questions for HCPs / Morning High

I have just completed Dafne course last week and during the first few days I have been lowering my lantus (which I take before bed), from 26u to 24u to 22u. For the last few days now, my BG before bed is good, but the next morning is very high. Do u think it be best to raise my lantus to 24 again for few days to try and eliminate morning highs. The morning highs are on Sunday 27th and Monday 28th.

Regards
Gordy

May 28, 2012

Ahmentep 99 posts

Topic: General Discussion / Hypo Treatment

Hi,

A Dextrose tablet is about 3g of carbohydrate as I recall, so you would need four or five to show any noticeable effect. Of course it depends entirely upon the depth of the hypo. I find actual Lucozade by far the best thing, and I usually take three or four mouthfulls.

Kind regards,

Roger

May 27, 2012

BMuffs 6 posts

Topic: General Discussion / Hypo Treatment

Hi,

Can anyone tell me how many dextrose or lucozade tablets you should take when treating a hypo please? I can't find this in my handbook but I remember the dietician showing us this on the course.

May 27, 2012

thebatoutofhull 60 posts

Topic: General Discussion / Split Lantus dose

I split my lantus as well. 17 in the morning. 13 in evening14 hrs later. My lantus lasts 18 hours max not 24. When you can find out how long your lantus lasts for you will be able to work out how to overlap the two injections. I am more interested in how lantus rolls off when it runs out. This has caused me to go high later in the evening. Lantus does not start working for approx. 1 hour. Then it rises from 4 hours to 8 hours. It then shelves for a further 2hours reaching max efficacy at 12 hours with a glucose infusion rate (mg*kg-1 min-1) of 1.8. (The peak of lets say insulatard is 3.1 - nearly double). Lantus then tails off over 12 hours between 0.5 and 1.0 G.I.R. It is this tail that is awkward. When you overlap how do you know when to have the second jab if you don't know when the first BI is ending?
I spent 2 months experimenting eating no carbs and background testing.
When over lapping my lantus I have to supplement the resulting trough with a little QA . Bloomin tricky to get right.
All the best.

May 29, 2012 Charlie C 2 posts	Topic: General Discussion / High BG at Lunch Mike, if it goes up but you havent had any breakfast or any quick acting insulin then i'd be looking at your slow acting (basal) insulin. However if it goes up after breakfast (which it should a little) then maybe you need to check you've counted your carbs correctly. Hope this helps. C

May 29, 2012 Anele46 109 posts	Topic: General Discussion / Hypo Awareness Thanks Marke, I remember reading in the forums in the past of people saying they developed Ketones when having too many carb free meals, must have read it wrong, sorry Thanks, Anele.

May 29, 2012 Mike_Holland 1 post	Topic: General Discussion / High BG at Lunch My BG reading is perfect at breakfast but by lunch has gone very high. The same thing happens if I eat breakfast or not. Which insulin should I increase?! Any help very gratefully taken......

May 29, 2012 slb23 5 posts	Topic: General Discussion / Exercise and high BG This is the most bizarre thing ever - glad I'm not the only one! I've recently started to go to the gym in the morning (30 minute run before breakfast); I'm usually 6-8 when I wake, and end up ~15 an hour after. So I do a few units (1 unit takes me down 2 mmol) to correct, as well as my breakfast units, but it continues to rise! Sometimes up to 17 two hours after. The idea of injecting before is scary, but think I'm going to have to try it. Will let you know! What's more bizarre is that when I was diagnosed over 10 years ago, I was always told to eat something (at that stage, a mini mars bar a day !) before PE classes, to stop me going low! Is that just because I used to do 2 mixed injections per day rather than DAFNE, or how did I not notice I was always high. Very odd, but so glad I found this!

May 29, 2012 GordyP 9 posts	Topic: General Discussion / TDD (Total daily dose) Hi, could anyone confirm that when Calculating TDD, that includes all insulin taken in that day including corrections. Speaking and researching this is giving me conflicting information on wether to include corrections or not. Any help much appreciated..... Regards, Gordy

May 28, 2012 marke 686 posts	Topic: General Discussion / Hypo Awareness Hi, as far as I am aware Ketones are caused by the abscence of insulin to transport blood sugar into cells resulting in 'fat' being used for energy. Therefore a carb free meal cannot result in ketones, it can result in a hypo if you BI is too high which is exactly what you are trying to establish. If you do have a carb free meal to test your BI its a good idea to test a bit more regularly just to ensure what IS happening to your BG.

May 28, 2012 Anele46 109 posts	Topic: General Discussion / Hypo Treatment I find 3 jelly babies works a treat followed by some toast. Helps avoid over-compensating. I also find 3 dextrose tablets is enough (for me anyway). Cheers, Anele.

May 28, 2012 Phil Maskell 194 posts	Topic: General Discussion / Hypo Treatment Hi, As mentioned on the DAFNE course, a small carton of Apple or Orange is about 2CP, perfect amount for a hypo, more bulky than Dextrose to carry round though. Phil

May 28, 2012 Moris 9 posts	Topic: General Discussion / Hypo Treatment Hi, I use one or two 25g tubes of Gluco Gel, (persciption) or a few Gluco Tabs followed by toast to back it up. The Gel tastes bad, but it works well. Moris.

May 28, 2012 Anele46 109 posts	Topic: General Discussion / Hypo Awareness The only thing to watch out is I've heard of people that often have carb free meals can develop ketones so just a wee minder Cheers, Anele.

May 28, 2012 Phil Maskell 194 posts	Topic: General Discussion / Hypo Awareness Thanks Might loose weight too as thats Atkins Phil

May 28, 2012 Anele46 109 posts	Topic: General Discussion / Hypo Awareness Hi Phil, I tend not have any carb free meals though if I were to I would have either some sort of salad with meat/ tuna/fish/cheese without any dressings that contain carbs. If it's breakfast or lunch then a fried/poached egg(s) with grilled bacon, sausages (although be careful as the cheaper sausages tend to contain carbs - steak ones should be ok), tomotoes, mushrooms. Also, any meat or fish with steamed veg isa good option too. Hope this helps Cheers, Anele.

May 28, 2012 Phil Maskell 194 posts	Topic: General Discussion / Hypo Awareness Thanks, It might be my background, what I will probably do over the weekend is have carb free meals and keep testing. What are good carb free meals, I was thinking salad, but tomatoes though I don't count them do have some. Phil

May 28, 2012 Anele46 109 posts	Topic: General Discussion / Hypo Awareness Hi Phil, I have never had "great" Hypo awareness and find that if I am busy at work I often miss the signs until it's time for me to check my blood before I eat (I'm generally always at my lowest at lunch time). My DSN advised that I was on too much BI (Lantus) and have reduced this and this helped. She also advised me to run my BGs a bit higher (1 or 2 mmol higher than my targets) and this definitely brought back the warning signs. However, now that I am pregnant I am having to run my BGs as low as possible and am starting to have Hypos as I strive to keep a tighter control for the baby. Having said that, my Hypos aren't as frequent as yours. Have you thought about checking your BI as it may be a little too much? A Carb free meal and a 3AM test would help check this out. Good luck, I would keep in touch with your DSN and keep writing everything down in your diary (I know it can be very time consuming) but it's the only way to see trends and make the best/safest adjustments Hope this helps in some way. All the best, Anele.

May 28, 2012 vic demain 87 posts	Topic: General Discussion / Night time cycle ride. Hi Jenny, was all geared uo for the long training ride Saturday, before slowing down the training, all going well when 13kms in I had a blow out. No spares, so call back up and that was the end of that! Having said that, training has gone really well and the fundraising support has been brilliant. You're going to think me really fussy but creamed rice I hate, reminds me of school dinners. Going for jacket potato with beans and cheese. Background insulin has been nearly halved and think I will miss it out altogether on the night. Think the team you refer to are local to me in High Wycombe and are linked to Sir Stephen Redgrave, the rower and Olympian. My diabetic nurse pointed me in their direction, although I found it very scientific. Thanks for your interest and good wishes.

May 28, 2012 Phil Maskell 194 posts	Topic: General Discussion / Hypo Awareness Hi, Never had the best control, but recently I have made a concerted effort to lower my hba1c, just had blood test so we will see! Problem is in tighter control I have been going hypo alot, I mean 4 or 5 times a day Yesterday and today I have a couple of 2.9s without any knowledge of them, no symptoms or anything, this worries me, I have never not had awareness! If I loosening my grip on control will awareness come back? How do others feel about this? Lower hba1c or awareness? Phil

May 28, 2012 GordyP 9 posts	Topic: Questions for HCPs / Morning High I was going to increase my basal by 10-20%, so from 22 to 24 for few days to see what effect that has. Would anyone agree/disagree

May 28, 2012 JennyNZ 29 posts	Topic: General Discussion / Night time cycle ride. hi Vic - hope all your training is going well and you've got your nutrition sorted. If you're not a fan of pasta, creamed rice is an absolutely yummy way to get carbs regularly. I'm sure this close to the ride things will be coming together a lot more. I saw an article on "runsweet" (I think) about a medical team in England who specialise in diabetics and sport - sounds good. All the best.

May 28, 2012 GordyP 9 posts	Topic: Questions for HCPs / Morning High I have just completed Dafne course last week and during the first few days I have been lowering my lantus (which I take before bed), from 26u to 24u to 22u. For the last few days now, my BG before bed is good, but the next morning is very high. Do u think it be best to raise my lantus to 24 again for few days to try and eliminate morning highs. The morning highs are on Sunday 27th and Monday 28th. Regards Gordy

May 28, 2012 Ahmentep 99 posts	Topic: General Discussion / Hypo Treatment Hi, A Dextrose tablet is about 3g of carbohydrate as I recall, so you would need four or five to show any noticeable effect. Of course it depends entirely upon the depth of the hypo. I find actual Lucozade by far the best thing, and I usually take three or four mouthfulls. Kind regards, Roger

May 27, 2012 BMuffs 6 posts	Topic: General Discussion / Hypo Treatment Hi, Can anyone tell me how many dextrose or lucozade tablets you should take when treating a hypo please? I can't find this in my handbook but I remember the dietician showing us this on the course.

May 27, 2012 thebatoutofhull 60 posts	Topic: General Discussion / Split Lantus dose I split my lantus as well. 17 in the morning. 13 in evening14 hrs later. My lantus lasts 18 hours max not 24. When you can find out how long your lantus lasts for you will be able to work out how to overlap the two injections. I am more interested in how lantus rolls off when it runs out. This has caused me to go high later in the evening. Lantus does not start working for approx. 1 hour. Then it rises from 4 hours to 8 hours. It then shelves for a further 2hours reaching max efficacy at 12 hours with a glucose infusion rate (mg*kg-1 min-1) of 1.8. (The peak of lets say insulatard is 3.1 - nearly double). Lantus then tails off over 12 hours between 0.5 and 1.0 G.I.R. It is this tail that is awkward. When you overlap how do you know when to have the second jab if you don't know when the first BI is ending? I spent 2 months experimenting eating no carbs and background testing. When over lapping my lantus I have to supplement the resulting trough with a little QA . Bloomin tricky to get right. All the best.