Recent Posts - DAFNE Online

May 16, 2012

Simon Heller 46 posts

Topic: Questions for HCPs / High Blood Pressure

Hi folks. High blood pressure is a very important sign in Type 1 diabetes as it can (although not always) signify early diabetic kidney disease which might progress. Anyone with type 1 diabetes should have any high BP reading considered along with the results of urine testing for early kidney damage (indicated by increased protein in the urine, what's called albumin/creat ratio) ideally measured on an early morning urine specimen. If two specimens show increased protein levels then even if BP isn't particularly high, we would advise treatment with either an ACE-inhibitor, (lisinopril, ramopril) or what's called an A2 receptor blocker (candesartan, losartan). So I agree that a high BP in isolation needs careful assessment with perhaps a 24 recording but if protein urine levels are raised we would be keen to start these treatments as soon as possible. They definitely slow down progression of kidney damage particularly if the BP can be lowered. Simon

May 15, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

I understand all your points................

I dont think anyone on here will be expecting anything from me, or anyone really, to be the gospels truth....................at least I hope that isnt the way I come across.......

Because I am quite involved with my own control, and some others, I feel I have a wide range of experience that should be shared, all be it educated opinions...... Wink

......maybe we could get some kind of post signature set up where I could tell people that I am not an HCP and that my ideas are purely from personal experience and that they are not the opinions of DAFNE UK and any of its affiliates........lol.......[dont really think thats neccesary...]

I agree you cant have an automated approach to diabetes, but certainly the process of counting carbs and dosing can be automated slightly.....................imagine everyone was as involved as me, then you would expect people to want some automation. I realise that I am probably a minority...... Very Happy

.....

On a brighter note though, I have been put forward for a pump today, so its about to get a lot more complicated................... Shocked

May 14, 2012

Jenny Spollen 13 posts

Topic: General Discussion / Hypos

I've def experience that tiredness. Quite often it accompanies a high volume of hypos and can leave me flattened and lasts up to 48 hours in the worst cases. I agree with Novorapidboi, it's a general body-wide extreme lack of sugar. A review of BI/QA ratios/any changes in routine/exercise would be a plan.

I've also learned to recognise it as a warning sign. It generally means I've been very low very often and that I'm in trouble and is generally followed by what I like to call the hypo-headache and is usually only one or two hypos away from the pukes and I'd be of the opinion that at that stage there would be no point in anyone even trying to stick me with a glucogen cause there would be nothing my liver would have to give. That said everyone is most def different and I hope the hypos get sorted Very Happy

May 14, 2012

Jenny Spollen 13 posts

Topic: General Discussion / What insulin pump??

The HSE were kind enough to supply me with a Medtronic VEO minimed there before Christmas and funding to get most of the consumables. I was lucky though cause I got in just before the pump tender was finalised and now Medtronic are supplying an older version of the pump and it's that or nothing here really as far as I know, but i don't know what one's on offer to ye in Dublin. As to the price of it I think that depends on who's trying to buy it. Cost the hospital in and around the 2-3 grand but the letter i got for the insurance is nearer the 5 and a half plus vat and carriage.....!

Some of the consumables are available on list f but the rest are def not but i don't know how much they cost. I do seem to go through an inordinate number of the things though. Some of the smaller things aren't covered on either as well as spares for stuff like set inserters and they are pricey enough - in and around 90â‚¬ a pop.

I don't see why you shouldn't get a choice of meter though. I'm currently working off two - one that blue tooths to the meter (bayer contour link) and one that's a BG and ketone combo (Optium Xceed). Am pretty fond of both of them. The contour link is new enough but holding up well and the optium seems to be pretty indistructable. The hospital always seems to have a selection of the things...and bayer were kind enough to send me a free spare in the post when i rang them.

Ask your chemist too, things like meters might be covered under list f but i couldn't tell you for certain, they have removed stuff off it of late with the cutbacks. You could chance your arm and ring the diff companies. They might send you one for nothing. You'll be sticking your finger enough that you'd be worth a fortune to them in test strips.

The pump def has the potential to be the business so would recommend you go for it if you can. That said, Medtronic wouldn't be my fav company to deal with (and in 25years they're the only one's have ever felt the need to say that about).

All the best with it,
Jenny

May 14, 2012

marke 686 posts

Topic: General Discussion / no DAFNE

I know what you mean, I live in fear of my consultant retiring. He is getting on now and I fear without him my clinic will fall into the same mode of operation as yours. Fortunately he is a strong character as well as being a superb consultant. Its hard when you see someone different all the time and cannot build a relationship. Let alone someone who understands DAFNE as well.

May 14, 2012

marke 686 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

thanks thats the response I wanted to get Very Happy

You just need to remember that a lot of people are not as keen as you to build a regime. I have met many people through DAFNE and Diabetes UK that are happy to just roll again with the basics. This is why I questioned the 'could be doing damage', its important to seperate an opinion from evidence based on medical research. I don't have any problem with people expressing opinions, I just like to make clear thats what they are. Many people take what the read on the internet as fact whereas the truth is anyone can set up a website and publish a load of garbage, there is some truly scary stuff out there. I'm not suggesting you are necessarily wrong, I agree with a lot of what you say, but for the sake of a balanced and objective site its good sometimes to question people.
I still don't think you can have an automated approach to Diabetes management because there are so many variables involved, but if people want to try thats good. The important point is they understand what they are getting is a best guess and not 100% accurate. Just like your meter, which gives you a best guess at your BG NOT a 100% accurate figure. Hopefully in our lifetimes we will see continuous BG meters linked to pumps that act as psuedo pancreas's or
even stem cell therapy that will restore islet cells, in the meantime we just have to make do with life as it is.

May 14, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Carbs and Cals Book - large / pocket?

I've got the both the large & the pocket versions but just wondering who else has got this book and whether you've got the large or pocket version or both like me.

For anyone who's got both how do you cope with the small version? After using the large version with 6 portion sizes of food on each page i just can't get used to only 2 portion sizes. How do you use the book when out and about and only 2 portion sizes to go from?

May 14, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / no DAFNE

My clinic is still up and running but I too can see a different consultant at each visit, which is annoying, but thankfully the DSN there is the same and any help or advice I need can come from her.........

May 14, 2012

thebatoutofhull 60 posts

Topic: General Discussion / no DAFNE

Sheffield have not stopped. It was me who moved away from Sheffield to a PCT that did not offer DAFNE. The support in Sheffield is excellent and has a lot of DAFNE grads.

For me the best thing is to use this site. The support and advice, or just wanting a nudge in the right direction is so helpful.

There have been a lot of changes in Herefordshire where I am now. I have had 3 different consultants. Usually Locums. Their care is very good but they are not able to offer continuity re: DAFNE. I believe it was offered once.

It would be nice if I could move home but still keep in touch with a DAFNE team.

May 14, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

By saying basic, I was highlighting that after you have completed DAFNE, it doesn't stop there, you need more that what has been supplied by DAFNE, as it is only the foundation from which to build and develop a regime that caters for each individual..........

I think saying 'you could be doing damage' is OK, as it could be happening, it might not though, but that's why encouraging people to test more often and to really get to know there own bodies behavior to different food and dose timings is really important, in my opinion anyway.

My control has improved greatly since DAFNE, but its not stopping complication occurring in my eyes, and a difficulty to achieve an HbA1c within the recommended target range. This I believe is down to between meal spikes.

Everyone is different and if they want to inject after a meal, that's fine, I am not saying its wrong or bad, and certainly wouldn't imply this is what DAFNE thinks either. The majority of folk will start digesting their food before the insulin has started to work properly. So this was why I mentioned that actually you should think about injecting before you eat, and sometimes, a good few minuted before. Again, this is purely from peoples [and mine] personal experiences, no documented medical facts. I like to encourage people to test, a lot, and build a picture of whats going on, in much more detail than DAFNE will teach you to.

I think the 'bolus' calculators that are being offered are good, certainly not something to be taken lightly, but its a sign that more and more people are taking a much more detailed and pro active approach to their control, and that they want a more automated approach to it all. Certainly if you have completed DAFNE training, I believe you a more than capable of using one of these functions without danger, and even more so if your on a pump, although there are some pumpers out there that have just been given it when they don't really know whats going on...... Evil or Very Mad

Regarding the app, I think it could be good. However I don't believe all graduates who sign up and download the app are at similar levels of competency in their regime, so its needs to be developed carefully I think...... Very Happy

May 14, 2012

Phil Maskell 194 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

Hi,

I often do post meal injections (not breakfast as its mostly the same cereal or toast) as I'm a pig and often go back for seconds or have dessert Very Happy

I thought this was the point of DAFNE?

Just my 2p

Phil

May 14, 2012

marke 686 posts

Topic: General Discussion / no DAFNE

Not sure what I will do, mine has just pulled the plug. I have not been told about Sheffield withdrawing though how did you find out about them withdawing ??

May 14, 2012

marke 686 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

NRB, there is no 'basic' DAFNE syllabus there is A DAFNE syllabus. I have seen lots of debate about digestion profiles and post meal spikes on other sites, however most of the discussions seem to revolve around peoples personnal beliefs rather than detailed medical research. I therefore don't believe its fair to say 'you could be doing damage' since there is no evidence to back up this claim. As we often repeat ( or favourite mantra) everyone is different and no two people will respond the same to insulin/food or any other number of factors. If someone wants to inject post meal there is no problem with this as far as DAFNE is concerned.
Its interesting that the 'expert' meter is limited to people who have had some training in does adjustment and calculation. There is discussion in other forums on the site about adding dose calculation to the DAFNEOnline App and this backs up my point that it is NOT a trivial thing and even meter companies are wary of providing the functionality. Personally I wouldn't do it but I'm not the one developing the app.

May 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

You could still input the carb amount even if your injecting after you eat........I use the insulinX but getting into that routine isn't hard and is useful in the future....

Injecting after you eat could be doing some damage as you likely won't be matching up the insulin and digestion profiles which will be giving you or could be giving you large spikes 1-2 hours post meal. Not covered in the basic DAFNE syllabus but definitely an important issue.....

Do you inject post meal because you find you don't always finish the entire meal.....?

May 12, 2012

JohnC 2 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

The Expert meter was handed out free at the end of my DAFNE course. The company rep said only people who have done DAFNE can have one. Its good but the only problem is you have to input your carbs at the same time as taking your blood reading. As I prefer to inject as soon as I've eaten (so I know how much I actually had to eat) it isn't that much use.

May 12, 2012

Ray O'Toole 4 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

The nurse in my clinic went through it with me in details for about a half an hour. She set up my preferences for me.

May 12, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Hypos

I suppose its because there literally is no energy being supplied to your cells, and at those levels, your brain me be affected too, giving you the feeling of tiredeness..............

any thought on your hypos? could a reduction in BI help, or is it at a specific time?

May 12, 2012

Alan 49 284 posts

Topic: General Discussion / Accu-Chek Aviva Expert Meters

Ray
That sounds great. What sort of instructions were you given when you got it?

May 12, 2012

Alun marshall 5 posts

Topic: General Discussion / Hypos

I'm having hypos quite a lot and don't get any warning signs until its really low but one thing I'm wondering Is why I'm feeling really tired when it's down to sort of 2.2,does anyone else get this?
Thanks in advance

May 12, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / What insulin pump??

No direct experience but I believe they cost about 3-4 grand and running may be a few grand for every 6 months, the running costs could be bollocks though.....

What's the deal where you are, you don't have to fund it yourself do you?

May 12, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Lantus, Levemir or pump therapy advice.

Levemir gives you more flexibility for exercise and alcohol and is suited better to a split regime. But naturally some folk do get on better with lantus but for the most part it's compatible with most.....

If you do get a pump then you will actually be taking the next step in your diabetes management, so DAFNE will still very much apply however there will be more things you will need to learn about like several basal rates, different kinds of QA delivery, the possibility of needing to give QA for non carb items......

If you do get a pump then your bound to get support with it, but being a DAfne graduate, your the best person to advise yourself when it comes to the DAFNE side of things, so the fact your pct or clinic don't offer it won't be a bad thing.

I would imagine your clinic staff are still DAFNE educated, no?

May 12, 2012

Podarcis 14 posts

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

Well spotted, Simon, and I agree that it is a good idea always to round down when performing positive corrections.

For negative corrections it will also be best always to round down for the same safety reasons. Eg BG 6.0 is below target range, so the calculated -0.5 unit correction should be rounded down to -1 unit.

In view of all that, perhaps the target base used in the calculation should be nearer the bottom of the target range, maybe even the actual low value of the target range. This is safe because any BG even slightly under the target range will cause a negative correction.

May 12, 2012

thebatoutofhull 60 posts

Topic: General Discussion / no DAFNE

Is there anyone out there who does not get DAFNE support from their PCT? What do you do?

May 12, 2012

thebatoutofhull 60 posts

Topic: General Discussion / Lantus, Levemir or pump therapy advice.

Hello, I have been given the choice to change from Lantus to Levemir or possibly Pump therapy.

1) Any advice on the pros and cons of Levemir would be appreciated .

2) Also how easy is it to combine pump therapy with the DAFNE regime? Will I have to leave my DAFNE security blanket as my PCT does not offer DAFNE anymore. (I do not know why)

May 12, 2012

Ahmentep 99 posts

Topic: Site Development / Standard Deviation..

The Accucheck Aviva Expert gives you standard deviation. I have been using one for a few weeks now and find that once it is correctly programmed it is very good. The bolus advice is almost perfect.

May 16, 2012 Simon Heller 46 posts	Topic: Questions for HCPs / High Blood Pressure Hi folks. High blood pressure is a very important sign in Type 1 diabetes as it can (although not always) signify early diabetic kidney disease which might progress. Anyone with type 1 diabetes should have any high BP reading considered along with the results of urine testing for early kidney damage (indicated by increased protein in the urine, what's called albumin/creat ratio) ideally measured on an early morning urine specimen. If two specimens show increased protein levels then even if BP isn't particularly high, we would advise treatment with either an ACE-inhibitor, (lisinopril, ramopril) or what's called an A2 receptor blocker (candesartan, losartan). So I agree that a high BP in isolation needs careful assessment with perhaps a 24 recording but if protein urine levels are raised we would be keen to start these treatments as soon as possible. They definitely slow down progression of kidney damage particularly if the BP can be lowered. Simon

May 15, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters I understand all your points................ I dont think anyone on here will be expecting anything from me, or anyone really, to be the gospels truth....................at least I hope that isnt the way I come across....... Because I am quite involved with my own control, and some others, I feel I have a wide range of experience that should be shared, all be it educated opinions...... ......maybe we could get some kind of post signature set up where I could tell people that I am not an HCP and that my ideas are purely from personal experience and that they are not the opinions of DAFNE UK and any of its affiliates........lol.......[dont really think thats neccesary...] I agree you cant have an automated approach to diabetes, but certainly the process of counting carbs and dosing can be automated slightly.....................imagine everyone was as involved as me, then you would expect people to want some automation. I realise that I am probably a minority...... ..... On a brighter note though, I have been put forward for a pump today, so its about to get a lot more complicated...................

May 14, 2012 Jenny Spollen 13 posts	Topic: General Discussion / Hypos I've def experience that tiredness. Quite often it accompanies a high volume of hypos and can leave me flattened and lasts up to 48 hours in the worst cases. I agree with Novorapidboi, it's a general body-wide extreme lack of sugar. A review of BI/QA ratios/any changes in routine/exercise would be a plan. I've also learned to recognise it as a warning sign. It generally means I've been very low very often and that I'm in trouble and is generally followed by what I like to call the hypo-headache and is usually only one or two hypos away from the pukes and I'd be of the opinion that at that stage there would be no point in anyone even trying to stick me with a glucogen cause there would be nothing my liver would have to give. That said everyone is most def different and I hope the hypos get sorted

May 14, 2012 Jenny Spollen 13 posts	Topic: General Discussion / What insulin pump?? The HSE were kind enough to supply me with a Medtronic VEO minimed there before Christmas and funding to get most of the consumables. I was lucky though cause I got in just before the pump tender was finalised and now Medtronic are supplying an older version of the pump and it's that or nothing here really as far as I know, but i don't know what one's on offer to ye in Dublin. As to the price of it I think that depends on who's trying to buy it. Cost the hospital in and around the 2-3 grand but the letter i got for the insurance is nearer the 5 and a half plus vat and carriage.....! Some of the consumables are available on list f but the rest are def not but i don't know how much they cost. I do seem to go through an inordinate number of the things though. Some of the smaller things aren't covered on either as well as spares for stuff like set inserters and they are pricey enough - in and around 90â‚¬ a pop. I don't see why you shouldn't get a choice of meter though. I'm currently working off two - one that blue tooths to the meter (bayer contour link) and one that's a BG and ketone combo (Optium Xceed). Am pretty fond of both of them. The contour link is new enough but holding up well and the optium seems to be pretty indistructable. The hospital always seems to have a selection of the things...and bayer were kind enough to send me a free spare in the post when i rang them. Ask your chemist too, things like meters might be covered under list f but i couldn't tell you for certain, they have removed stuff off it of late with the cutbacks. You could chance your arm and ring the diff companies. They might send you one for nothing. You'll be sticking your finger enough that you'd be worth a fortune to them in test strips. The pump def has the potential to be the business so would recommend you go for it if you can. That said, Medtronic wouldn't be my fav company to deal with (and in 25years they're the only one's have ever felt the need to say that about). All the best with it, Jenny

May 14, 2012 marke 686 posts	Topic: General Discussion / no DAFNE I know what you mean, I live in fear of my consultant retiring. He is getting on now and I fear without him my clinic will fall into the same mode of operation as yours. Fortunately he is a strong character as well as being a superb consultant. Its hard when you see someone different all the time and cannot build a relationship. Let alone someone who understands DAFNE as well.

May 14, 2012 marke 686 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters thanks thats the response I wanted to get You just need to remember that a lot of people are not as keen as you to build a regime. I have met many people through DAFNE and Diabetes UK that are happy to just roll again with the basics. This is why I questioned the 'could be doing damage', its important to seperate an opinion from evidence based on medical research. I don't have any problem with people expressing opinions, I just like to make clear thats what they are. Many people take what the read on the internet as fact whereas the truth is anyone can set up a website and publish a load of garbage, there is some truly scary stuff out there. I'm not suggesting you are necessarily wrong, I agree with a lot of what you say, but for the sake of a balanced and objective site its good sometimes to question people. I still don't think you can have an automated approach to Diabetes management because there are so many variables involved, but if people want to try thats good. The important point is they understand what they are getting is a best guess and not 100% accurate. Just like your meter, which gives you a best guess at your BG NOT a 100% accurate figure. Hopefully in our lifetimes we will see continuous BG meters linked to pumps that act as psuedo pancreas's or even stem cell therapy that will restore islet cells, in the meantime we just have to make do with life as it is.

May 14, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Carbs and Cals Book - large / pocket? I've got the both the large & the pocket versions but just wondering who else has got this book and whether you've got the large or pocket version or both like me. For anyone who's got both how do you cope with the small version? After using the large version with 6 portion sizes of food on each page i just can't get used to only 2 portion sizes. How do you use the book when out and about and only 2 portion sizes to go from?

May 14, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / no DAFNE My clinic is still up and running but I too can see a different consultant at each visit, which is annoying, but thankfully the DSN there is the same and any help or advice I need can come from her.........

May 14, 2012 thebatoutofhull 60 posts	Topic: General Discussion / no DAFNE Sheffield have not stopped. It was me who moved away from Sheffield to a PCT that did not offer DAFNE. The support in Sheffield is excellent and has a lot of DAFNE grads. For me the best thing is to use this site. The support and advice, or just wanting a nudge in the right direction is so helpful. There have been a lot of changes in Herefordshire where I am now. I have had 3 different consultants. Usually Locums. Their care is very good but they are not able to offer continuity re: DAFNE. I believe it was offered once. It would be nice if I could move home but still keep in touch with a DAFNE team.

May 14, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters By saying basic, I was highlighting that after you have completed DAFNE, it doesn't stop there, you need more that what has been supplied by DAFNE, as it is only the foundation from which to build and develop a regime that caters for each individual.......... I think saying 'you could be doing damage' is OK, as it could be happening, it might not though, but that's why encouraging people to test more often and to really get to know there own bodies behavior to different food and dose timings is really important, in my opinion anyway. My control has improved greatly since DAFNE, but its not stopping complication occurring in my eyes, and a difficulty to achieve an HbA1c within the recommended target range. This I believe is down to between meal spikes. Everyone is different and if they want to inject after a meal, that's fine, I am not saying its wrong or bad, and certainly wouldn't imply this is what DAFNE thinks either. The majority of folk will start digesting their food before the insulin has started to work properly. So this was why I mentioned that actually you should think about injecting before you eat, and sometimes, a good few minuted before. Again, this is purely from peoples [and mine] personal experiences, no documented medical facts. I like to encourage people to test, a lot, and build a picture of whats going on, in much more detail than DAFNE will teach you to. I think the 'bolus' calculators that are being offered are good, certainly not something to be taken lightly, but its a sign that more and more people are taking a much more detailed and pro active approach to their control, and that they want a more automated approach to it all. Certainly if you have completed DAFNE training, I believe you a more than capable of using one of these functions without danger, and even more so if your on a pump, although there are some pumpers out there that have just been given it when they don't really know whats going on...... Regarding the app, I think it could be good. However I don't believe all graduates who sign up and download the app are at similar levels of competency in their regime, so its needs to be developed carefully I think......

May 14, 2012 Phil Maskell 194 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters Hi, I often do post meal injections (not breakfast as its mostly the same cereal or toast) as I'm a pig and often go back for seconds or have dessert I thought this was the point of DAFNE? Just my 2p Phil

May 14, 2012 marke 686 posts	Topic: General Discussion / no DAFNE Not sure what I will do, mine has just pulled the plug. I have not been told about Sheffield withdrawing though how did you find out about them withdawing ??

May 14, 2012 marke 686 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters NRB, there is no 'basic' DAFNE syllabus there is A DAFNE syllabus. I have seen lots of debate about digestion profiles and post meal spikes on other sites, however most of the discussions seem to revolve around peoples personnal beliefs rather than detailed medical research. I therefore don't believe its fair to say 'you could be doing damage' since there is no evidence to back up this claim. As we often repeat ( or favourite mantra) everyone is different and no two people will respond the same to insulin/food or any other number of factors. If someone wants to inject post meal there is no problem with this as far as DAFNE is concerned. Its interesting that the 'expert' meter is limited to people who have had some training in does adjustment and calculation. There is discussion in other forums on the site about adding dose calculation to the DAFNEOnline App and this backs up my point that it is NOT a trivial thing and even meter companies are wary of providing the functionality. Personally I wouldn't do it but I'm not the one developing the app.

May 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters You could still input the carb amount even if your injecting after you eat........I use the insulinX but getting into that routine isn't hard and is useful in the future.... Injecting after you eat could be doing some damage as you likely won't be matching up the insulin and digestion profiles which will be giving you or could be giving you large spikes 1-2 hours post meal. Not covered in the basic DAFNE syllabus but definitely an important issue..... Do you inject post meal because you find you don't always finish the entire meal.....?

May 12, 2012 JohnC 2 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters The Expert meter was handed out free at the end of my DAFNE course. The company rep said only people who have done DAFNE can have one. Its good but the only problem is you have to input your carbs at the same time as taking your blood reading. As I prefer to inject as soon as I've eaten (so I know how much I actually had to eat) it isn't that much use.

May 12, 2012 Ray O'Toole 4 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters The nurse in my clinic went through it with me in details for about a half an hour. She set up my preferences for me.

May 12, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Hypos I suppose its because there literally is no energy being supplied to your cells, and at those levels, your brain me be affected too, giving you the feeling of tiredeness.............. any thought on your hypos? could a reduction in BI help, or is it at a specific time?

May 12, 2012 Alan 49 284 posts	Topic: General Discussion / Accu-Chek Aviva Expert Meters Ray That sounds great. What sort of instructions were you given when you got it?

May 12, 2012 Alun marshall 5 posts	Topic: General Discussion / Hypos I'm having hypos quite a lot and don't get any warning signs until its really low but one thing I'm wondering Is why I'm feeling really tired when it's down to sort of 2.2,does anyone else get this? Thanks in advance

May 12, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / What insulin pump?? No direct experience but I believe they cost about 3-4 grand and running may be a few grand for every 6 months, the running costs could be bollocks though..... What's the deal where you are, you don't have to fund it yourself do you?

May 12, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Lantus, Levemir or pump therapy advice. Levemir gives you more flexibility for exercise and alcohol and is suited better to a split regime. But naturally some folk do get on better with lantus but for the most part it's compatible with most..... If you do get a pump then you will actually be taking the next step in your diabetes management, so DAFNE will still very much apply however there will be more things you will need to learn about like several basal rates, different kinds of QA delivery, the possibility of needing to give QA for non carb items...... If you do get a pump then your bound to get support with it, but being a DAfne graduate, your the best person to advise yourself when it comes to the DAFNE side of things, so the fact your pct or clinic don't offer it won't be a bad thing. I would imagine your clinic staff are still DAFNE educated, no?

May 12, 2012 Podarcis 14 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right Well spotted, Simon, and I agree that it is a good idea always to round down when performing positive corrections. For negative corrections it will also be best always to round down for the same safety reasons. Eg BG 6.0 is below target range, so the calculated -0.5 unit correction should be rounded down to -1 unit. In view of all that, perhaps the target base used in the calculation should be nearer the bottom of the target range, maybe even the actual low value of the target range. This is safe because any BG even slightly under the target range will cause a negative correction.

May 12, 2012 thebatoutofhull 60 posts	Topic: General Discussion / no DAFNE Is there anyone out there who does not get DAFNE support from their PCT? What do you do?

May 12, 2012 thebatoutofhull 60 posts	Topic: General Discussion / Lantus, Levemir or pump therapy advice. Hello, I have been given the choice to change from Lantus to Levemir or possibly Pump therapy. 1) Any advice on the pros and cons of Levemir would be appreciated . 2) Also how easy is it to combine pump therapy with the DAFNE regime? Will I have to leave my DAFNE security blanket as my PCT does not offer DAFNE anymore. (I do not know why)

May 12, 2012 Ahmentep 99 posts	Topic: Site Development / Standard Deviation.. The Accucheck Aviva Expert gives you standard deviation. I have been using one for a few weeks now and find that once it is correctly programmed it is very good. The bolus advice is almost perfect.