Recent Posts - DAFNE Online

May 8, 2012

novorapidboi26 1,819 posts

Topic: Site Development / Have "amber" colour for just-over BG

Just out of curiosity, what recent changes had you to re learn?

I would be interested to hear them...... Very Happy

May 8, 2012

thebatoutofhull 60 posts

Topic: Site Development / Have "amber" colour for just-over BG

'the DAFNE programme or course which is generally what people on this site are looking to follow' marke site admin.

This site is excellent and truly has made a huge difference to my diabetic control. However users willingly follow the DAFNE programme. There has to be scope for change and innovation! You talk of evidence over opinion. I agree but where is your evidence that users of this site would not want to follow the 'DAFNE programme' with alteration? From 2000 the DAFNE approach HAS changed. New terminology and tweeks have been implimented, I have had to re learn recently, changes put into practice.

The DAFNE ethos is about choice and adaptability. ADJUSTMENT for normal eating.

May 8, 2012

novorapidboi26 1,819 posts

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

Podacris,

No, I don't correct using the banded fashion that you set out, just a simple matching up of BG level to the strength of 1 unit.....it would be madness to try and do your banded version.......

I came to those corrections by simply observing what 1 unit done at each band of BG level......once I got enough readings to spot a pattern I was confident enough to use them...

I think having a QA calculator would be possible, and I see there are concerns as to whether it would be on/off. Ultimately it will only be a guide, a back up to your mental arithmetic. I can never be anything more and so its irrelevant whether its on or off by default....... Very Happy

May 8, 2012

thebatoutofhull 60 posts

Topic: Site Development / Have "amber" colour for just-over BG

I ran a similar idea by the team, l think it was last year and got a +ve reply. However nothing has changed yet. This would help me when I see my G.P. I take my ipad with me and show the graphs. She seams somewhat alarmed at the amount of bad/high results. In fact a lot are in the 7.6 to 10 range. I get ten minutes with her. Most of which is used explaining. This is wasted time / money!!

Podarcis You have my full support.

Diabetes is not red and green, Life is not red and green, DAFNE online is!

Any one on the development, team this is an idea worth pursuing. It still allows the official DAFNE bands to be displayed (which you can change yourself anyway) but also gives greater depth of information to doctors.

This idea is not going away.

May 7, 2012

marke 681 posts

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

make that two grumpy old men Very Happy

I think it should be defaulted to off since it will be too complicated for 90% of people and I don't believe its possible to get
it 'right', we are are not machines that can be defined by formulae rather than random BG events looking for a pattern Wink

May 7, 2012

marke 681 posts

Topic: Site Development / Have "amber" colour for just-over BG

When I say 'evidence' I am referring to research to investigate something not personal opinion which is not medical evidence, it is one persons opinion. It is clear you believe it is a good idea and correspondingly clear I do not. As I said Simon may well implement it but I believe it should be an option that a user turns off
or on because it does not form part of the DAFNE programme or course which is generally what people on this site are looking to follow,

May 7, 2012

Alan 49 284 posts

Topic: Questions for HCPs / High Blood Pressure

Wow Roger! 234/84 - it's a wonder you didn't explode!

Your GP should have picked up these contra-indications before prescribing this combination of medications. That's part of the job.

I have been suffering from high-blood pressure for a long time. It seemed that every time I had my BP checked, my medication was increased, until I was taking the maximum recommended dose of 4 different BP tablets. About a year ago I started to feel really lousy in the mornings - everything was a real effort. I even had to have a lie-down after taking a shower. I went to my GP who referred me to the hospital for investigation.
I had various scans and procedures, but nothing showed up. After all these hospital visits I was passed to the Cardiology department. While this was going on, I checked my BP with my own meter, which showed that every time I felt lousy, I had low BP. One day it was 84/44. The Cardiology department gave me a 24 hour BP meter, which was then returned for analysis. When I went back to see a Cardiologist I took my prescription re-order form. When he saw all the BP medication, he immediately said that I was on too much. He stopped one of the tablets and halved the dosage of another.
Since then, I am glad to say, I have stopped feeling lousy and my BP is not too bad.

As you might guess, I have a pretty low opinion of my GP after this.

May 7, 2012

Stew B 125 posts

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

Crikey, my head is spinning..
Presumeably any function which calculates QA and correction values will be optional (and hopefully not the default option)? For me, the beauty of the DAFNE diary is that it lays out the information for me to make a judgement. Yes, much of the time the QA calculation is a straightforward one, but often I have to take into account things like planned exercise, temperature (things are very different for me during cold weather) etc. DAFNE is a peculiar mixture of science and "art", and of course I may be becoming a grumpy old man, resistant to change..
Stew

May 7, 2012

JayBee 587 posts

Topic: Questions for HCPs / Dawn Phenomenon possibility?

I'm gonna sit on it for a bit at the moment. Shall post again soon.

May 7, 2012

Podarcis 14 posts

Topic: Site Development / Have "amber" colour for just-over BG

Well, Mark, I can tell you that evidence DOES exist, and here it is. For me, I can manage with a BG level of 7.6 or even 10.5 without any correction and nothing bad will happen. But I can't manage a level BG of 19.6 without any correction, since things would get very bad if I did. I need a correction of some +6 units for a BG of 19.6, and ignoring that correction would NOT be a good idea.

Let me say that in practice I would correct both 7.6 and 10.5: 7.6 with +1 unit and 10.5 with +2 units. But for me this is an amber situation, and I could ignore it without danger.

May 7, 2012

Podarcis 14 posts

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

Thanks for that info, novorapid, that's very helpful. At present for myself I apply 1 unit for a bit more than 2 mmol/l (say 2.2, but it's usually an approx calculation, though with the app doing it, as I hope for, an accurate one will be possible). Like you I also have occasional very highs, especially after sport when I have been stuffing sugar into me to keep from going hypo while playing and then ended up with far too much in my system (36mmol on one occasion not long ago).

Can I ask you, though, do you treat each band separately, or make just one calculation? Eg, if your BG was 20 and your target was 5, would you correct by 15 units (ie 1 unit for each mmol/l, using your rate for adjustments above 17mmol/l, or would you compute the correction in a banded fashion as follows:
correct 20mmol/l to 17 mmol/l with (20-17) / 1 = 3 units
plus correct 17mmol/l to 13 mmol/l with (17-13) / 1.5 = 2.67 units
plus correct 13mmol/l to 10 mmol/l with (13-10) / 2 = 1.5 units
plus correct 10mmol/l to 5 mmol/l with (10-5) / 2.5 = 2 units,
giving a total correction of 3+2.67+1.5+2 = 9 units.

I suppose you must use the former, since the latter banded method is too complex to do in one's head. But maybe the banded method is more likely to give consistent results, and a computerised app could certainly perform such a calculation. That would require more settings data to be stored in the app, though.

Would anyone else like to say how they correct for very high BG? As Simon says above, let's get it right. To do so, we ideally need comments from many users. Do we need banded correction rates, and if so how should they be used?

May 6, 2012

marke 681 posts

Topic: Site Development / Have "amber" colour for just-over BG

Sorry I think this is a bad idea, but if others want it then maybe Simon can implement it as an option. I accept that 7.4 and 7.6 are pretty much then same but a reading of 10.5 is not for me amber its red. I think since there is no evidence of 'less severe' levels outside the suggested 'DAFNE range' then anything outside is red. That said I don't worry about the colours, its a lot more complicated than Green, Amber, Red. I could be in the 'Green' the whole time and suffer problems or be in the Red the whole time and never have a problem. I don't think its worth people discussing the difficulty of implementation, thats not relevant to people wanting it or not.

May 6, 2012

novorapidboi26 1,819 posts

Topic: Site Development / Slow site response....

I understand, not totally convinced its will continue like this, there is no reason for this site to be experiencing this, at least in terms of the content on site. I visit other forums at work also.....

I agree that I will need to accept it and/or wait it out......

Moving offices and servers on the 6th of June so maybe things will improve.......it won't stop me visiting that's for sure...... Very Happy

May 6, 2012

novorapidboi26 1,819 posts

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

I worked it out by trial and error, so record how much your correction dropped you by at different levels. Making sure all other variables are constant is important obviously, so it can take some time as you can imagine........

But yeah once it as been established it should be possible to enter this information in and get a correction dose out........

My current correction factors are:

below 10mmol/l = 1 unit for 2.5mmol/l

10-13mmol/l = 1 unit for 2mmol/l

13-17mmol/l = 1 unit for 1.5mmol/l

above 17mmol/l = 1 unit for 1mmol/l

So a logical approach with the limitations of MDI, I imagine with a pump and extensive trial an error more factors could be established should they need it, but I personally dont need more than this........but I try not get into the higher levels if I can, still do sometimes though.......;)

May 6, 2012

marke 681 posts

Topic: Site Development / Slow site response....

Simon is correct the security is there for a reason and unfrotunately what he told you to do will not prove anything nor help. A proxy is used to 'speed' up web pages and control which pages you can access. It has nothing to do with 'ping' which uses a completely different protocol and will be treated completely differently by your companies security systems. It is quite possible you can browse other sites without issue and not ours, it very much depends on the
content of the other sites. Changing browser is unlikely to help since it is unlikely to be an issue with your local machine more your companies network.

As you have found, because the issue does not exist at home then the issue is with your companies systems. Obviously we cannot comment on these, I have rules for my users and unless they can provide a valid business need for me to grant them an exception to access a site then I won't. I suspect you will just have to live with it, sorry

May 6, 2012

Podarcis 14 posts

Topic: Site Development / Have "amber" colour for just-over BG

Yes, I accept you're right - there's more than one way to do this, and it's not up to me to decide how it's done.

But there is a way that potentially doesn't require any database changes. Simply use yellow for values above the target range but no more than the width of the target range higher than the upper limit.

I was thinking of that solution when I proposed this, but I agree that a more sophisticated solution may provide more flexibility and could be considered.

May 6, 2012

Phil Maskell 194 posts

Topic: Site Development / Have "amber" colour for just-over BG

Podarcis,

I know it may seem like only presentation, but a range of values for the amber colour is most likely needed and as a developer I would assume that this would be best placed in the database, possibly configurable like the ranges we already have. What I was saying is sometimes a little presentation tweak can mean a vast change behind the scenes if the data structures aren't setup for it. I don't work on the site so am only guessing, you may know better than me, I was trying to set people's expectations. Very Happy

Even if it is a lot of work, I still agree its a good idea

Phil

May 6, 2012

Podarcis 14 posts

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

I would be interested in knowing how you calculate dose corrections for various BG levels. So long as you can specify it there is no reason why the app cannot apply the same logic and do it for you.

May 6, 2012

Podarcis 14 posts

Topic: Site Development / Have "amber" colour for just-over BG

Thanks for your replies. Nobody has so far said it is not a good idea, which is encouraging.

I can assure Phil that no change to the database will be needed. It is just a matter of presentation.

May 5, 2012

Simon 578 posts

Topic: Site Development / Slow site response....

I doubt that your work will let you circumvent the proxy, they are put there for security reasons... Have you tried in a different web browser?

May 5, 2012

Simon 578 posts

Topic: Site Development / Setting my time zone for Blood Glucose Diary entries

Hi Warwick,

Ill take a look at getting the right time displayed for you and the rest of our Australia and New Zealand members.

On the search question, you should see a link to search the forums just under the topic heading and at the top of most forum pages.

Simon

May 8, 2012 novorapidboi26 1,819 posts	Topic: Site Development / Have "amber" colour for just-over BG Just out of curiosity, what recent changes had you to re learn? I would be interested to hear them......

May 8, 2012 thebatoutofhull 60 posts	Topic: Site Development / Have "amber" colour for just-over BG 'the DAFNE programme or course which is generally what people on this site are looking to follow' marke site admin. This site is excellent and truly has made a huge difference to my diabetic control. However users willingly follow the DAFNE programme. There has to be scope for change and innovation! You talk of evidence over opinion. I agree but where is your evidence that users of this site would not want to follow the 'DAFNE programme' with alteration? From 2000 the DAFNE approach HAS changed. New terminology and tweeks have been implimented, I have had to re learn recently, changes put into practice. The DAFNE ethos is about choice and adaptability. ADJUSTMENT for normal eating.

May 8, 2012 novorapidboi26 1,819 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right Podacris, No, I don't correct using the banded fashion that you set out, just a simple matching up of BG level to the strength of 1 unit.....it would be madness to try and do your banded version....... I came to those corrections by simply observing what 1 unit done at each band of BG level......once I got enough readings to spot a pattern I was confident enough to use them... I think having a QA calculator would be possible, and I see there are concerns as to whether it would be on/off. Ultimately it will only be a guide, a back up to your mental arithmetic. I can never be anything more and so its irrelevant whether its on or off by default.......

May 8, 2012 thebatoutofhull 60 posts	Topic: Site Development / Have "amber" colour for just-over BG I ran a similar idea by the team, l think it was last year and got a +ve reply. However nothing has changed yet. This would help me when I see my G.P. I take my ipad with me and show the graphs. She seams somewhat alarmed at the amount of bad/high results. In fact a lot are in the 7.6 to 10 range. I get ten minutes with her. Most of which is used explaining. This is wasted time / money!! Podarcis You have my full support. Diabetes is not red and green, Life is not red and green, DAFNE online is! Any one on the development, team this is an idea worth pursuing. It still allows the official DAFNE bands to be displayed (which you can change yourself anyway) but also gives greater depth of information to doctors. This idea is not going away.

May 7, 2012 marke 681 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right make that two grumpy old men I think it should be defaulted to off since it will be too complicated for 90% of people and I don't believe its possible to get it 'right', we are are not machines that can be defined by formulae rather than random BG events looking for a pattern

May 7, 2012 marke 681 posts	Topic: Site Development / Have "amber" colour for just-over BG When I say 'evidence' I am referring to research to investigate something not personal opinion which is not medical evidence, it is one persons opinion. It is clear you believe it is a good idea and correspondingly clear I do not. As I said Simon may well implement it but I believe it should be an option that a user turns off or on because it does not form part of the DAFNE programme or course which is generally what people on this site are looking to follow,

May 7, 2012 Alan 49 284 posts	Topic: Questions for HCPs / High Blood Pressure Wow Roger! 234/84 - it's a wonder you didn't explode! Your GP should have picked up these contra-indications before prescribing this combination of medications. That's part of the job. I have been suffering from high-blood pressure for a long time. It seemed that every time I had my BP checked, my medication was increased, until I was taking the maximum recommended dose of 4 different BP tablets. About a year ago I started to feel really lousy in the mornings - everything was a real effort. I even had to have a lie-down after taking a shower. I went to my GP who referred me to the hospital for investigation. I had various scans and procedures, but nothing showed up. After all these hospital visits I was passed to the Cardiology department. While this was going on, I checked my BP with my own meter, which showed that every time I felt lousy, I had low BP. One day it was 84/44. The Cardiology department gave me a 24 hour BP meter, which was then returned for analysis. When I went back to see a Cardiologist I took my prescription re-order form. When he saw all the BP medication, he immediately said that I was on too much. He stopped one of the tablets and halved the dosage of another. Since then, I am glad to say, I have stopped feeling lousy and my BP is not too bad. As you might guess, I have a pretty low opinion of my GP after this.

May 7, 2012 Stew B 125 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right Crikey, my head is spinning.. Presumeably any function which calculates QA and correction values will be optional (and hopefully not the default option)? For me, the beauty of the DAFNE diary is that it lays out the information for me to make a judgement. Yes, much of the time the QA calculation is a straightforward one, but often I have to take into account things like planned exercise, temperature (things are very different for me during cold weather) etc. DAFNE is a peculiar mixture of science and "art", and of course I may be becoming a grumpy old man, resistant to change.. Stew

May 7, 2012 JayBee 587 posts	Topic: Questions for HCPs / Dawn Phenomenon possibility? I'm gonna sit on it for a bit at the moment. Shall post again soon.

May 7, 2012 Podarcis 14 posts	Topic: Site Development / Have "amber" colour for just-over BG Well, Mark, I can tell you that evidence DOES exist, and here it is. For me, I can manage with a BG level of 7.6 or even 10.5 without any correction and nothing bad will happen. But I can't manage a level BG of 19.6 without any correction, since things would get very bad if I did. I need a correction of some +6 units for a BG of 19.6, and ignoring that correction would NOT be a good idea. Let me say that in practice I would correct both 7.6 and 10.5: 7.6 with +1 unit and 10.5 with +2 units. But for me this is an amber situation, and I could ignore it without danger.

May 7, 2012 Podarcis 14 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right Thanks for that info, novorapid, that's very helpful. At present for myself I apply 1 unit for a bit more than 2 mmol/l (say 2.2, but it's usually an approx calculation, though with the app doing it, as I hope for, an accurate one will be possible). Like you I also have occasional very highs, especially after sport when I have been stuffing sugar into me to keep from going hypo while playing and then ended up with far too much in my system (36mmol on one occasion not long ago). Can I ask you, though, do you treat each band separately, or make just one calculation? Eg, if your BG was 20 and your target was 5, would you correct by 15 units (ie 1 unit for each mmol/l, using your rate for adjustments above 17mmol/l, or would you compute the correction in a banded fashion as follows: correct 20mmol/l to 17 mmol/l with (20-17) / 1 = 3 units plus correct 17mmol/l to 13 mmol/l with (17-13) / 1.5 = 2.67 units plus correct 13mmol/l to 10 mmol/l with (13-10) / 2 = 1.5 units plus correct 10mmol/l to 5 mmol/l with (10-5) / 2.5 = 2 units, giving a total correction of 3+2.67+1.5+2 = 9 units. I suppose you must use the former, since the latter banded method is too complex to do in one's head. But maybe the banded method is more likely to give consistent results, and a computerised app could certainly perform such a calculation. That would require more settings data to be stored in the app, though. Would anyone else like to say how they correct for very high BG? As Simon says above, let's get it right. To do so, we ideally need comments from many users. Do we need banded correction rates, and if so how should they be used?

May 6, 2012 marke 681 posts	Topic: Site Development / Have "amber" colour for just-over BG Sorry I think this is a bad idea, but if others want it then maybe Simon can implement it as an option. I accept that 7.4 and 7.6 are pretty much then same but a reading of 10.5 is not for me amber its red. I think since there is no evidence of 'less severe' levels outside the suggested 'DAFNE range' then anything outside is red. That said I don't worry about the colours, its a lot more complicated than Green, Amber, Red. I could be in the 'Green' the whole time and suffer problems or be in the Red the whole time and never have a problem. I don't think its worth people discussing the difficulty of implementation, thats not relevant to people wanting it or not.

May 6, 2012 novorapidboi26 1,819 posts	Topic: Site Development / Slow site response.... I understand, not totally convinced its will continue like this, there is no reason for this site to be experiencing this, at least in terms of the content on site. I visit other forums at work also..... I agree that I will need to accept it and/or wait it out...... Moving offices and servers on the 6th of June so maybe things will improve.......it won't stop me visiting that's for sure......

May 6, 2012 novorapidboi26 1,819 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right I worked it out by trial and error, so record how much your correction dropped you by at different levels. Making sure all other variables are constant is important obviously, so it can take some time as you can imagine........ But yeah once it as been established it should be possible to enter this information in and get a correction dose out........ My current correction factors are: below 10mmol/l = 1 unit for 2.5mmol/l 10-13mmol/l = 1 unit for 2mmol/l 13-17mmol/l = 1 unit for 1.5mmol/l above 17mmol/l = 1 unit for 1mmol/l So a logical approach with the limitations of MDI, I imagine with a pump and extensive trial an error more factors could be established should they need it, but I personally dont need more than this........but I try not get into the higher levels if I can, still do sometimes though.......;)

May 6, 2012 marke 681 posts	Topic: Site Development / Slow site response.... Simon is correct the security is there for a reason and unfrotunately what he told you to do will not prove anything nor help. A proxy is used to 'speed' up web pages and control which pages you can access. It has nothing to do with 'ping' which uses a completely different protocol and will be treated completely differently by your companies security systems. It is quite possible you can browse other sites without issue and not ours, it very much depends on the content of the other sites. Changing browser is unlikely to help since it is unlikely to be an issue with your local machine more your companies network. As you have found, because the issue does not exist at home then the issue is with your companies systems. Obviously we cannot comment on these, I have rules for my users and unless they can provide a valid business need for me to grant them an exception to access a site then I won't. I suspect you will just have to live with it, sorry

May 6, 2012 Podarcis 14 posts	Topic: Site Development / Have "amber" colour for just-over BG Yes, I accept you're right - there's more than one way to do this, and it's not up to me to decide how it's done. But there is a way that potentially doesn't require any database changes. Simply use yellow for values above the target range but no more than the width of the target range higher than the upper limit. I was thinking of that solution when I proposed this, but I agree that a more sophisticated solution may provide more flexibility and could be considered.

May 6, 2012 Phil Maskell 194 posts	Topic: Site Development / Have "amber" colour for just-over BG Podarcis, I know it may seem like only presentation, but a range of values for the amber colour is most likely needed and as a developer I would assume that this would be best placed in the database, possibly configurable like the ranges we already have. What I was saying is sometimes a little presentation tweak can mean a vast change behind the scenes if the data structures aren't setup for it. I don't work on the site so am only guessing, you may know better than me, I was trying to set people's expectations. Even if it is a lot of work, I still agree its a good idea Phil

May 6, 2012 Podarcis 14 posts	Topic: Site Development / Auto calculate QA from BG - let's get it right I would be interested in knowing how you calculate dose corrections for various BG levels. So long as you can specify it there is no reason why the app cannot apply the same logic and do it for you.

May 6, 2012 Podarcis 14 posts	Topic: Site Development / Have "amber" colour for just-over BG Thanks for your replies. Nobody has so far said it is not a good idea, which is encouraging. I can assure Phil that no change to the database will be needed. It is just a matter of presentation.

May 5, 2012 Simon 578 posts	Topic: Site Development / Slow site response.... I doubt that your work will let you circumvent the proxy, they are put there for security reasons... Have you tried in a different web browser?

May 5, 2012 Simon 578 posts	Topic: Site Development / Setting my time zone for Blood Glucose Diary entries Hi Warwick, Ill take a look at getting the right time displayed for you and the rest of our Australia and New Zealand members. On the search question, you should see a link to search the forums just under the topic heading and at the top of most forum pages. Simon