Recent Posts - DAFNE Online

Apr 18, 2012

Johnstonai 2 posts

Topic: General Discussion / Dose adjustment due to GI

I've been Type 1 for 25 years but I'm new to DAFNE. I'm fairly well controlled apart from a few hypos and highs after eating meals with high or below average GI's. My normal evening meal QA ratio is 1:1 and I take my novorapid immediately before eating ( this seems ok normally ), however I'm trying to get my head around what to do with my ratio and/or QA injection times prior to any meal which has a high or slightly low GI, does anyone know the generic rules that need to be applied?
Am I correct in thinking that high fat and large meals also need some adjustment re: QA ratio or injection time.

Regards,
Andy

Apr 17, 2012

Nicky B 5 posts

Topic: General Discussion / Dawn Phenomenon

Hi Everyone,

Since doing DAFNE and going from hardly any BGs to now being a 4 times a day BG tester, I have now seen a patten of high blood sugars in the morning. I have tested at 3am for a few days and my results are coming back "normal".

Has anyone else had dawn phenomenon and had it "fixed" ?

I am currently on 3 x Apidra and 1 x Lantus in the evening (plus 3 x Metformin)

Thanks, Nicky Very Happy

Apr 16, 2012

JayBee 587 posts

Topic: DAFNE Online Mobile / Android app

Here we go, just sent it right now... Added ~JWo to help identify. Time sent was 18.57. Feel free to ask me to do it again. Smile

Apr 16, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Pumps N Stuff

Good luck with it.............. Cool

Apr 16, 2012

Carolin 83 posts

Topic: General Discussion / Help with sickday rules

JuliaW said:
The doctor gave me some anti sickness tablets which then meant I was able to eat and take some QA which gradually brought the keytones down during the night.
Thanks again.

Glad you got sorted Julia, sorry I didn't see your message until today.

It's a learning point for everyone really, that you can get 'starvation ketones' when you're not eating, so if you have ketones but your BG is OK you simply need to try to get some CPs down with usual ratio of QA. That's why once you started eating the ketones began to clear.

Take care,

Carolin

Apr 16, 2012

KeithCl 43 posts

Topic: DAFNE Online Mobile / Android app

The best way for me to start looking into this is if you reproduce the error and then choose the "Report" option (so that error information is recorded that I can access; note that its a code stack trace that is recordeed not any data you enter) and then add a reply here containing the date and time that you did this. This wil allow me to distinguish between your error and others that get reported (such as network failures).

Sorry this is going wrong,
Keith

PS Just tried the app on my daughter's Samsung Nexus running Android 4.0.4 and the upload worked ok. So its probably not an Android version issue - still need the report as above.

Apr 16, 2012

JayBee 587 posts

Topic: DAFNE Online Mobile / Android app

I've become a regular user of the Android app since I got my first Smartphone in December. Smile

I am very impressed; however, since I upgraded my phone's operating system (to Android 4.0.3.) recently, the DAFNE app has been crashing everytime I do a diary entry. Thankfully it still sends the information through to both the app and the site still but it is a bit annoying to have to keep reopening it when you're not finished using it.

My phone is a HTC Sensation if it helps to know that too, just in case its not happening on other models.

Thanks!

Apr 13, 2012

Macka 7 posts

Topic: General Discussion / Pumps N Stuff

Sorry for the late reply,

no i havnt had any training although i have done the dafne course , the team dealing with me are amazing, and i have 100% confidence in them, so fingers crossed it will all be fine !!

Apr 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Help with sickday rules

But remember that the sick day rules exist to process ketones, so you don't need to eat anything to take QA..........

When I had the flu 2 Christmases ago I couldn't eat anything, so every 2 hours I tested my blood, they were on target, but I had ketones, so I still had to inject 7-10 units every 2 hours, the ketones were brought under control and my BG levels remained steady.......

So you didn't really need to go out to the clinic, but confidence in using these rules will come with time.....

Glad your feeling better today.........

Apr 13, 2012

JuliaW 2 posts

Topic: General Discussion / Help with sickday rules

Hi James & Simon
Thanks for your replies. I ended up going to my OOH clinic in the early hours as my keytones had risen to +++ and I was still being sick. The doctor gave me some anti sickness tablets which then meant I was able to eat and take some QA which gradually brought the keytones down during the night.
Feeling alot better this morning Smile

Thanks again.

Apr 12, 2012

SA2010 69 posts

Topic: General Discussion / Help with sickday rules

Hi Julia

Just to add to James's advice - the flowchart does say you have QA's so long as keytones are present. The statement re high BG just says usually it would be above 13 mmol/l so the flowchart applies even if your BG is only 6.5.

For keytones of ++ the amount is 10% of the TDD which would be 1 unit every two hours whilst the keytones are at the ++ level. This would be in addition to the Background insulin and any QAs for CPs.

http://www.dafneonline.co.uk/hbook_topics/188

Apr 12, 2012

SA2010 69 posts

Topic: Site Development / Injection site list

Hi

I am also having QA and BI at the same time with one in one left thigh and the other in right thigh, It would be good if it is possible to capture the informaton and somehow show the two injection locations. Not sure how you present it on the screen - maybe one below the other or prefix QA and BI for each?

I input the data using the BG Diary screen on the full web site rather than a smartphone or iPad app.

regards

simon

Apr 12, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Help with sickday rules

ketones are the same as glucose in that they need insulin to be processed..............

so as your not eating, you should be testing every 2 hours and giving the advised amount od QA as well, which is 20% I think.........so for you 2 units every 2 hours......you cant keep ketone levels down without insulin.........

what do you mean when you say you have been advised to not take any QA, surely you need insulin................even if your are very sensitive to it.............

you must always take your BI insulin whether your eating or not.................

have a look at the online handbook to get a better picture of what you need to do..............the rules work.............. Wink

Apr 12, 2012

zm 3 posts

Topic: General Discussion / Blog

Thanks a lot JWo - very kind of you. I also think it's really important to raise awareness of DAFNE and will certainly be singing it's praises on the blog. I'm also going to try to get connected to Facebook but I'm a bit of a novice on that front!

If I can help with anything please let me know.

Thanks again.

Apr 12, 2012

JayBee 587 posts

Topic: General Discussion / Blog

I just checked the messages and retweeted both your mentions. I like to think of looking after the DAFNEOnline feed as doing my bit to raise awareness of DAFNE. Smile

I'll add you back so I can help you promote!

Apr 12, 2012

zm 3 posts

Topic: General Discussion / Blog

Thanks for the replies - I'll try to post as much as I can and hopefully people will join the discussion.

@ JWo Just noticed that you maintain the twitter page for the DAFNE - nice to see it's a graduate doing that! If there was ever a chance of a wee tweet about the blog in the next few weeks that would be great. As I say, it would be great to get people involved.

Dafne has been so important to me and has really turned my diabetes control around! the one thing that still seems to be slightly erratic in my regime is exercise - hence the blog. I also feel that it will be beneficial to me as I can use it as something of an extended diary to catalogue more than just BGs and CPs. Hopefully it will be of interest or even use to people - early days yet.

Apr 12, 2012

JuliaW 2 posts

Topic: General Discussion / Help with sickday rules

Hi, can anyone give me some advice please. I have a sickness bug that started early this morning and is still ongoing Sad

I've eaten nothing at all today. My BG was 10.8 first thing so I had my usual 1 unit of humlin i and 1 unit of humalog to correct. I've monitored my BG's all day and they have stayed stable and within range. I've just taken my BG and its 6.5 but I have ++ keytones. My TTD is only 9 units (its very little I know!). I can't take any QA as advised by dafne as I run the risk of a hypo. What do I do if my keytone levels are worse in 2 hours time but my BG is normal? and do I still take my BI of 4 units of humulin i before bed? I'm abit worried so any help or advice would be appreciated.

Apr 12, 2012

JayBee 587 posts

Topic: General Discussion / Blog

Nice! I'm certainly interested in what you discover during your exercise adventures since it can be a bit of a pain in the bum!
I noticed you started following the DAFNEOnline Twitter feed this week; nice to see you on here too! Smile

Apr 12, 2012

JayBee 587 posts

Topic: Questions for HCPs / Dawn Phenomenon possibility?

Sadly last night the dreaded 3 BG got me twice around 3am... and this was after a much less eventful evening... so I'm going to try 21 tonight. Hopefully then it's all nipped in the bud...

Not sure why my results aren't showing on the previous post.. but here's today's lot.

Apr 12, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Blog

Welcome to the forum.......

Thanks for the link, look forward to reading............ Wink

Apr 12, 2012

zm 3 posts

Topic: General Discussion / Blog

I graduated from the DAFNE course about 6 months ago. I found it absolutely brilliant and my control has been so much better since.

The one thing I have always struggled with is BG control in connection with exercise and this can be annoying as I am a cyclist who uses the bike for travel/town-commuting and mountain biking for leisure.

As a result of this frustration I have started a blog about life as a diabetic who wants to stay fit, healthy and enjoy exercise - specifically cycling - in order to live a healthy life. If anyone was interested, please feel free to have a look:

http://www.saddledwithdiabetes.com

Any comments welcome!

Apr 12, 2012

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Dawn Phenomenon possibility?

Good job.........

Obviously being in the low 4s may feel a bit too low for some folk, but in reality is perfectly safe, if you can hover on those levels your HbA1c would be magnificent. But, not one day is the same though I suppose.........

If the 22 works out, you can proceed to the daytime basal testing.............. Very Happy

Apr 12, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Pumps N Stuff

There will be more requirement for blood tests on the pump, so more finger pricking I am afraid............

Currently there are pumps, or pump, that can operate side by side with a CGM [Continuous Glucose Monitor], however funding for these is non existent I believe and so are only provided on a temporary basis to investigate blood sugar levels more accurately overnight and during the day too.....the information can then be used to tweak the basal setting for example.........

Some people have self funded CGMs I believe, but its costly............

Have you been trained any on how to use the pump, test your basal etc.........

Apr 12, 2012

SA2010 69 posts

Topic: General Discussion / What has gone wrong with Lantus adjustments

Hi Garry. Yes I was aware of the 2-3 days delay for BI Lantus changes and I was waiting 2-3 days but this morning just got frustrated and decided to put the level of Lantus back and give it a rest for changes for a while.

May be I need to wait 3 days at least

Changes I made from previous doses of BI 5 with breakfast and 4 at 11pm:

3rd April Evening BI increased from 4 to 5 and moved earlier to be with evening meal
5th April Morning BI increased from 5 to 6
7th/8th April 1 unit of BI switched from evening to morning :
7th April Evening BI reduced from 5 to 4
8th April morning BI increased from 6 to 7
11th April Morning BI increased from 7 to 8
12th April Morning BI reduced to 6 (Premature change - in frustration)

I will just run with 6 and 4 for a while

Regards

Simon

Apr 18, 2012 Johnstonai 2 posts	Topic: General Discussion / Dose adjustment due to GI I've been Type 1 for 25 years but I'm new to DAFNE. I'm fairly well controlled apart from a few hypos and highs after eating meals with high or below average GI's. My normal evening meal QA ratio is 1:1 and I take my novorapid immediately before eating ( this seems ok normally ), however I'm trying to get my head around what to do with my ratio and/or QA injection times prior to any meal which has a high or slightly low GI, does anyone know the generic rules that need to be applied? Am I correct in thinking that high fat and large meals also need some adjustment re: QA ratio or injection time. Regards, Andy

Apr 17, 2012 Nicky B 5 posts	Topic: General Discussion / Dawn Phenomenon Hi Everyone, Since doing DAFNE and going from hardly any BGs to now being a 4 times a day BG tester, I have now seen a patten of high blood sugars in the morning. I have tested at 3am for a few days and my results are coming back "normal". Has anyone else had dawn phenomenon and had it "fixed" ? I am currently on 3 x Apidra and 1 x Lantus in the evening (plus 3 x Metformin) Thanks, Nicky

Apr 16, 2012 JayBee 587 posts	Topic: DAFNE Online Mobile / Android app Here we go, just sent it right now... Added ~JWo to help identify. Time sent was 18.57. Feel free to ask me to do it again.

Apr 16, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Pumps N Stuff Good luck with it..............

Apr 16, 2012 Carolin 83 posts	Topic: General Discussion / Help with sickday rules JuliaW said: The doctor gave me some anti sickness tablets which then meant I was able to eat and take some QA which gradually brought the keytones down during the night. Thanks again. Glad you got sorted Julia, sorry I didn't see your message until today. It's a learning point for everyone really, that you can get 'starvation ketones' when you're not eating, so if you have ketones but your BG is OK you simply need to try to get some CPs down with usual ratio of QA. That's why once you started eating the ketones began to clear. Take care, Carolin

Apr 16, 2012 KeithCl 43 posts	Topic: DAFNE Online Mobile / Android app The best way for me to start looking into this is if you reproduce the error and then choose the "Report" option (so that error information is recorded that I can access; note that its a code stack trace that is recordeed not any data you enter) and then add a reply here containing the date and time that you did this. This wil allow me to distinguish between your error and others that get reported (such as network failures). Sorry this is going wrong, Keith PS Just tried the app on my daughter's Samsung Nexus running Android 4.0.4 and the upload worked ok. So its probably not an Android version issue - still need the report as above.

Apr 16, 2012 JayBee 587 posts	Topic: DAFNE Online Mobile / Android app I've become a regular user of the Android app since I got my first Smartphone in December. I am very impressed; however, since I upgraded my phone's operating system (to Android 4.0.3.) recently, the DAFNE app has been crashing everytime I do a diary entry. Thankfully it still sends the information through to both the app and the site still but it is a bit annoying to have to keep reopening it when you're not finished using it. My phone is a HTC Sensation if it helps to know that too, just in case its not happening on other models. Thanks!

Apr 13, 2012 Macka 7 posts	Topic: General Discussion / Pumps N Stuff Sorry for the late reply, no i havnt had any training although i have done the dafne course , the team dealing with me are amazing, and i have 100% confidence in them, so fingers crossed it will all be fine !!

Apr 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Help with sickday rules But remember that the sick day rules exist to process ketones, so you don't need to eat anything to take QA.......... When I had the flu 2 Christmases ago I couldn't eat anything, so every 2 hours I tested my blood, they were on target, but I had ketones, so I still had to inject 7-10 units every 2 hours, the ketones were brought under control and my BG levels remained steady....... So you didn't really need to go out to the clinic, but confidence in using these rules will come with time..... Glad your feeling better today.........

Apr 13, 2012 JuliaW 2 posts	Topic: General Discussion / Help with sickday rules Hi James & Simon Thanks for your replies. I ended up going to my OOH clinic in the early hours as my keytones had risen to +++ and I was still being sick. The doctor gave me some anti sickness tablets which then meant I was able to eat and take some QA which gradually brought the keytones down during the night. Feeling alot better this morning Thanks again.

Apr 12, 2012 SA2010 69 posts	Topic: General Discussion / Help with sickday rules Hi Julia Just to add to James's advice - the flowchart does say you have QA's so long as keytones are present. The statement re high BG just says usually it would be above 13 mmol/l so the flowchart applies even if your BG is only 6.5. For keytones of ++ the amount is 10% of the TDD which would be 1 unit every two hours whilst the keytones are at the ++ level. This would be in addition to the Background insulin and any QAs for CPs. http://www.dafneonline.co.uk/hbook_topics/188

Apr 12, 2012 SA2010 69 posts	Topic: Site Development / Injection site list Hi I am also having QA and BI at the same time with one in one left thigh and the other in right thigh, It would be good if it is possible to capture the informaton and somehow show the two injection locations. Not sure how you present it on the screen - maybe one below the other or prefix QA and BI for each? I input the data using the BG Diary screen on the full web site rather than a smartphone or iPad app. regards simon

Apr 12, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Help with sickday rules ketones are the same as glucose in that they need insulin to be processed.............. so as your not eating, you should be testing every 2 hours and giving the advised amount od QA as well, which is 20% I think.........so for you 2 units every 2 hours......you cant keep ketone levels down without insulin......... what do you mean when you say you have been advised to not take any QA, surely you need insulin................even if your are very sensitive to it............. you must always take your BI insulin whether your eating or not................. have a look at the online handbook to get a better picture of what you need to do..............the rules work..............

Apr 12, 2012 zm 3 posts	Topic: General Discussion / Blog Thanks a lot JWo - very kind of you. I also think it's really important to raise awareness of DAFNE and will certainly be singing it's praises on the blog. I'm also going to try to get connected to Facebook but I'm a bit of a novice on that front! If I can help with anything please let me know. Thanks again.

Apr 12, 2012 JayBee 587 posts	Topic: General Discussion / Blog I just checked the messages and retweeted both your mentions. I like to think of looking after the DAFNEOnline feed as doing my bit to raise awareness of DAFNE. I'll add you back so I can help you promote!

Apr 12, 2012 zm 3 posts	Topic: General Discussion / Blog Thanks for the replies - I'll try to post as much as I can and hopefully people will join the discussion. @ JWo Just noticed that you maintain the twitter page for the DAFNE - nice to see it's a graduate doing that! If there was ever a chance of a wee tweet about the blog in the next few weeks that would be great. As I say, it would be great to get people involved. Dafne has been so important to me and has really turned my diabetes control around! the one thing that still seems to be slightly erratic in my regime is exercise - hence the blog. I also feel that it will be beneficial to me as I can use it as something of an extended diary to catalogue more than just BGs and CPs. Hopefully it will be of interest or even use to people - early days yet.

Apr 12, 2012 JuliaW 2 posts	Topic: General Discussion / Help with sickday rules Hi, can anyone give me some advice please. I have a sickness bug that started early this morning and is still ongoing I've eaten nothing at all today. My BG was 10.8 first thing so I had my usual 1 unit of humlin i and 1 unit of humalog to correct. I've monitored my BG's all day and they have stayed stable and within range. I've just taken my BG and its 6.5 but I have ++ keytones. My TTD is only 9 units (its very little I know!). I can't take any QA as advised by dafne as I run the risk of a hypo. What do I do if my keytone levels are worse in 2 hours time but my BG is normal? and do I still take my BI of 4 units of humulin i before bed? I'm abit worried so any help or advice would be appreciated.

Apr 12, 2012 JayBee 587 posts	Topic: General Discussion / Blog Nice! I'm certainly interested in what you discover during your exercise adventures since it can be a bit of a pain in the bum! I noticed you started following the DAFNEOnline Twitter feed this week; nice to see you on here too!

Apr 12, 2012 JayBee 587 posts	Topic: Questions for HCPs / Dawn Phenomenon possibility? Sadly last night the dreaded 3 BG got me twice around 3am... and this was after a much less eventful evening... so I'm going to try 21 tonight. Hopefully then it's all nipped in the bud... Not sure why my results aren't showing on the previous post.. but here's today's lot.

Apr 12, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Blog Welcome to the forum....... Thanks for the link, look forward to reading............

Apr 12, 2012 zm 3 posts	Topic: General Discussion / Blog I graduated from the DAFNE course about 6 months ago. I found it absolutely brilliant and my control has been so much better since. The one thing I have always struggled with is BG control in connection with exercise and this can be annoying as I am a cyclist who uses the bike for travel/town-commuting and mountain biking for leisure. As a result of this frustration I have started a blog about life as a diabetic who wants to stay fit, healthy and enjoy exercise - specifically cycling - in order to live a healthy life. If anyone was interested, please feel free to have a look: http://www.saddledwithdiabetes.com Any comments welcome!

Apr 12, 2012 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Dawn Phenomenon possibility? Good job......... Obviously being in the low 4s may feel a bit too low for some folk, but in reality is perfectly safe, if you can hover on those levels your HbA1c would be magnificent. But, not one day is the same though I suppose......... If the 22 works out, you can proceed to the daytime basal testing..............

Apr 12, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Pumps N Stuff There will be more requirement for blood tests on the pump, so more finger pricking I am afraid............ Currently there are pumps, or pump, that can operate side by side with a CGM [Continuous Glucose Monitor], however funding for these is non existent I believe and so are only provided on a temporary basis to investigate blood sugar levels more accurately overnight and during the day too.....the information can then be used to tweak the basal setting for example......... Some people have self funded CGMs I believe, but its costly............ Have you been trained any on how to use the pump, test your basal etc.........

Apr 12, 2012 SA2010 69 posts	Topic: General Discussion / What has gone wrong with Lantus adjustments Hi Garry. Yes I was aware of the 2-3 days delay for BI Lantus changes and I was waiting 2-3 days but this morning just got frustrated and decided to put the level of Lantus back and give it a rest for changes for a while. May be I need to wait 3 days at least Changes I made from previous doses of BI 5 with breakfast and 4 at 11pm: 3rd April Evening BI increased from 4 to 5 and moved earlier to be with evening meal 5th April Morning BI increased from 5 to 6 7th/8th April 1 unit of BI switched from evening to morning : 7th April Evening BI reduced from 5 to 4 8th April morning BI increased from 6 to 7 11th April Morning BI increased from 7 to 8 12th April Morning BI reduced to 6 (Premature change - in frustration) I will just run with 6 and 4 for a while Regards Simon