Recent Posts - DAFNE Online

Mar 19, 2012

novorapidboi26 1,816 posts

Topic: General Discussion / Ineffective BI?

So is the overlap giving you reasonable waking levels then?

What problems is your daytime dose of Lantus giving you.....?

Mar 19, 2012

novorapidboi26 1,816 posts

Topic: General Discussion / daily average of QA

I average about 21-22 CPs ans then my ratios on top of that, which are 1.5:1 apart from breakfast which is 3:1, so a lot of insulin.......

Mar 19, 2012

Nicky B 5 posts

Topic: General Discussion / daily average of QA

Hi - I use the DAFNE app on my iPhone and in the Diary Section - View Diary Summary there are some averages on how much insulin you are taking on a daily basis (it includes both BI+QA) - thought that might help Very Happy

Nicky

Mar 18, 2012

Wolf 3 posts

Topic: General Discussion / A Petition Regarding Changes to the NHS

Hello, Blue Labour wasted all the tax bucks paying high wage adminstrators, the NHS has to come to terms with the real world now.

Mar 18, 2012

thebatoutofhull 60 posts

Topic: General Discussion / daily average of QA

25 years ago I was asked to say how much QA I used by my car insurance company. They actually set a ceiling amount! I remember the forms. Thank goodness we don't do that anymore. Oo, I now have 1-30 units a day.

Mar 18, 2012

thebatoutofhull 60 posts

Topic: General Discussion / Ineffective BI?

Thanks Marke. Lantus lasts a little over 17 hrs from when I inject it. I have been using it for 18 months. I did very strict testing to discover this. I approached my diabetes team but was asked nicely to persevere. My control went out of the window not long after going onto it. I was correcting with QA. I now have two injections of Lantus at different times. The more I have of Lantus the longer it lasts in my system. The two injections are roughly the same but I am still evaluating. I tend to have elevated BG in the morning, most times after I have got up. I am trying to lower this morning peak by injecting the second dose of Lantus before the first has finished thus overlapping creating a shorter Lantus boost. Tiny carbs at the mo whilst eval.. Lantus works really well overnight for me. It's just not doing the doo in the day time. It would be nice for once to have BG results I can be proud of.

Mar 18, 2012

marke 643 posts

Topic: General Discussion / Ineffective BI?

Simon, presumably your Diabetes team agreed to your splitting your Lantus dose ? I ask because the HCP's I have spoken to insist that Lantus IS a 24hr insulin and that Levemir is better for splitting your dose. That said, in agreement with the original theme of this thread, one size does NOT fit all and Lantus may work better for you. I agree with your description of a normal bodies operation, although hopefully in years to come if we all get CDM's then we might have the feedback mechanism to allow us to control insulin release in our bodies to simulate a 'normal' pancreas.

The normal way of caclulating your BI needs is to not eat, monitor you BG and adjust your BI accordingly. It is supposed to provide your non-eating insulin requirement which largely should be 'relatively' stable, of course I say largely because life just isn't that simple unfortunately. As you have found there are variations and the only way you can tackle these really is QA adjustments. Its not perfect but then any insulin regime is just a rough simulation and thats the best we can do.

Mar 18, 2012

marke 643 posts

Topic: General Discussion / daily average of QA

Well I'm an IT person but if you put certain types of computer in front on me I wouldn't know where to start. The same goes for medical people, just becasue they have studied medicine doesn't mean they understand Diabetes. The good ones will openly admit this, the bad ones will make bland comments like 'that seems a bit high' without explination or justification. I would just ignore it, if they didn't provide a sound and clear explination as to why it is high then they shouldn't have said it in the first place. My daily dose varies all over the place and I see no reason to work out an average since I don't see what benefit knowing it would provide. Laughing

Mar 18, 2012

marke 643 posts

Topic: General Discussion / Correction dose ratios?

Hi, according to 'experts' at the DAFNE Collaborative lasy year, Lantus IS a 24hr insulin and so it is not working for you if it runs out, I would agree with Debbie that you should try Levemir. Although this is marketed as a 24hr insulin it is definately not and most of us take it in a split dose. It may be that it works better with you anyway as we all react differently to different Insulins. Obviously you would need to do this in co-ordination with your diabetes team so they can monitor and assist in the changeover. It may not fix your issue but you won't know unless you try.

Mar 18, 2012

DebbieS 9 posts

Topic: General Discussion / Correction dose ratios?

I used to have a similar issue with Lantus - was always going low in morning (was only doing 1 dose before bed) but since I changed to Levimir I have not had this happen, I do it before bed and when I wake and it really has made a difference. It might be worth talking to your DSN about changing to this. Once your BI is sorted your QA and correction ratio will be so much easier to get right. Good Luck x

Mar 18, 2012

thebatoutofhull 60 posts

Topic: General Discussion / Correction dose ratios?

Thank you for your reply. In response: I am more than sure my BI is not correct. I struggle to change it accurately. If I increase it I have hypos in the night. If I leave it I go high in the day. I tend to have a peak sometime in the morning and again at bedtime. The bedtime peak I am sure is from Lantus running out now as I have split my dose.( it doesn't last 24 hours) After doing this I do feel better though. I am not eating carbs, and have been doing this for a while, giving me chance to get to grips with my BI.

Mar 18, 2012

MARIER 42 posts

Topic: General Discussion / daily average of QA

Thanks Guys --------------- I did find it very strange but mayb Medical Person was just tryn to test me b ut i honestly couldnt answer it and he baffled me even more when he made the comment of it just seems quite high Confused

Mar 17, 2012

DebbieS 9 posts

Topic: General Discussion / Change of BI

I changed from Lantus to Levimir about 4 months ago, I was on 20 units of Lantus and had a lot of early morning hypos and am now on 10 units before bed and 9 units in morning of Levimir. I have found it so much better and when it is that time of the month you can reduce it by 10-20% and get an instant result. I think it is worth a go.

Mar 17, 2012

meltow 78 posts

Topic: General Discussion / daily average of QA

I'm averaging around 20 QA units.
Impossible to make a comparison as it all depends on carbohydrate intake and ratios...we are all different....
Suggest your consultant reads the Dafne handbook! Rolling Eyes

Mar 17, 2012

Alan 49 280 posts

Topic: General Discussion / daily average of QA

Obviously this "medical person" doesn't know much about diabetes, Marie. My daily average is around 33 units, but everyone is different and, as you say, it will depend on what you eat. Different people have different metabolisms, requiring different dosages of insulin.

Mar 17, 2012

DebbieS 9 posts

Topic: General Discussion / Correction dose ratios?

Are you sure that your BI is correct as it could be that your bloods were rising so the QA dose worked but on the rising BG. Or you may have an extreme Dawn phenonomen? Does the correction dose work as you would expect at other times of the day?

Mar 17, 2012

Eugene 27 posts

Topic: General Discussion / Exercise classes and type1?

My diet is heavily carbohydrate based.....I think its reason my control is so good,sugar released slower into my system .I train 3/4 times per week .The workouts are extreme lasting minimum of 80 minutes always full body workout including cardio,and lots of supersets ......SO DON'T stop your training.......

Mar 16, 2012

Simon Robinson 4 posts

Topic: DAFNE Online Mobile / Download entries from site?

Hi Simon

Good work Smile

I have just downloaded it and it worked first time.

Thanks

Simon

Mar 16, 2012

MARIER 42 posts

Topic: General Discussion / daily average of QA

What is everyones dailt average of Quick Acting Insulin ????
I was asked this question on Tue by a medical person and when i said i couldnt really answr as i havnt countd but did say roughly between 10 + 16 just depends on what i eat He was very confused and said to me that seems a bit high

Compared to what you would normally do especially if your having Hypos !!!!!! Im not really sure where he was going with the Question or what it was all about So can anyone inlighten me
Marie

Mar 16, 2012

Simon 574 posts

Topic: DAFNE Online Mobile / Download entries from site?

Hi,

I'm hoping the latest update (1.5.2) will fix your download issues; it's on the app store now so let me know if it works for you.

Simon

Mar 16, 2012

Joanne L 7 posts

Topic: General Discussion / Change of BI

I changed from Lantus to Levemir in October. I was taking 28 units of Lantus at teatime and am now taking two daily injections of Levemir totalling 46 units!! It took me a while to get my basal insulin sorted but my 3am hypos have now stopped and i have reduced my QA insulin. Its much easier to control my blood sugars now that i'm on twice daily Levemir :0)

Mar 16, 2012

SimonC 78 posts

Topic: General Discussion / Ineffective BI?

Lantus was initially billed as 'one injection a day', but many of us realized it doesn't fit the bill. I now split my Lantus, one at 0900 and the second at 2100.

However, I only came to this conclusion after testing, many times a day. I was initially on one injection at 2100 daily, but noticed that after lunchtime my results were rising regardless as to actual BG and CP's taken.

You can only come to the conclusion that you need to split you Lantus after being able to point to a rise in BG 18, 19,20 etc hours after taking the one dose of Lantus.

If you are seeing this pattern ie not just on one day, but over a week, then I would consider splitting the Lantus despite the makers claim it will last 24hrs. I split mine equally ie I was taking 24 units once daily but now take 12 units twice daily, but everyone is different and after a week of the new split doses you may need to the readjust your doses.

The BI is there to act like your body does, but in a different way, your body releases a constant supply of QA insulin, although in very very small amounts, which it boosts when you eat, to deal with the intake of carbs. Your body is very adept at doing this.

What we do is only a rough approximation using the limited tools available - those on pumps get closer by ditching the BI and always pumping a very small amount of QA - please anyone feel free to correct me, as I am a non pump user, although I would wish to use one.

The pump users will get very good results - although they have to do lots of testing to get it right, but those of us with out can get very good results, and one way is splitting the BI to twice daily.

You may argue that splitting the BI even more may get closer to what the body is able to do naturally, but I would imagine that the counter argument is that you have to increase the injections and it becomes a burden.

Using the current BI method is a blunter tool than the pump and the natural flow, but it is better than older regimes.

Simon

Mar 19, 2012 novorapidboi26 1,816 posts	Topic: General Discussion / Ineffective BI? So is the overlap giving you reasonable waking levels then? What problems is your daytime dose of Lantus giving you.....?

Mar 19, 2012 novorapidboi26 1,816 posts	Topic: General Discussion / daily average of QA I average about 21-22 CPs ans then my ratios on top of that, which are 1.5:1 apart from breakfast which is 3:1, so a lot of insulin.......

Mar 19, 2012 Nicky B 5 posts	Topic: General Discussion / daily average of QA Hi - I use the DAFNE app on my iPhone and in the Diary Section - View Diary Summary there are some averages on how much insulin you are taking on a daily basis (it includes both BI+QA) - thought that might help Nicky

Mar 18, 2012 Wolf 3 posts	Topic: General Discussion / A Petition Regarding Changes to the NHS Hello, Blue Labour wasted all the tax bucks paying high wage adminstrators, the NHS has to come to terms with the real world now.

Mar 18, 2012 thebatoutofhull 60 posts	Topic: General Discussion / daily average of QA 25 years ago I was asked to say how much QA I used by my car insurance company. They actually set a ceiling amount! I remember the forms. Thank goodness we don't do that anymore. Oo, I now have 1-30 units a day.

Mar 18, 2012 thebatoutofhull 60 posts	Topic: General Discussion / Ineffective BI? Thanks Marke. Lantus lasts a little over 17 hrs from when I inject it. I have been using it for 18 months. I did very strict testing to discover this. I approached my diabetes team but was asked nicely to persevere. My control went out of the window not long after going onto it. I was correcting with QA. I now have two injections of Lantus at different times. The more I have of Lantus the longer it lasts in my system. The two injections are roughly the same but I am still evaluating. I tend to have elevated BG in the morning, most times after I have got up. I am trying to lower this morning peak by injecting the second dose of Lantus before the first has finished thus overlapping creating a shorter Lantus boost. Tiny carbs at the mo whilst eval.. Lantus works really well overnight for me. It's just not doing the doo in the day time. It would be nice for once to have BG results I can be proud of.

Mar 18, 2012 marke 643 posts	Topic: General Discussion / Ineffective BI? Simon, presumably your Diabetes team agreed to your splitting your Lantus dose ? I ask because the HCP's I have spoken to insist that Lantus IS a 24hr insulin and that Levemir is better for splitting your dose. That said, in agreement with the original theme of this thread, one size does NOT fit all and Lantus may work better for you. I agree with your description of a normal bodies operation, although hopefully in years to come if we all get CDM's then we might have the feedback mechanism to allow us to control insulin release in our bodies to simulate a 'normal' pancreas. The normal way of caclulating your BI needs is to not eat, monitor you BG and adjust your BI accordingly. It is supposed to provide your non-eating insulin requirement which largely should be 'relatively' stable, of course I say largely because life just isn't that simple unfortunately. As you have found there are variations and the only way you can tackle these really is QA adjustments. Its not perfect but then any insulin regime is just a rough simulation and thats the best we can do.

Mar 18, 2012 marke 643 posts	Topic: General Discussion / daily average of QA Well I'm an IT person but if you put certain types of computer in front on me I wouldn't know where to start. The same goes for medical people, just becasue they have studied medicine doesn't mean they understand Diabetes. The good ones will openly admit this, the bad ones will make bland comments like 'that seems a bit high' without explination or justification. I would just ignore it, if they didn't provide a sound and clear explination as to why it is high then they shouldn't have said it in the first place. My daily dose varies all over the place and I see no reason to work out an average since I don't see what benefit knowing it would provide.

Mar 18, 2012 marke 643 posts	Topic: General Discussion / Correction dose ratios? Hi, according to 'experts' at the DAFNE Collaborative lasy year, Lantus IS a 24hr insulin and so it is not working for you if it runs out, I would agree with Debbie that you should try Levemir. Although this is marketed as a 24hr insulin it is definately not and most of us take it in a split dose. It may be that it works better with you anyway as we all react differently to different Insulins. Obviously you would need to do this in co-ordination with your diabetes team so they can monitor and assist in the changeover. It may not fix your issue but you won't know unless you try.

Mar 18, 2012 DebbieS 9 posts	Topic: General Discussion / Correction dose ratios? I used to have a similar issue with Lantus - was always going low in morning (was only doing 1 dose before bed) but since I changed to Levimir I have not had this happen, I do it before bed and when I wake and it really has made a difference. It might be worth talking to your DSN about changing to this. Once your BI is sorted your QA and correction ratio will be so much easier to get right. Good Luck x

Mar 18, 2012 thebatoutofhull 60 posts	Topic: General Discussion / Correction dose ratios? Thank you for your reply. In response: I am more than sure my BI is not correct. I struggle to change it accurately. If I increase it I have hypos in the night. If I leave it I go high in the day. I tend to have a peak sometime in the morning and again at bedtime. The bedtime peak I am sure is from Lantus running out now as I have split my dose.( it doesn't last 24 hours) After doing this I do feel better though. I am not eating carbs, and have been doing this for a while, giving me chance to get to grips with my BI.

Mar 18, 2012 MARIER 42 posts	Topic: General Discussion / daily average of QA Thanks Guys --------------- I did find it very strange but mayb Medical Person was just tryn to test me b ut i honestly couldnt answer it and he baffled me even more when he made the comment of it just seems quite high

Mar 17, 2012 DebbieS 9 posts	Topic: General Discussion / Change of BI I changed from Lantus to Levimir about 4 months ago, I was on 20 units of Lantus and had a lot of early morning hypos and am now on 10 units before bed and 9 units in morning of Levimir. I have found it so much better and when it is that time of the month you can reduce it by 10-20% and get an instant result. I think it is worth a go.

Mar 17, 2012 meltow 78 posts	Topic: General Discussion / daily average of QA I'm averaging around 20 QA units. Impossible to make a comparison as it all depends on carbohydrate intake and ratios...we are all different.... Suggest your consultant reads the Dafne handbook!

Mar 17, 2012 Alan 49 280 posts	Topic: General Discussion / daily average of QA Obviously this "medical person" doesn't know much about diabetes, Marie. My daily average is around 33 units, but everyone is different and, as you say, it will depend on what you eat. Different people have different metabolisms, requiring different dosages of insulin.

Mar 17, 2012 DebbieS 9 posts	Topic: General Discussion / Correction dose ratios? Are you sure that your BI is correct as it could be that your bloods were rising so the QA dose worked but on the rising BG. Or you may have an extreme Dawn phenonomen? Does the correction dose work as you would expect at other times of the day?

Mar 17, 2012 Eugene 27 posts	Topic: General Discussion / Exercise classes and type1? My diet is heavily carbohydrate based.....I think its reason my control is so good,sugar released slower into my system .I train 3/4 times per week .The workouts are extreme lasting minimum of 80 minutes always full body workout including cardio,and lots of supersets ......SO DON'T stop your training.......

Mar 16, 2012 Simon Robinson 4 posts	Topic: DAFNE Online Mobile / Download entries from site? Hi Simon Good work I have just downloaded it and it worked first time. Thanks Simon

Mar 16, 2012 MARIER 42 posts	Topic: General Discussion / daily average of QA What is everyones dailt average of Quick Acting Insulin ???? I was asked this question on Tue by a medical person and when i said i couldnt really answr as i havnt countd but did say roughly between 10 + 16 just depends on what i eat He was very confused and said to me that seems a bit high Compared to what you would normally do especially if your having Hypos !!!!!! Im not really sure where he was going with the Question or what it was all about So can anyone inlighten me Marie

Mar 16, 2012 Simon 574 posts	Topic: DAFNE Online Mobile / Download entries from site? Hi, I'm hoping the latest update (1.5.2) will fix your download issues; it's on the app store now so let me know if it works for you. Simon

Mar 16, 2012 Joanne L 7 posts	Topic: General Discussion / Change of BI I changed from Lantus to Levemir in October. I was taking 28 units of Lantus at teatime and am now taking two daily injections of Levemir totalling 46 units!! It took me a while to get my basal insulin sorted but my 3am hypos have now stopped and i have reduced my QA insulin. Its much easier to control my blood sugars now that i'm on twice daily Levemir :0)

Mar 16, 2012 SimonC 78 posts	Topic: General Discussion / Ineffective BI? Lantus was initially billed as 'one injection a day', but many of us realized it doesn't fit the bill. I now split my Lantus, one at 0900 and the second at 2100. However, I only came to this conclusion after testing, many times a day. I was initially on one injection at 2100 daily, but noticed that after lunchtime my results were rising regardless as to actual BG and CP's taken. You can only come to the conclusion that you need to split you Lantus after being able to point to a rise in BG 18, 19,20 etc hours after taking the one dose of Lantus. If you are seeing this pattern ie not just on one day, but over a week, then I would consider splitting the Lantus despite the makers claim it will last 24hrs. I split mine equally ie I was taking 24 units once daily but now take 12 units twice daily, but everyone is different and after a week of the new split doses you may need to the readjust your doses. The BI is there to act like your body does, but in a different way, your body releases a constant supply of QA insulin, although in very very small amounts, which it boosts when you eat, to deal with the intake of carbs. Your body is very adept at doing this. What we do is only a rough approximation using the limited tools available - those on pumps get closer by ditching the BI and always pumping a very small amount of QA - please anyone feel free to correct me, as I am a non pump user, although I would wish to use one. The pump users will get very good results - although they have to do lots of testing to get it right, but those of us with out can get very good results, and one way is splitting the BI to twice daily. You may argue that splitting the BI even more may get closer to what the body is able to do naturally, but I would imagine that the counter argument is that you have to increase the injections and it becomes a burden. Using the current BI method is a blunter tool than the pump and the natural flow, but it is better than older regimes. Simon