Recent Posts - DAFNE Online

Feb 24, 2019

NottsKnots 10 posts

Topic: General Discussion / recording diary entries when travelling across time zones

Diabetestravel.org has some pretty good advice for timezone travel here
http://diabetestravel.org/time-zones/

I’ve summarised it in my Dafne Quick Reference guide for my own travels and added my own personal experience as:

0-4 TZ, West: Delay next BI after departure to correct time in destination time zone.
4-12 TZ, West: Half BI at correct time in departure time zone. Change watch to destination time. Remaining half BI at correct time in destination time zone.

0-4TZ, East: Consider reducing next BI after departure by up to one quarter and take at correct time in destination time zone.
4-12TZ, East: Reduce next BI dose after departure, take at correct time in departure zone.
Dose = BI x (0.9 - (#Zones/24)) e.g. LHR to HKG crosses 8 zones, dose = 57% of normal.
Change watch to destination time. Take next full dose at correct time in destination zone.

In all cases, monitor and correct BG with QA following correction rules. Administer QA with meals as normal.

Those rules pretty much reflect what I used to do, but they stuck a nice formula rather than my “best guess” adjustments, and they missed out the monitor and correct bit. Your doses will never be spot on whilst crossing TZs, and you physical activity is all messed up (hours of sitting doing nothing, followed by a burst of walking miles and weight lifting luggage, so monitoring is important. Make sure you have some insulin active when coming in to land, and some carbs in your system, or the exercise at the destination could push your BG high. Stanstead is a low exercise airport, but Heathrow, well its a marathon to get anywhere. Good luck.

Feb 21, 2019

CHUW 1 post

Topic: General Discussion / Ketones and high blood sugar reading

Coleen said:
I am finding it really hard to get my blood sugars down I am hardly eating and yet my blood sugars are high and my ketones are anyone know anything that I can do to bring them down I think it maybe down to having a really bad cold

The links are very helpful but beware as I spent a night in hospital as a result of ketoacidosis caused by a bad cold
It happened very suddenly and I felt extremely ill
I would say monitor very carefully and see your doctor if you are worried
Clare

Feb 21, 2019

The Chief 2 posts

Topic: General Discussion / recording diary entries when travelling across time zones

I always struggle to remember how I should deal with travelling long haul and recording my blood sugars on the DAFNE app.

I normally keep my meter set to UK time until I arrive at my destination then adjust accordingly. Similarly on return I keep the meter set to departure time zone until back in the UK. This latter approach causes issues especially when travelling east west

Is there a better way?

Any tips out there?

As far as BI is concerned I usually adjust the dose according to the number of hours time difference. I split my BI into 8 am/4 night. So if there is a 4 hour difference travelling west/east at night I'll reduce the BI by 4/12 to compensate for the 4 hours shorter day. Travelling East/west I increase the BI to compensate for the longer day.

again Am I right or does anyone know a better way?

Thanks

Feb 19, 2019

Coleen 3 posts

Topic: General Discussion / Ketones and high blood sugar reading

sjohno said:
http://www.dafneonline.co.uk/hbook_topics/47

The above link in DAFNE will explain what you can follow, hope this helps.

Sarah

thank you

Feb 19, 2019

sjohno 37 posts

Topic: General Discussion / Ketones and high blood sugar reading

http://www.dafneonline.co.uk/hbook_topics/47

The above link in DAFNE will explain what you can follow, hope this helps.

Sarah

Feb 19, 2019

Coleen 3 posts

Topic: General Discussion / Ketones and high blood sugar reading

I am finding it really hard to get my blood sugars down I am hardly eating and yet my blood sugars are high and my ketones are anyone know anything that I can do to bring them down I think it maybe down to having a really bad cold Rolling Eyes

Feb 19, 2019

Coleen 3 posts

Topic: General Discussion / Ketones and high blood sugar reading

I am finding it really hard to get my blood sugars down I am hardly eating and yet my blood sugars are high and my ketones are anyone know anything that I can do to bring them down I think it maybe down to having a really bad cold Rolling Eyes

Feb 19, 2019

torana 53 posts

Topic: General Discussion / HbA1c news

I thought it is worthwhile to highlight recent news about dismal HBA1C levels in both the US and Australia which also may be reflective of levels in the UK. “Despite the availability of newer insulin analogs and increased use of insulin pumps and CGMs in the U.S., the mean A1c levels for patients with type 1 diabetes have increased in the past 5 years and only 1 out 5 patients reach ADA target A1c levels," says DTT Editor-in-Chief and co-author of the article, Satish Garg, MD, Professor of Medicine and Pediatrics at the University of Colorado Denver (Aurora). "Above all these data represent 30,000 patients followed at the leading centers in the U.S."
This research is fascinating in terms of the questions the data raises for DAFNE members. For me personally, having up to six needles a day and testing up to 10 times I have high expectations that my HBA1C will be 7 or below. However if these results of only 20% achieving their HBA1C of the American study above, are also reflecting DAFNE members, should we question the efficacy of our routines or on the other hand has there been any studies showing that DAFNE members achieve more consistent and lower Blood Glucose levels than their diabetic counterparts?
It is also interesting that with all the new apps available on Apple and google play there has been a lack of research or scientific analysis of how effective these apps are in reducing HBA1C. This is of great concern for diabetics putting their trust into using
apps that in reality may be ineffective or lead to problems in personal management. “https://www.mja.com.au/system/files/issues/209_10/10.5694mja18.00066.pdf”

Feb 17, 2019

joelle20 3 posts

Topic: General Discussion / Type 1 Diabetics WANTED please! Short survey on the effects of different glucose monitoring systems.

marke said:
just done the survey so would encourage others to do the same !

Thank-you so much I appreciate it!

Feb 17, 2019

marke 681 posts

Topic: General Discussion / Type 1 Diabetics WANTED please! Short survey on the effects of different glucose monitoring systems.

just done the survey so would encourage others to do the same !

Feb 17, 2019

joelle20 3 posts

Topic: General Discussion / Type 1 Diabetics WANTED please! Short survey on the effects of different glucose monitoring systems.

Hello everyone,

I am a Type 1 Diabetic and I am looking for other Type 1 Diabetics to take part in a short 10 minute survey. I have decided to focus my final year project on the differences in psychological well-being and quality of life in Type 1 diabetics depending on which monitoring system they use (e.g. Self-Monitoring Blood Glucose finger pricks, Flash Glucose Monitoring). I'm really interested to see whether one glucose monitoring system is psychologically more beneficial than another, especially with the unfortunate postcode lottery for Flash at the moment which many of us are victims of.

So, if you are a Type 1 Diabetic aged 18+ I'd be extremely grateful if you could please fill out the survey. There is further information and details by following the link too.

Thanks!
Link: https://lboro.onlinesurveys.ac.uk/the-effects-of-different-glucose-monitoring-systems-on-qua

Feb 10, 2019

Caroline Litch 4 posts

Topic: General Discussion / Black Coffee

Thank you NottsKnots for your reply, I might just try the fasting lunch just for interest. There is no reason why black coffee should raise my BG and it doesn't always happen

Feb 10, 2019

NottsKnots 10 posts

Topic: General Discussion / Quick Reference Guide?

Does anyone know if there is a quick reference guide for the Dafne principles? If not, would anyone find one useful?

Theres a LOT of information in the Dafne manual, but having completed the course, most of it is not something I need to use again (e.g. examples and exercises). I would find a small guide useful with things like exercise guidance, sick day rules, alcohol guidance etc, for the times when I need the extras that I dont do “every day”. Something I could either carry around on my phone (maybe embedded in the app?), or print off and stash with my insulin whilst travelling.

If anyone knows of such a thing, please could you point me in the right direction. If it doesnt exist, and you would be interested then post a reply; maybe its something I’ll collate from the manual and share (subject to copyright, medical approval, and any other hoops that might need jumping through Smile

.

Feb 10, 2019

NottsKnots 10 posts

Topic: General Discussion / Black Coffee

I drink 20-30 mugs of black coffee a day, and has no effect on my BG. I did notice that waking and having a couple of mugs before checking my BG and having breakfast, my BG was elevated; I put that down to waking hormones working before I’d taken on the insulin as there was no other event in the preceding day or overnight. If I have the coffee with breakfast (or any time during the day), its just the other carbs and insulin doing their thing.

It might be worth trying coffee after a fasting lunch, and see what happens during the course of the afternoon. I’m no medical practitioner, but maybe its stimulating some hormone release that raises BG (like a stress response), but that should resolve itself when your liver takes back any glucose it released. Just a possible theory, with no clinical basis!

Feb 5, 2019

Caroline Litch 4 posts

Topic: General Discussion / Black Coffee

Hi Sarah

I think your right, it's just one of those things. Thank you anyway Smile

Regards
Caroline

Feb 5, 2019

Clare Mol68 3 posts

Topic: DAFNE Online Mobile / Dafne app on android

I agree, it is frustrating that I have to have a link to the website on my phone which is fiddly and not user friendly at all Crying or Very sad

Feb 5, 2019

sjohno 37 posts

Topic: General Discussion / Black Coffee

Caroline Litch said:
Hi Sarah

Yes, a lot of the time. Does that make a difference?

Hi Caroline

No not really as coffee has no carbs in it at all, I just wondered if your body/insulin was still in the middle of processing other things Very Happy

Different things affect all of us perhaps coffee is yours Smile

Feb 4, 2019

Caroline Litch 4 posts

Topic: General Discussion / Black Coffee

Hi Sarah

Yes, a lot of the time. Does that make a difference?

Feb 4, 2019

sjohno 37 posts

Topic: General Discussion / Black Coffee

Hi Caroline

Are you drinking the black coffee on an empty stomach?

regards

Sarah

Feb 4, 2019

hamisharchie 2 posts

Topic: DAFNE Online Mobile / Dafne app on android

Come on app developers, please reinstate the app for Android users or tell us where to find it.

Feb 4, 2019

landylara 14 posts

Topic: DAFNE Online Mobile / Dafne app on android

It must have been removed as I can't find it either Sad

Feb 2, 2019

torana 53 posts

Topic: General Discussion / Anxiety / Stress and Dose Adjustment

Hi Catskinbuddy, sorry to heat you haven’t been well. Hospital stays can be very problematic for diabetics and it is firstly important to tell the supervising medicals that you have concerns regarding blood glucose levels and need assistance to get them to a satisfactory level. I have been in the situation many times where medicos simply state “you know what you’re doing”. This is really not good enough and there may be an endocrinologist they can contact to give post operative advice.
Secondly, morphine can make you unaware of lows so it is important that if drowsy the nurse come into your room on a regular basis to check your blood sugars. INSIST! There are many variables that can trigger high BG’s in hospital. Just lying in a bed, stress, change of routines, crappy food etc....
Post operative effects on blood sugars need to be addressed by the medical team in the hospital and at home. Your body needs insulin especially when you are ill. Your liver will most likely release sugar to help you fight infection, this will raise your Blood Sugar even if you don't eat. When your Blood Sugar exceeds certain levels you are likely to produce Ketones that if they are not treated can make you very ill. Again, you may need to increase you insulin levels to counter this rise in blood sugars however beforehand discuss this with your medical team at hospital or even get them to ring up your DAFNE endocrinologist for advice.

Feb 2, 2019

Catskinbuddy... 1 post

Topic: General Discussion / Anxiety / Stress and Dose Adjustment

I’m currently in hospital with sepsis after having a burst appendix my question is can morphine or pain killers affect blood glucose
Many thanks catherine

Feb 24, 2019 NottsKnots 10 posts	Topic: General Discussion / recording diary entries when travelling across time zones Diabetestravel.org has some pretty good advice for timezone travel here http://diabetestravel.org/time-zones/ I’ve summarised it in my Dafne Quick Reference guide for my own travels and added my own personal experience as: 0-4 TZ, West: Delay next BI after departure to correct time in destination time zone. 4-12 TZ, West: Half BI at correct time in departure time zone. Change watch to destination time. Remaining half BI at correct time in destination time zone. 0-4TZ, East: Consider reducing next BI after departure by up to one quarter and take at correct time in destination time zone. 4-12TZ, East: Reduce next BI dose after departure, take at correct time in departure zone. Dose = BI x (0.9 - (#Zones/24)) e.g. LHR to HKG crosses 8 zones, dose = 57% of normal. Change watch to destination time. Take next full dose at correct time in destination zone. In all cases, monitor and correct BG with QA following correction rules. Administer QA with meals as normal. Those rules pretty much reflect what I used to do, but they stuck a nice formula rather than my “best guess” adjustments, and they missed out the monitor and correct bit. Your doses will never be spot on whilst crossing TZs, and you physical activity is all messed up (hours of sitting doing nothing, followed by a burst of walking miles and weight lifting luggage, so monitoring is important. Make sure you have some insulin active when coming in to land, and some carbs in your system, or the exercise at the destination could push your BG high. Stanstead is a low exercise airport, but Heathrow, well its a marathon to get anywhere. Good luck.

Feb 21, 2019 CHUW 1 post	Topic: General Discussion / Ketones and high blood sugar reading Coleen said: I am finding it really hard to get my blood sugars down I am hardly eating and yet my blood sugars are high and my ketones are anyone know anything that I can do to bring them down I think it maybe down to having a really bad cold The links are very helpful but beware as I spent a night in hospital as a result of ketoacidosis caused by a bad cold It happened very suddenly and I felt extremely ill I would say monitor very carefully and see your doctor if you are worried Clare

Feb 21, 2019 The Chief 2 posts	Topic: General Discussion / recording diary entries when travelling across time zones I always struggle to remember how I should deal with travelling long haul and recording my blood sugars on the DAFNE app. I normally keep my meter set to UK time until I arrive at my destination then adjust accordingly. Similarly on return I keep the meter set to departure time zone until back in the UK. This latter approach causes issues especially when travelling east west Is there a better way? Any tips out there? As far as BI is concerned I usually adjust the dose according to the number of hours time difference. I split my BI into 8 am/4 night. So if there is a 4 hour difference travelling west/east at night I'll reduce the BI by 4/12 to compensate for the 4 hours shorter day. Travelling East/west I increase the BI to compensate for the longer day. again Am I right or does anyone know a better way? Thanks

Feb 19, 2019 Coleen 3 posts	Topic: General Discussion / Ketones and high blood sugar reading sjohno said: http://www.dafneonline.co.uk/hbook_topics/47 The above link in DAFNE will explain what you can follow, hope this helps. Sarah thank you

Feb 19, 2019 sjohno 37 posts	Topic: General Discussion / Ketones and high blood sugar reading http://www.dafneonline.co.uk/hbook_topics/47 The above link in DAFNE will explain what you can follow, hope this helps. Sarah

Feb 19, 2019 Coleen 3 posts	Topic: General Discussion / Ketones and high blood sugar reading I am finding it really hard to get my blood sugars down I am hardly eating and yet my blood sugars are high and my ketones are anyone know anything that I can do to bring them down I think it maybe down to having a really bad cold

Feb 19, 2019 Coleen 3 posts	Topic: General Discussion / Ketones and high blood sugar reading I am finding it really hard to get my blood sugars down I am hardly eating and yet my blood sugars are high and my ketones are anyone know anything that I can do to bring them down I think it maybe down to having a really bad cold

Feb 19, 2019 torana 53 posts	Topic: General Discussion / HbA1c news I thought it is worthwhile to highlight recent news about dismal HBA1C levels in both the US and Australia which also may be reflective of levels in the UK. “Despite the availability of newer insulin analogs and increased use of insulin pumps and CGMs in the U.S., the mean A1c levels for patients with type 1 diabetes have increased in the past 5 years and only 1 out 5 patients reach ADA target A1c levels," says DTT Editor-in-Chief and co-author of the article, Satish Garg, MD, Professor of Medicine and Pediatrics at the University of Colorado Denver (Aurora). "Above all these data represent 30,000 patients followed at the leading centers in the U.S." This research is fascinating in terms of the questions the data raises for DAFNE members. For me personally, having up to six needles a day and testing up to 10 times I have high expectations that my HBA1C will be 7 or below. However if these results of only 20% achieving their HBA1C of the American study above, are also reflecting DAFNE members, should we question the efficacy of our routines or on the other hand has there been any studies showing that DAFNE members achieve more consistent and lower Blood Glucose levels than their diabetic counterparts? It is also interesting that with all the new apps available on Apple and google play there has been a lack of research or scientific analysis of how effective these apps are in reducing HBA1C. This is of great concern for diabetics putting their trust into using apps that in reality may be ineffective or lead to problems in personal management. “https://www.mja.com.au/system/files/issues/209_10/10.5694mja18.00066.pdf”

Feb 17, 2019 joelle20 3 posts	Topic: General Discussion / Type 1 Diabetics WANTED please! Short survey on the effects of different glucose monitoring systems. marke said: just done the survey so would encourage others to do the same ! Thank-you so much I appreciate it!

Feb 17, 2019 marke 681 posts	Topic: General Discussion / Type 1 Diabetics WANTED please! Short survey on the effects of different glucose monitoring systems. just done the survey so would encourage others to do the same !

Feb 17, 2019 joelle20 3 posts	Topic: General Discussion / Type 1 Diabetics WANTED please! Short survey on the effects of different glucose monitoring systems. Hello everyone, I am a Type 1 Diabetic and I am looking for other Type 1 Diabetics to take part in a short 10 minute survey. I have decided to focus my final year project on the differences in psychological well-being and quality of life in Type 1 diabetics depending on which monitoring system they use (e.g. Self-Monitoring Blood Glucose finger pricks, Flash Glucose Monitoring). I'm really interested to see whether one glucose monitoring system is psychologically more beneficial than another, especially with the unfortunate postcode lottery for Flash at the moment which many of us are victims of. So, if you are a Type 1 Diabetic aged 18+ I'd be extremely grateful if you could please fill out the survey. There is further information and details by following the link too. Thanks! Link: https://lboro.onlinesurveys.ac.uk/the-effects-of-different-glucose-monitoring-systems-on-qua

Feb 10, 2019 Caroline Litch 4 posts	Topic: General Discussion / Black Coffee Thank you NottsKnots for your reply, I might just try the fasting lunch just for interest. There is no reason why black coffee should raise my BG and it doesn't always happen

Feb 10, 2019 NottsKnots 10 posts	Topic: General Discussion / Quick Reference Guide? Does anyone know if there is a quick reference guide for the Dafne principles? If not, would anyone find one useful? Theres a LOT of information in the Dafne manual, but having completed the course, most of it is not something I need to use again (e.g. examples and exercises). I would find a small guide useful with things like exercise guidance, sick day rules, alcohol guidance etc, for the times when I need the extras that I dont do “every day”. Something I could either carry around on my phone (maybe embedded in the app?), or print off and stash with my insulin whilst travelling. If anyone knows of such a thing, please could you point me in the right direction. If it doesnt exist, and you would be interested then post a reply; maybe its something I’ll collate from the manual and share (subject to copyright, medical approval, and any other hoops that might need jumping through .

Feb 10, 2019 NottsKnots 10 posts	Topic: General Discussion / Black Coffee I drink 20-30 mugs of black coffee a day, and has no effect on my BG. I did notice that waking and having a couple of mugs before checking my BG and having breakfast, my BG was elevated; I put that down to waking hormones working before I’d taken on the insulin as there was no other event in the preceding day or overnight. If I have the coffee with breakfast (or any time during the day), its just the other carbs and insulin doing their thing. It might be worth trying coffee after a fasting lunch, and see what happens during the course of the afternoon. I’m no medical practitioner, but maybe its stimulating some hormone release that raises BG (like a stress response), but that should resolve itself when your liver takes back any glucose it released. Just a possible theory, with no clinical basis!

Feb 5, 2019 Caroline Litch 4 posts	Topic: General Discussion / Black Coffee Hi Sarah I think your right, it's just one of those things. Thank you anyway Regards Caroline

Feb 5, 2019 Clare Mol68 3 posts	Topic: DAFNE Online Mobile / Dafne app on android I agree, it is frustrating that I have to have a link to the website on my phone which is fiddly and not user friendly at all

Feb 5, 2019 sjohno 37 posts	Topic: General Discussion / Black Coffee Caroline Litch said: Hi Sarah Yes, a lot of the time. Does that make a difference? Hi Caroline No not really as coffee has no carbs in it at all, I just wondered if your body/insulin was still in the middle of processing other things Different things affect all of us perhaps coffee is yours

Feb 4, 2019 Caroline Litch 4 posts	Topic: General Discussion / Black Coffee Hi Sarah Yes, a lot of the time. Does that make a difference?

Feb 4, 2019 sjohno 37 posts	Topic: General Discussion / Black Coffee Hi Caroline Are you drinking the black coffee on an empty stomach? regards Sarah

Feb 4, 2019 hamisharchie 2 posts	Topic: DAFNE Online Mobile / Dafne app on android Come on app developers, please reinstate the app for Android users or tell us where to find it.

Feb 4, 2019 landylara 14 posts	Topic: DAFNE Online Mobile / Dafne app on android It must have been removed as I can't find it either

Feb 2, 2019 torana 53 posts	Topic: General Discussion / Anxiety / Stress and Dose Adjustment Hi Catskinbuddy, sorry to heat you haven’t been well. Hospital stays can be very problematic for diabetics and it is firstly important to tell the supervising medicals that you have concerns regarding blood glucose levels and need assistance to get them to a satisfactory level. I have been in the situation many times where medicos simply state “you know what you’re doing”. This is really not good enough and there may be an endocrinologist they can contact to give post operative advice. Secondly, morphine can make you unaware of lows so it is important that if drowsy the nurse come into your room on a regular basis to check your blood sugars. INSIST! There are many variables that can trigger high BG’s in hospital. Just lying in a bed, stress, change of routines, crappy food etc.... Post operative effects on blood sugars need to be addressed by the medical team in the hospital and at home. Your body needs insulin especially when you are ill. Your liver will most likely release sugar to help you fight infection, this will raise your Blood Sugar even if you don't eat. When your Blood Sugar exceeds certain levels you are likely to produce Ketones that if they are not treated can make you very ill. Again, you may need to increase you insulin levels to counter this rise in blood sugars however beforehand discuss this with your medical team at hospital or even get them to ring up your DAFNE endocrinologist for advice.

Feb 2, 2019 Catskinbuddy... 1 post	Topic: General Discussion / Anxiety / Stress and Dose Adjustment I’m currently in hospital with sepsis after having a burst appendix my question is can morphine or pain killers affect blood glucose Many thanks catherine