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Jan 25, 2012
CathySbd
7 posts
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Pre tea is on average 5 to 9. I am on 15 units levimir which i have 10pm. I do 1.5 to 1 ratio for tea. Am a terrible snacker in evenings. An hour or two after tea i might have say a packet of crisps (take say 2 units) , often dont test bg then cos is not long enough after tea. Then hour later might have 2 toast, take 3 units, again dont always test cos is not far from previous snack. Take 15 levimir 10-10.30 pm. Test bg say midnight, is often around 12. Wake up with bg's of 12. I realise i am doing stuff wrong but it's become a bad habit. Funnily enough I rarely snack in the day. |
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Jan 25, 2012
CathySbd
7 posts
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Topic: DAFNE Online Mobile / Mobile use question Hi, I see now yes of course! I went on the week DAFNE course about 5 years ago at my local hospital. Funding for it was withdrawn not long after. I think I am a bit rusty and perhaps lazy is not quite the word but I could do with getting to grips with it properly to get my HBA1c lower as it's sneaking up to the high 8's. I feel on the whole, alone in looking after my health, dont get me wrong, I get my check-ups at the hosp but I often wish there was more. Glas I've found this online and especially use on the ifone as I use that a lot. Pre-dafne my hba1c's were always 12+ then went briefly to 7.3 then up to 8's where they have stayed. Cathy |
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Jan 25, 2012
Anele46
109 posts
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Topic: General Discussion / Redoing DAFNE???
Hi Lizzie, I can totally understand why you use your stomach and I certainly don't inject through my clothes and wouldn't recommend it so the tum is often the most convenient and least painful place. Just out of interest, what size of needles do you use? I started on 6mm when I was first diagnosed and then was offered 5mm at my DAFNE course which has really helped with the pain and was also offered 4mm which can be useful for injecting in your arms. I haven't tried my arms yet and don't fancy it to be honest so right now I switch between both thighs and my tum for my QA and my buttocks for my Lantus (BI) as I remember from my DAFNE course that it is recommended to inject your BI in a different site to your QA but in real life this isn't always possible. Hope this helps in some way  Cheers, Anele x |
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Jan 25, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Redoing DAFNE??? Your carb count seems to be fine..................People are more resistant in the morning through lack of activity in the muscles, so its quite common to have a higher ratio, I am on 3:1......... If you unsure just do the tests, 2-3 days results, make a decision.......... Theoretically you should only be injecting once when out at work, for lunch...............I personally wear short sleeved t shirts most of the time so can inject into my arms no problem at work, but also use my stomach, and if I happen to need the toilet at the same time I will do it in there on my legs, I cant really see how its anymore unhygienic than outside the toilet.............it could be argued, but no one could provide any significant evidence to suggest its less hygienic to do it in there.......... You dont really inject on the outside or inside of the leg, its on the front, so the front facing part of the the thigh at the top.................another great location is your bum cheeks, I often inject there also..................I am quite fortunate to be in a good routine regards my sites, a habit I adopted from my younger diabetic brother when he was a child, he was diagnosed at 2, me 15........... It can be significant though in terms of absorption and so can effect your dose adjustment decisions too.............. Dont beat yourself up about your results, the other alternative to it is not testing, and then you wouldn't know if they were good or bad, but it seems they are better than you expected, would you not agree?. |
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Jan 25, 2012
Lizzie
87 posts
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Topic: General Discussion / Redoing DAFNE??? Novorapidboi, that is a good point about waiting longer before correcting. Like I mentioned before, I tend to panic.The numbers are not representative though, I am trying hard atm as I know I will be sharing these results with others. I think a large part of the problem as I mentioned is my eating and in order to monitor insulin I have needed to cut down on the CPs a little. For breakfast I had 2 slices of toast (16g per slice according to bread packet), and a glass of fruit juice (200ml, 20g) so total 5CPs and I estimated 2.5:1 as I have been told people are more resistant in the mornings. Anelo26, you are right about injecting in my stomach. It is the easiest place as I can just inject quickly under the table, I am not confident injecting through my clothes to my legs or arms and I don’t want to go into a toilet to inject really either, it isn’t hygienic. But I will try to use my thighs when I inject at home. When injected in my thigh before it has hurt, I think I must be doing it wrong somehow. The diagrams I see online say it should be done on the outside of the leg but it seemed less painful on the inside to me. I will try again. Thanks both of you for your helpful comments. |
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Jan 25, 2012
Anele46
109 posts
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Topic: General Discussion / Redoing DAFNE???
Thanks Novorapidboi26  Lizzie, Just another thing that I forgot to mention about injection sites, if you do change your injection sites and use one that hasn't been used before or in a long time you may see quite different results as the Insulin could be absorbed more quickly. Cheers, Anele. |
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Jan 25, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Redoing DAFNE??? Excellent observation Anele................ |
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Jan 25, 2012
Anele46
109 posts
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Topic: General Discussion / Redoing DAFNE???
Hi Lizzie, Just wanted to say well done for your results so far They look really good. The only thing I would like to mention that may help (but hopefully not confuse matters) is I see from your diary that you have always injected in your stomach. Do you inject anywhere else or is it only in your Stomach? If the same site is used over and over you can develop lumps (Lipo's) and these can cause the absorption rate for the Insulin to be different which may explain some unsual results. I could be totally off the mark and this could well not be the case with you but just something to bear in mind that rotating injection sites is a good idea but I unserstand that (for me anyway) I find that the stomach is the least painful so I tend to inject maybe once or twice a day or when I am out-side as this is quite a discete place to inject. Like I say, just a wee thought but well done for all your efforts so far and as Simon said earlier, when you see the good results written down it is a confidence boost that things are going well and helps explain why some readings may not be as good. I wish you all the very best Cheers, Anele. |
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Jan 25, 2012
novorapidboi26
1,819 posts
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Topic: DAFNE Online Mobile / Mobile use question The app or the online site does not work out correction doses, as these can be different for everyone at different times of the day.......For example, I would take 6 units to come down from 14 to 5.5, on the assumption that at that specific level, 1 unit drops me by 1.5 mmol/l... On both the app and website/mobile website you enter in your corrections within the QA field, represented by +2 for 2 units correction etc........ Basically just the same way as you would write it down, which is taught in the course........... Have you done the course? I only ask as it does not say you are a graduate next to your name................ 
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Jan 25, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Evening and late night snacking What are your pre bed test results, and by pre bed I mean a maximum of 5 hours after you have the snack................?If this is on target, then you would assume that it would be; 1. Not enough background insulin 2. Dawn Phenomenon What BI insulin are you on and when?
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Jan 25, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Need a second opinion You should only change one thing at a time..................that is the most effective way to do it.....................From the majority of your results it seems as though your 8 units of Levemir in the evening is doing its job and keeping you pretty much stable overnight...............I would confirm this by testing overnight for 3 nights consecutively, without any insulin or carbs going in 5 hours prior to the pre bed test................. As far as your breakfast ratio of 3:1 is concerned, the results [last 3 days] would suggest that this dose is OK too due to being on target at lunchtime for the majority of the time.................the hypos are not regular enough in my opinion to warrant changing that ratio....... However you may want to check your breakfast Levemir dose with a missed meal or carb free meal................ If you are planning to check both basal and bolus doses, the basal should always comes first, as this insulin dose is the foundation for the quicker acting insulin............ So to conclude, confirm your evening dose of 8 is holding you steady till morning, remember no carbs or QA going in 5 hours prior to pre bed test............... Then miss some meals/have some carb free meals and test you daytime Levemir dose for 2-3 days in a row.............you may find you need more during the day and this might bring down your QA ratios............ |
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Jan 25, 2012
CathySbd
7 posts
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I have found over time that I simply cannot snack after about 7pm. My blood sugars are always high in the mornings if I eat late. I have the correct short acting, I have adjusted the long acting but no matter what I do I cant keep good control with any late eating. Anyone else find this? Thanks, Cathy |
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Jan 25, 2012
CathySbd
7 posts
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Topic: DAFNE Online Mobile / Mobile use question Am enjoying entering my daily info onto DAFNE online via my iphone3. It's great. Tookme a while to figure out a few things. Does it work out your correction dose of short acting depending on your blood sugar, not sure about this? Eg: If I tested my blood sugar before tea and it was 14 I would have an extra 2 units on top of whatever I was injecting for my tea. Where do other people add this into their diary? Thanks. Cathy |
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Jan 25, 2012
Derek Brown
32 posts
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Topic: General Discussion / Need a second opinion Apologies for taking so much space but I thought it a better way to show the diary than sharing with various people to look at.To cut a long storyshort for various personal happenings I gave up on my diabetes from counting and recording to going days without insulin. I now realise that I need to get back on track and since 2nd January I've tried my hardest to monitor and stick to DAFNE rules. It started of not too bad, I;m especially chuffed about my readings on 11th Has anybody ever recorded a whole green day, i.e in target?After there it went a little wonky though and the last couple of nights my nighttime seems to have risen by morning time making me think the levemir needs upped. I'm including the fact last night's 4.9 should'nt have risen to 9.6 this morning even with the 1CP. I'm not certain if I should up the Levemir tonight by 1u and keep checking the next few days, or do a couple 3 am to rule out it dipping during the night. Also normaly a 3:1 ratio at breakfast would see me good to lunchtime but it's dipped a bit last couple of days by then so I'm thinking og going to 2.5:1 ratio. But which to do first check my basal, or drop my breakfast ratio? I know it should be one change at a time a sensible is to check the basal but someone else might have done both and have advice on it. Thanks, Derek |
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Jan 25, 2012
Derek Brown
32 posts
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Topic: General Discussion / Need a second opinion Part 2 |
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Jan 25, 2012
Derek Brown
32 posts
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Topic: General Discussion / Need a second opinion Bare with me as I post as much of my recent diary as I can (been a while since I last did it) |
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Jan 25, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Redoing DAFNE???
WOW, your results are quite good, better than you expected I would imagine...............  For any roll I take them as 3 CPs, unless they are smaller than a normal sized one............have a look at the carb book on the site, there is also the book carbs and cals that you can get from amazon, this is really helpful also, I have this for mainly calories but comes in useful for carbs too......... A comment I would make is that you are not giving your insulin 5 hours to work, so leaving 5 hours between MAIN meals.............for example, between 13:40 and 16:41 is only 3 hours, so that 11.5 you corrected for would of still needed an extra hour, hour and a half to come down with the 16 units you injected at 13:40..................if you can do this you will know for sure whether your dose is right, and it looks pretty much there to me......... Your overnight numbers look to be good also, as you woke up the same as you went to bed with, this would suggest your BI dose of 28 is correct, however, do another couple of nights to confirm it............. I suspect your low may be down to too much insulin at breakfast or a miscalculation of the carbs, but you can only really go down that path once you know the BI is right............ What did you have for breakfast this morning................... Well done in doing the tests, you should be proud. I hope that seeing your results, which are really good by the way, has made you feel more confident that your BG control is good............the odd high number in amongst numbers like that will not do any harm whatsoever.......... Again, well done.................
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Jan 25, 2012
Lizzie
87 posts
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Topic: General Discussion / Redoing DAFNE??? Well these are my results so far. |
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Jan 25, 2012
Stew B
125 posts
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Topic: Site Development / ONLINE DIARY LINK I visit the site 2 -3 times a week on my pc (I update my on-line diary using my iPod touch and the excellent DAFNE app.). Usually when I click on the forums link I get a nice green square next to any of the forums which have been active since my last visit, so I know I've only got to look at those. This function hasn't worked on my last few visits - is it me, and is there anything I can do to restore this? |
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Jan 25, 2012
Stew B
125 posts
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Topic: General Discussion / Accu Chek Aviva Expert A few patients at our clinic (including me) were given Accu Check Aviva Experts as part of the early trials. Unfortunately, the one I was given was giving me readings which were consistently at least 1 above the readings I was getting from my one-touch ultra meter. As a consequence when I was getting early signs of a hypo, the meter was telling me I was in target (which was what alerted me to the problem). I ran the two meters together for a few days and then stopped using the expert (I am still using the multi-clix "pricker" though!). I've had a similar (though not so significant) problem with a one-touch ultra easy, so I'm not suggesting that this is a problem unique to the Expert, and was probably just the individual meter I was allocated.I know that the small-print says that meters are not precise, and can vary up to 10%, but in DAFNE terms 10% can make a real difference to decisions about doses and corrections. |
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Jan 24, 2012
Carolin
83 posts
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Topic: General Discussion / Accu Chek Aviva Expert
Hi Naz, Well done on the HbA1c improvement! Great to see your hard work paying off isn't it These new bolus adviser meters have been introduced on the back of pump therapy really, where they've been incorporated in some way in pumps to enable users to more accurately calculate the bolus required and take away some of the complicated maths you need to do. We've tried them out in Sheffield, indeed a few of our DAFNE graduates took part in the early 'trials' (which weren't really scientifically done and pts were self-selected). I think they were a bit of a novelty and most stopped using them as they could do the maths quicker in their own heads following DAFNE training, so it became a bit of a pain to put all the data in each time you test or eat CPs. Having said that, I have had a few people who have found them useful, especially those who have had problems with hypos, often after correcting high BG, this is because the calculator factors in the 'active insulin', I.e, the previous dose of QA that may still be having an effect on the BG when you test it. So in that way it can stop you from overcorrecting your BG and prevents hypos. The impending REPOSE study (see DAFNE main website) will test out bolus advisers in both pts using multiple dose insulin and those using insulin pumps, so we should start to gather much more useful data on them over the next couple of years. Good luck! Carolin |