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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 |
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Jan 24, 2012
Carolin
83 posts
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Topic: General Discussion / Dafne & sports nutrition. How does it work?
Hi Jenny. You're quite right that you will need the additional carbs during the training / event, as well as reductions in your insulin doses. The standard DAFNE curriculum and workbook doesn't go into this in great detail as it's meant to give people just the basics, but the runsweet website, or the Diabetic Athelete Handbook (available through Amazon) are fantastic in giving guidelines for the extra carbs required. 60g per hour does sound about right, so try to think of forms that you can easily keep in your swimming gear, e.g. Glucose gels. Good luck! Carolin |
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Jan 24, 2012
Lizzie
87 posts
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Topic: General Discussion / Redoing DAFNE??? Hi SimonThanks for mending the Handbook. I have entered a couple of tests in the Diary section already, did not realise how good it was. Thanks both for your help. Will try my best tonight and see how it goes. |
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Jan 24, 2012
Simon
578 posts
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Topic: General Discussion / Redoing DAFNE???
Apologies, Mark and I have been upgrading the site and some errors slipped through the net, the handbook is working again now  I think novorapidboi is giving some real sound advice to you here. Don't underestimate the power of writing your readings down - if you can see them on paper (or on the diary here) then you will be able to notice trends and see where adjustments in dosage might need to be made. If you use the diary on here, even if you aren't able to spot the trends in the diary, you can share with other people and ask for advice - there are so many people helping each other out here. One comment:
I'd say try and test more often, not only will it contribute to keeping a record of your sugars so that you can make adjustments; you may be pleasantly surprised and find that some readings are in range - which could show you that getting on-target readings is possible, and motivate you to keep track of and adjust your insulin doses. |
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Jan 24, 2012
Lizzie
87 posts
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Topic: General Discussion / Redoing DAFNE??? Thanks, I think the best thing is to set an alarm.I panic because I am so terrified of complications. I have been told many people panic when they get hypo but I have never worried about that. I am lucky to have good warning signs so all it is is a quick check to make sure I am indeed hypo, then 20g carbs and that's it. I panic because I hate the idea that all the highs are having an effect which I will feel in years to come, like a sword suspended over my head. I worry that although there is no immediate effect, my body is storing it all up to suddenly dump on me in the future. That small unnoticeable changes are happening to tiny cells in my eyes, kidneys and nerve endings, and these will become apparent at some future date when my body decides it is going to let me down again. This probably all sounds crazy to you. I know I worry too much. I know my weight has nothing to do with my blood sugars, but try telling them that. Everything seems to be about weight. I don't understand why they wanted me to take Metformin as I was losing weight and doing well anyway. The last time I checked I was on 3:1 but that was before the Metformin. At lunch I tried 2:1. |
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Jan 24, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Redoing DAFNE??? The reason for the 5 hours is because by then all QA insulin from dinner and Carbs from your dinner will be gone, leaving nothing but your Lantus in your system, this means you can accurately see how its doing overnight..............If you still had insulin and carbs working then your pre bed test would be different from the morning......................the 5 hours is the maximum the QA insulin works is all, I am Novorapid, but it doesn't last that long in me, so it could be the same for you, however when testing you want to eliminate all the variables....... You could set an alarm for 12:00 or after that, do a test, then back to bed.............. You could skip dinner or have a carb free dinner [meat, cheese, eggs, most vegetables], then you would not be taking QA insulin......... Whatever level you feel is uncomfortable would be the level to correct, but for test purposes you really need to be free of QA insulin. The low teens would be perfectly safe just for testing your background, but as I say, if you feel rough, just correct and try again another night.......why do you think you panic when your high, do you feel high? If you dont know you ratios its likely your on a 1:1 ratio, which equates to 1 unit of insulin for 10grams [1CP] of carbohydrates.................and this wont effect the test, as your not concerned with that insulin for now.....................how much insulin do you take before eating, just random guesses? You dont what insulin could be causing the problem, that's why you need to test your background, to make sure its correct..........then you know if there are any issues it will be your QA [Humalog].......... Dont feel stupid, I was in the dark also, at least until DAFNE...............................your course must not have been conducted very well............. All you are looking for from the nurses is advice on adjusting doses, your weight has nothing to do with your blood sugar control, I have sacrificed my weight for good blood sugar control, well, I eat too much, but my blood sugar has more of a priority.......... You can only ask, you need to, you have a right to the same care as everyone else................ You can get support on here, and over at www.diabetessupport.co.uk......................... I will help as much as I can................. |
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Jan 24, 2012
Lizzie
87 posts
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Topic: General Discussion / Redoing DAFNE??? Thanks for all the help.If I don't eat for 5 hrs before bed (11pm) I will need to have tea around 5pm, so that's not doable. Does it need to be 5 hours? What is the minimum length of time it could be? I usually go to bed around 11 and get in from work about 6pm, so I would need to get going immediately on tea and eat something that doesn't take long to make to have it early enough. Or should I skip tea altogether or would that affect the results? And how high would I need to be before bed to make it worrying enough for correction? I panic when I am high and often overcorrect. I would worry if I am high before bed. Would the fact that I don't know my QA ratios affect the results of the Lantus tests, if that makes any sense? I mean, if I am high/low, how do I know whether it is a result of the Lantus being wrong or a result of the QA ratio being wrong? I am sorry for being overcautious about all this. But like I said I am really afraid of doing something wrong and it makes me feel really stupid to not know any of this after nearly 20 years. Even thinking about it now makes me worried and frustrated and I feel like crying but I know I have to try. Tbh, I don't know if the nurses or doctors can help me. They are nice people but they are judgmental about my weight and cannot see past that to helping me sort out my diabetes. |
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Jan 24, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Redoing DAFNE??? OK....................So you need to start from the beginning, which is to test your Lantus dose..................so dont have any food or QA 5 hours before you go to bed, do a test before bed, record the result...........even if its high [use discretion] dont correct it..............test before breakfast, record the result............ If you are within 1-2mmol/l then the Lantus is doing its job. However, you should do about 3 consecutive days to make sure the results your seeing, whether there right, too much or too little, are consistent..............once your sure bump up your dose if your readings went up over night, and bump down if your reading went down, or do nothing if your blood sugar held steady.........when changing background doses its wise to do a 3am test to make sure your not going low overnight, which could result in a high and therefore possibly give the impression you need more when in fact you dont.......... Once this is right, you can move on to your QA ratios.............. REMEMBER that the effects of changing Lantus, as opposed to Levemir, take a day or 2 to show up, so you should be patient at first......... Explaining the next stages might just complicate things for you, so if you concentrate on you Lantus dose for now that would be good............ Try and contact the DAFNE trained nurses at your clinic and make an appointment, this should be possible as its not an official clinic appointment, they will be better equipped to get you back on track as they will be face to face........ Would you like me to email my excel spreadsheet to you..........? |