Recent Posts - DAFNE Online

Jan 14, 2012

CathySbd 7 posts

Topic: General Discussion / Hi, new on here

Hi everyone and thank you all for the lovely replies. Its nice to have people out there who understand and are there for you. I am a bit of a worrier (hypochondriac!) about my health these days and sometimes i feel it would be good to be able to ask other people questions of how they are doing etc. xcathy

Jan 14, 2012

ChristineBat... 23 posts

Topic: General Discussion / Hi, new on here

Hi Cathy, welcome! I've been type 1 diabetic for 33 years, and I'm 43. Good luck for 2012, and I hope you feel supported on here. Christine

Jan 14, 2012

marke 686 posts

Topic: General Discussion / Hi, new on here

Hi cathy and welcome. If nothing else you are testing regularly and that's a big bonus. We are all bad from time to time no one is perfect but at least now you have the tools to improve things. As for the other nurses about time they listened and stopped preaching. In every job we all have new things to learn and never know it all even if we think we do.

Jan 14, 2012

marke 686 posts

Topic: Questions for HCPs / steroids and glucose management

Simon made a very good point that I had forgotten about, which is surprising considering the circumstances. You need to be careful when you stop taking the steroids. They will taper them off slowly so that you body resumes production of 'natural' steroids. However my insulin requirements became a bit unpredictable for a week or two after I had finished the steroids completely. I had my only ever assisted hypo during this period. I was at work and apparently started behaving strangely then went to sleep at my desk. Sadly despite all my previous instructions to colleagues they called an ambulance. The operator told them to give me coca cola. I remember waking up and thinking oh there is an ambulance crew here, I wonder why. Oh sh*t it's for me !! I have been fine ever since.

Jan 14, 2012

Alan 49 284 posts

Topic: General Discussion / New Needles

That sounds like rubbish to me - you're still going to need the same dosage whether you inject it deeper with the 8mm needles, or not so deep with the 4mm. Perhaps you should get your GP to explain it.

I would recommend the shorter needles, though. I use 5mm needles and the actual injections are a lot more comfortable than with the 8mm ones.

Jan 14, 2012

Simon Heller 46 posts

Topic: Questions for HCPs / steroids and glucose management

Marke is right. Everyone responds differently to steroids but since they are very effective at turning the body's fat and muscle stores into glucose (in the liver) they will make glucose go up in everyone. Just increasing bolus and corrective doses may well not work if the doses are large enough and then background insulin has to be increased to bring the fasting, i.e. starting glucose of the day down. Morning BI also needs increasing by and large as Marke indicates. You also need to remember that when the steroids are reduced and this is normally gradually, then doses should begin to be wound down within 24 hours of a dose reduction. It is frustrating that there is no std formula so the secret is applying DAFNE principles very precisely as well as seeking help from a local DAFNE educator or doc. Simon

Jan 14, 2012

CathySbd 7 posts

Topic: General Discussion / Hi, new on here

Hi. Thought I'd introduce myself. Type 1 diabetic 39 years! Am 48 but don't look it!!!! Been on DAFNE about 5 years. HBA1c been 8.something for long time. Would like to get this lower. Trying to lose 30 lbs with Slimming World-am inclined to 'binge' hence probs getting HBA1c lower. Work parttime (26.5 hrs). Work in a hospital where other ppl in the department where I work (ie the nurses) are convinced I am a very bad diabetic because of how I eat, what I eat and when etc. i have tried to explain DAFNE but they all think it's some newfangled rubbish and not good for me. Their attitudes annoy me. Love the Dafne regime, it is the one thing that got me test my blood sugar regularly as pre-dafne I would go for 6 months or more without testing. I always had good intentions but never followed them. Have very supportive husband and 2 great kids age 20 and 14. Want 2012 the year i get fitter and healthier-and relax more!!! Xcathy

Jan 13, 2012

marke 686 posts

Topic: Questions for HCPs / steroids and glucose management

I have experience but no simple solution. I have been on steriods a number of times and experienced insulin resistance as a result. The only solution I found was trial and error, however I also found that the larger the meal I ate, the harder it was to adjust for the resistance. It didn't seem to be linear i.e if I at 4 CP's and used a ratio of 2:1, if I ate 8 CP's then a 2:1 ratio was not enough. The only solution I found was to try and keep the CP's down and maybe eat more often and inject for each. Another important factor is to increase your BI accordingly as well. This will require acting like you are starting from scratch and try to get your BI right with carb free days. It won't 'fix' the issue but it will improve it by giving a better baseline to adjust the QA for.

Jan 13, 2012

LeonT 6 posts

Topic: General Discussion / Sensible drinkers need not apply...

Thank you all. I think, as Alp147 said, it'll probably take a bit of trial and error. It's interesting to see that the dosage levels vary so much between different people.

I'm going to have another look at the DAFNE handbook because, to be honest, the alcohol section confused me when we went through it on the course. I sort of like the idea of injecting throughout a "session" though - who knows, it might inadvertently keep me sober(ish) lol!

Jan 13, 2012

DRS 6 posts

Topic: General Discussion / New Needles

I currently use 8mm needles for my insulin injections. My GP's surgery have written recommending switching to 4mm needles which they say may help to reduce the amount of insulin I need to take. Does this sound right?

Jan 13, 2012

alp147 4 posts

Topic: General Discussion / Sensible drinkers need not apply...

When i drink i tend to stick to spirits and diet mixer, so i dont have any insulin for that. If i drink cocktails i just count the juice as i would a juice drink normally, i go by say for every 100mls i take 1 unit and jab as a i go along. And i too have something to eat at the end of the night which i dont count. I test my bg when i get in, unless it is rediculously high i leave it as it will drop =] lots of trial and error though!

Jan 13, 2012

ketostix pla... 25 posts

Topic: General Discussion / Sensible drinkers need not apply...

Hi LeonT, Im not a massive drinker as not very good at it lol, however will occasionaly go on a massive adhoc session. The way I tend to do it which works well for me apart from the hangover, is first pint dont count. Then after every two pints I do 1 unit QA, however I tend to keep a mental count of pints and do an injection after four pints as tend to inject to often for my liking if on a mission with mates. I dont count shots or spirits if having a break from lager, apart from if mixed with OJ but I only drink diet coke with spirits. The important rule I always follow is on way home have kebab or burger and chips but dont count them, as my blood glucose will crash during the night. I have to keep a close eye on my levels the following day, but tend to be in good range. I remember on Dafne course they said that alchol is a bit of a grey area but there are details in the training guide if I remember correctly, but you need to find what works for you. enjoy yourself and remember its only one day, so you will get back into a routine after the madness which we are allowed!!!

Jan 13, 2012

SimonC 78 posts

Topic: General Discussion / Sensible drinkers need not apply...

I have had type for 22 years - almost to the day, and of course I have never strayed of the virtuous path, but when no one is looking I'm may have the odd pint or three. I used to deal with it by having extra the day after, but always remembering that you can have sudden drops due to the effect of alcohol, however, I now try to l add a small dose of QA as I go along, which is much better, for me, but I don't always remember.

It is always useful to take into account what it is you are drinking, for pints, I would have a shot of 3 units per pint, but if drinking wine I wouldn't have any.

For me, it is easier to jab as I go along.

Jan 13, 2012

LeonT 6 posts

Topic: General Discussion / Sensible drinkers need not apply...

Ok, so I've had type one for yearssss (21) and graduated from DAFNE earlier this year. Now, I've got quite a few stag weekends comIng up and I was wondering the best way of dealing with drunken nights out. The delegates on my DAFNE course were all "perfect" - nobody drank more than 2 pints a year ;o) - but I'm a tad different lol.

So, how do you deal with boozey sessions? Do you attempt to inject as you go along, or do you leave it until the next morning when you've sobered up sufficiently? Alternatively, do you just abstain on the grounds that you have Type 1 diabetes?

Jan 13, 2012

LeonT 6 posts

Topic: General Discussion / App developments

Rapidcalc (iphone app) does something similar although it doesnt take into account DAFNE principles.

Jan 13, 2012

mum2westiesGill 502 posts

Topic: General Discussion / Exciting news............

novorapidboi26 said:
Confirmed a girl......................

So a wee boy and a wee girl, the perfect family..................

I'm very happy for you & your wife and as you say it's the perfect wee family.

Gill

Jan 13, 2012

Chchch 17 posts

Topic: Carbohydrate Counting / Counting veg

It's funny what you say Helen about a carb free day being a no food day - I'm reading a book at the moment (forgive me, can't remember the name, but it's to do with success on a pump- highly recommended) and he says to test basal you should eat nothing apart from a small (small was in bold) amount of cheese or nuts. This is contrary to Dafne obv, which says you could have meat, eggs, salad, etc. I'll be testing my basal today so will only be having the little bit of cheese - I'll let you know how I get on. I'll be delirious with hunger!
Sorry to hear you have such a nightmare with your control - it is in my experience an incredibly frustrating condition. I always think that if I didn't have diabetes I don't know what I'd do with my time!

Jan 13, 2012

Aarti 4 posts

Topic: Questions for HCPs / steroids and glucose management

I have a patient who has to have steroids post chemotherapy which is making her blood sugars go extremely high whilst on the steroids. She is increasing her ratio 4-fold but still not managing glucose levels. Has anyone got any experience in dealing with glucose management whilst on steroids?

Jan 13, 2012

HelenP 218 posts

Topic: General Discussion / Street Food

I am not so sure the pump is more discreet. Every time I eat I do a blood test, drag out the pump enter the carbs and the Bg count up the units etc and press the button. It certainly takes longer than just doing a mental calculation and winding it up. In my experience more people are familiar with insulin injections but the sight of a pump and the plastic tube disappearing into you somewhere is cause for curiosity. If I cop a stare I simple say "it keeps me alive!" Some ask what it is but most are embarrassed!
In Australia we don't have multiple layers of clothes issue to deal with, My theory is if you do it quickly then less people notice.
Helen

Jan 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / Exciting news............

Confirmed a girl......................

So a wee boy and a wee girl, the perfect family.................. Wink

Jan 13, 2012

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Counting veg

Thanks a lot............it was confirmed last night as a girl with a 4d scan, really excited now..............

Thats a lot of corrections......do you think it may be connected with menstrual behavior, obviously I am not experienced with this, but the time scales you are describing seem to be similar...........

Your need to count all items on plate can be explained by the pump, due to lack of a slower acting insulin to mop up the fats and proteins............

How long have you been pumping........

Jan 13, 2012

HelenP 218 posts

Topic: Carbohydrate Counting / Counting veg

Hi Novorapidboi!

When on MDIs I was on 90+ a day with 68 being Lantus (2x34 6am/6pm) and the rest (30 odd) was 10CPs at about 2.7 units per CP.

On a pump now and on a really good day the basals are 38.8 a day and the rest (still 100g of CHO) make up the 25units. The pump has been good BUT I still experience days (or rather consecutive days) where the corrections can add 30 units to the total. I am currently being investigated for chronic low grade infection in an attempt to find a cause for the four-five day periods (about every two-three weeks) where the BGs are a nightmare. Long way from it just ticking over! I try to lead a very routine life as I find the diabetes more manageable

Congratulations on the baby news.
Helen

Jan 13, 2012

novorapidboi26 1,819 posts

Topic: General Discussion / SE KENT PCT DAFNE scrapped

Thats rubbish................

Do you think staff could still be trained up in DAFNE in order to support those graduates that remain?

marke, I hope your questions will get folk talking...........

Jan 13, 2012

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Counting veg

I am 70-120 units a day, 70 being my BI dose................so millions...........

I assume your BI dose is nearer the 55 mark?

Jan 14, 2012 CathySbd 7 posts	Topic: General Discussion / Hi, new on here Hi everyone and thank you all for the lovely replies. Its nice to have people out there who understand and are there for you. I am a bit of a worrier (hypochondriac!) about my health these days and sometimes i feel it would be good to be able to ask other people questions of how they are doing etc. xcathy

Jan 14, 2012 ChristineBat... 23 posts	Topic: General Discussion / Hi, new on here Hi Cathy, welcome! I've been type 1 diabetic for 33 years, and I'm 43. Good luck for 2012, and I hope you feel supported on here. Christine

Jan 14, 2012 marke 686 posts	Topic: General Discussion / Hi, new on here Hi cathy and welcome. If nothing else you are testing regularly and that's a big bonus. We are all bad from time to time no one is perfect but at least now you have the tools to improve things. As for the other nurses about time they listened and stopped preaching. In every job we all have new things to learn and never know it all even if we think we do.

Jan 14, 2012 marke 686 posts	Topic: Questions for HCPs / steroids and glucose management Simon made a very good point that I had forgotten about, which is surprising considering the circumstances. You need to be careful when you stop taking the steroids. They will taper them off slowly so that you body resumes production of 'natural' steroids. However my insulin requirements became a bit unpredictable for a week or two after I had finished the steroids completely. I had my only ever assisted hypo during this period. I was at work and apparently started behaving strangely then went to sleep at my desk. Sadly despite all my previous instructions to colleagues they called an ambulance. The operator told them to give me coca cola. I remember waking up and thinking oh there is an ambulance crew here, I wonder why. Oh sh*t it's for me !! I have been fine ever since.

Jan 14, 2012 Alan 49 284 posts	Topic: General Discussion / New Needles That sounds like rubbish to me - you're still going to need the same dosage whether you inject it deeper with the 8mm needles, or not so deep with the 4mm. Perhaps you should get your GP to explain it. I would recommend the shorter needles, though. I use 5mm needles and the actual injections are a lot more comfortable than with the 8mm ones.

Jan 14, 2012 Simon Heller 46 posts	Topic: Questions for HCPs / steroids and glucose management Marke is right. Everyone responds differently to steroids but since they are very effective at turning the body's fat and muscle stores into glucose (in the liver) they will make glucose go up in everyone. Just increasing bolus and corrective doses may well not work if the doses are large enough and then background insulin has to be increased to bring the fasting, i.e. starting glucose of the day down. Morning BI also needs increasing by and large as Marke indicates. You also need to remember that when the steroids are reduced and this is normally gradually, then doses should begin to be wound down within 24 hours of a dose reduction. It is frustrating that there is no std formula so the secret is applying DAFNE principles very precisely as well as seeking help from a local DAFNE educator or doc. Simon

Jan 14, 2012 CathySbd 7 posts	Topic: General Discussion / Hi, new on here Hi. Thought I'd introduce myself. Type 1 diabetic 39 years! Am 48 but don't look it!!!! Been on DAFNE about 5 years. HBA1c been 8.something for long time. Would like to get this lower. Trying to lose 30 lbs with Slimming World-am inclined to 'binge' hence probs getting HBA1c lower. Work parttime (26.5 hrs). Work in a hospital where other ppl in the department where I work (ie the nurses) are convinced I am a very bad diabetic because of how I eat, what I eat and when etc. i have tried to explain DAFNE but they all think it's some newfangled rubbish and not good for me. Their attitudes annoy me. Love the Dafne regime, it is the one thing that got me test my blood sugar regularly as pre-dafne I would go for 6 months or more without testing. I always had good intentions but never followed them. Have very supportive husband and 2 great kids age 20 and 14. Want 2012 the year i get fitter and healthier-and relax more!!! Xcathy

Jan 13, 2012 marke 686 posts	Topic: Questions for HCPs / steroids and glucose management I have experience but no simple solution. I have been on steriods a number of times and experienced insulin resistance as a result. The only solution I found was trial and error, however I also found that the larger the meal I ate, the harder it was to adjust for the resistance. It didn't seem to be linear i.e if I at 4 CP's and used a ratio of 2:1, if I ate 8 CP's then a 2:1 ratio was not enough. The only solution I found was to try and keep the CP's down and maybe eat more often and inject for each. Another important factor is to increase your BI accordingly as well. This will require acting like you are starting from scratch and try to get your BI right with carb free days. It won't 'fix' the issue but it will improve it by giving a better baseline to adjust the QA for.

Jan 13, 2012 LeonT 6 posts	Topic: General Discussion / Sensible drinkers need not apply... Thank you all. I think, as Alp147 said, it'll probably take a bit of trial and error. It's interesting to see that the dosage levels vary so much between different people. I'm going to have another look at the DAFNE handbook because, to be honest, the alcohol section confused me when we went through it on the course. I sort of like the idea of injecting throughout a "session" though - who knows, it might inadvertently keep me sober(ish) lol!

Jan 13, 2012 DRS 6 posts	Topic: General Discussion / New Needles I currently use 8mm needles for my insulin injections. My GP's surgery have written recommending switching to 4mm needles which they say may help to reduce the amount of insulin I need to take. Does this sound right?

Jan 13, 2012 alp147 4 posts	Topic: General Discussion / Sensible drinkers need not apply... When i drink i tend to stick to spirits and diet mixer, so i dont have any insulin for that. If i drink cocktails i just count the juice as i would a juice drink normally, i go by say for every 100mls i take 1 unit and jab as a i go along. And i too have something to eat at the end of the night which i dont count. I test my bg when i get in, unless it is rediculously high i leave it as it will drop =] lots of trial and error though!

Jan 13, 2012 ketostix pla... 25 posts	Topic: General Discussion / Sensible drinkers need not apply... Hi LeonT, Im not a massive drinker as not very good at it lol, however will occasionaly go on a massive adhoc session. The way I tend to do it which works well for me apart from the hangover, is first pint dont count. Then after every two pints I do 1 unit QA, however I tend to keep a mental count of pints and do an injection after four pints as tend to inject to often for my liking if on a mission with mates. I dont count shots or spirits if having a break from lager, apart from if mixed with OJ but I only drink diet coke with spirits. The important rule I always follow is on way home have kebab or burger and chips but dont count them, as my blood glucose will crash during the night. I have to keep a close eye on my levels the following day, but tend to be in good range. I remember on Dafne course they said that alchol is a bit of a grey area but there are details in the training guide if I remember correctly, but you need to find what works for you. enjoy yourself and remember its only one day, so you will get back into a routine after the madness which we are allowed!!!

Jan 13, 2012 SimonC 78 posts	Topic: General Discussion / Sensible drinkers need not apply... I have had type for 22 years - almost to the day, and of course I have never strayed of the virtuous path, but when no one is looking I'm may have the odd pint or three. I used to deal with it by having extra the day after, but always remembering that you can have sudden drops due to the effect of alcohol, however, I now try to l add a small dose of QA as I go along, which is much better, for me, but I don't always remember. It is always useful to take into account what it is you are drinking, for pints, I would have a shot of 3 units per pint, but if drinking wine I wouldn't have any. For me, it is easier to jab as I go along.

Jan 13, 2012 LeonT 6 posts	Topic: General Discussion / Sensible drinkers need not apply... Ok, so I've had type one for yearssss (21) and graduated from DAFNE earlier this year. Now, I've got quite a few stag weekends comIng up and I was wondering the best way of dealing with drunken nights out. The delegates on my DAFNE course were all "perfect" - nobody drank more than 2 pints a year ;o) - but I'm a tad different lol. So, how do you deal with boozey sessions? Do you attempt to inject as you go along, or do you leave it until the next morning when you've sobered up sufficiently? Alternatively, do you just abstain on the grounds that you have Type 1 diabetes?

Jan 13, 2012 LeonT 6 posts	Topic: General Discussion / App developments Rapidcalc (iphone app) does something similar although it doesnt take into account DAFNE principles.

Jan 13, 2012 mum2westiesGill 502 posts	Topic: General Discussion / Exciting news............ novorapidboi26 said: Confirmed a girl...................... So a wee boy and a wee girl, the perfect family.................. I'm very happy for you & your wife and as you say it's the perfect wee family. Gill

Jan 13, 2012 Chchch 17 posts	Topic: Carbohydrate Counting / Counting veg It's funny what you say Helen about a carb free day being a no food day - I'm reading a book at the moment (forgive me, can't remember the name, but it's to do with success on a pump- highly recommended) and he says to test basal you should eat nothing apart from a small (small was in bold) amount of cheese or nuts. This is contrary to Dafne obv, which says you could have meat, eggs, salad, etc. I'll be testing my basal today so will only be having the little bit of cheese - I'll let you know how I get on. I'll be delirious with hunger! Sorry to hear you have such a nightmare with your control - it is in my experience an incredibly frustrating condition. I always think that if I didn't have diabetes I don't know what I'd do with my time!

Jan 13, 2012 Aarti 4 posts	Topic: Questions for HCPs / steroids and glucose management I have a patient who has to have steroids post chemotherapy which is making her blood sugars go extremely high whilst on the steroids. She is increasing her ratio 4-fold but still not managing glucose levels. Has anyone got any experience in dealing with glucose management whilst on steroids?

Jan 13, 2012 HelenP 218 posts	Topic: General Discussion / Street Food I am not so sure the pump is more discreet. Every time I eat I do a blood test, drag out the pump enter the carbs and the Bg count up the units etc and press the button. It certainly takes longer than just doing a mental calculation and winding it up. In my experience more people are familiar with insulin injections but the sight of a pump and the plastic tube disappearing into you somewhere is cause for curiosity. If I cop a stare I simple say "it keeps me alive!" Some ask what it is but most are embarrassed! In Australia we don't have multiple layers of clothes issue to deal with, My theory is if you do it quickly then less people notice. Helen

Jan 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / Exciting news............ Confirmed a girl...................... So a wee boy and a wee girl, the perfect family..................

Jan 13, 2012 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Counting veg Thanks a lot............it was confirmed last night as a girl with a 4d scan, really excited now.............. Thats a lot of corrections......do you think it may be connected with menstrual behavior, obviously I am not experienced with this, but the time scales you are describing seem to be similar........... Your need to count all items on plate can be explained by the pump, due to lack of a slower acting insulin to mop up the fats and proteins............ How long have you been pumping........

Jan 13, 2012 HelenP 218 posts	Topic: Carbohydrate Counting / Counting veg Hi Novorapidboi! When on MDIs I was on 90+ a day with 68 being Lantus (2x34 6am/6pm) and the rest (30 odd) was 10CPs at about 2.7 units per CP. On a pump now and on a really good day the basals are 38.8 a day and the rest (still 100g of CHO) make up the 25units. The pump has been good BUT I still experience days (or rather consecutive days) where the corrections can add 30 units to the total. I am currently being investigated for chronic low grade infection in an attempt to find a cause for the four-five day periods (about every two-three weeks) where the BGs are a nightmare. Long way from it just ticking over! I try to lead a very routine life as I find the diabetes more manageable Congratulations on the baby news. Helen

Jan 13, 2012 novorapidboi26 1,819 posts	Topic: General Discussion / SE KENT PCT DAFNE scrapped Thats rubbish................ Do you think staff could still be trained up in DAFNE in order to support those graduates that remain? marke, I hope your questions will get folk talking...........

Jan 13, 2012 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Counting veg I am 70-120 units a day, 70 being my BI dose................so millions........... I assume your BI dose is nearer the 55 mark?