Recent Posts - DAFNE Online

Nov 4, 2011

Ahmentep 99 posts

Topic: General Discussion / How do i get on a DAFNE course

I second that rosscortb.

Nov 3, 2011

DavidJ 23 posts

Topic: Questions for HCPs / Local Authority Changes

PALS have replied and this is their response
It is true that we have across the whole PCT looked to reduce the amount of BGTS we prescribe. We were one of the highest prescribers of BGTS in the country, literally in the top 3 nationally. We went about addressing this in a number of ways. We adopted a formulary so that whilst prescribers were able to prescribe whatever strip they wanted we did have a more limited recommendation of choices of strips. Again historically we prescribed every single strip that was on the market.
Of course the manufacturers didnâ€™t help with any of this dumping free meters in as many paces as possible so patients ended up with two or even three different meters all of which needed different strips fuelling the problem further and not adding anything to clinical well being of patients. In fact despite being a high spending PCT on BGTS (and diabetes generally) we only had low average outcomes.
All this is a bit of background really. The level of prescribing of strips has reduced to nearer to SHA levels however we do want patients have the strips they clinically need. To this end at the same time as putting the formulary in place we did issue expected levels of strip usage for different types of diabetic. So for example Type 1s , as per this patient, would be expected to test more frequently compared to Type 2s.
If you let me have the patient & practice details Iâ€™ll make sure the practice has a copy sent again of the expected frequency of testing. This should help ensure that the patient is able to obtain the number of strips needed for his recommended testing regimen.

Nov 2, 2011

HelenP 218 posts

Topic: General Discussion / Meters

My 2 cents worth!

I have two Optium Xceeds. Great to use the same strips in both my meters. Handy to have a spare when travelling and only needing the same strips etc. Keep one beside the bed which I bring downstairs in the morning and have another in my bag which I take with me in the car. Also if I get the occasional bizarre reading can check on the other. Advantage in Australia is that we can buy as many strips as we like at about $AUD16/hundred (subsidized by govt). Sometimes I use 12+ a day!
The Optium tests ketones but I find I rarely get sick enough to throw ketones and the strips go out of date before I have used the pack so have to buy a new box.

I also have a ONETOUCH Verio (promotional) but found it a hassle to have to keep two different lots of strips. It has more functions.

Helen

Nov 1, 2011

rosscortb 2 posts

Topic: General Discussion / How do i get on a DAFNE course

Quick advice, if you get the chance to do dafne- do it...can't stress this enough

Nov 1, 2011

rosscortb 2 posts

Topic: General Discussion / Meters

I did use the nano for a few yrs but now changed to a Glucmen lxplus. Reason was the nano over time just kept giving me to many E7 error messages which is a fault with the machine. Accu chek are aware of this when I phoned them and they will post you another one but had enough of the nano. See how you get on though. Ross

Nov 1, 2011

DavidJ 23 posts

Topic: Questions for HCPs / Local Authority Changes

Hi Guys,
I had this problem 2 years ago when I was only issued 100 strips/ month. Last month, I discovered my test strips had been removed completely from my repeat. I contacted PALS a week ago and so far they haven't replied. When I queried the removal at the reception desk I was given 2 options. First I could write my request for test strips on my next repeat and my GP would decide whether or not I could have any. Second, I could appeal directly by making an appointment with my GP in order to get the test strips re-instated. Sad

I have checked the averages on my meter and I used 150 during the last 30 days which I don't think is excessive at all.

Nov 1, 2011

leonard.8 7 posts

Topic: General Discussion / Insulin new user any tips welcome

Thank you Christine, what you say makes sense and gives me some things to try. Will let you know how I get on

Nov 1, 2011

ChristineBat... 23 posts

Topic: General Discussion / Insulin new user any tips welcome

PS I have shared my diary with you if you want to see how I do things and how I work things out....you may be surprised at my results? (top right hand tool box....)

Nov 1, 2011

ChristineBat... 23 posts

Topic: General Discussion / Insulin new user any tips welcome

Considering you have little support I think you are doing very well. I have been diabetic for 32 years since the age of 10 and have just done a DAFNE course. First of all, your results are VERY good, believe me. Stop testing so much,ONLY test before each meal, or, if you feel hypo, or you are going to drive. (you must be 5mmol to drive) STOP testing and having insulin between meals, you will never get a pattern. Yesterday mornings insulin worked beautifully. You must work out how many units of quick acting insulin you need to match 10 carbohydrates or 1CP as Dafne says.
Yesterday morning for breakfast you had 10 units for 2cps/20 carbohydrates, which saw you through to lunch time beautifully, so that ratio is 5:1 or 5 units per 10 carbohydrates/ 1 cp.
I am not sure what ratio you used for lunch, 9 cps and 12 units, however, make it easier try 1.5 units of insulin per 1 cp. In which case yesterday for your 9 cps you could have had 13 units of insulin, which may have given you a slightly lower evening meal result. Last night you used a 2 unit per 1cp ratio, which again gave you a good result at 20.30, but I wonder what you were at bed time?

Dafne says to start on a 1 unit per 1 cp ratio for meals, and increase half a unit at a time, and WAIT for patterns, suffer when you feel high, you must because if you have a shot of insulin to correct a high you will never understand what's going on. If you are unsure about which insulin needs changing, you can have a carbohydrate free luch for example (so have no quick acting insulin) and see if by your evening meal you have remained the same, if you have remained on target, your backgound insulin is fine and start working on fine tuning your quick acting.

I have had huge problems waiting for patterns as I had been in the habit of having 'correctors' between meals to bring my glucose down.

Good luck, you are doing very well and I wish I could get my results as good as yours!

Nov 1, 2011

leonard.8 7 posts

Topic: General Discussion / Insulin new user any tips welcome

I was discharged from Hope hospital Salford about 3 weeks ago, went in with a kidney stone and came out type 2 diabetic.
Whilst in there the diabetic nurse saw me and I chose to use insulin rather than try tablets because of the control it gives you.
I came home from Hospital with a pen of Levemir and a pen of Novarapid and left to my own devices told to adjust my doses through trial and error and to see my G.P. for more supplies.
However since my discharge from Salford I have had no follow up care as I live in Wigan, received couple of calls from the Salford diabetic nurse to see how I am going on and she thinks I am doing fine. I however think things could be a lot better.
Both myself and the nurse from Salford have rang the Wigan diabetic team phone never been answered and we have both left messages which have not been replied to as yet. If this is the level of care I can expect rom the Wigan team I feel I may as well forget about them and get busy teaching myself. I have managed to get an appointment with the pactice nurse at my G.P. but that's not until 10th November.
I am using Levemir and Novarapid.
Any advice from those of you with more experience and knowledge than me would be appreciated

Oct 31, 2011

marke 686 posts

Topic: General Discussion / Pump Users

I wouldn't worry too much, the end of the article says he wrote software for Meditronic so he was party to information on exactly how the devices communicate. This is not your 'average' hacker. It is also highly unlikely someone would spend the amount of time necessary to hack into the devices and reprogram them. There is no financial gain to be had from doing it which is the biggest reason by far for hacking. Its not comparible with sabotaging a saline drip that requires no great effort just access.
Unfortunately there are always 'proof of concepts' like this being reported and the press often distort what is being said into a more 'interesting' story. Whilst there is ALWAYS a risk with any wireless device, you have to weigh up the benefits and the risks. The benefits are potentially high and the risks are very low.

Oct 31, 2011

ChristineBat... 23 posts

Topic: General Discussion / Hi Everyone, new member

Hi Charlie, nice to have another new member. Like Roger, I was diagnosed in 1979, at the age of 10years old! (32 years ago).... I'm almost the same age as you Charlie. Being diabetic hasn't stopped me doing anything in life, I've lived and travelled overseas and also had a baby, who, thank the Lord at the moment is NOT diabetic. Stay positive, you will have days when you want to bang your head of a brick wall but every day you will learn and just being engaged in your condition is a huge step in the right direction to eliminating complications. I haven't always been so careful, I was a complete rebel during my teenage years. However, most of the time since then I have done my best, and after 32 years I have no complications yet....Hang on in there and get support from fellow diabetics...we all understand eachother! Good luck

Oct 31, 2011

Alan 49 284 posts

Topic: General Discussion / Pump Users

Who knows? Same reason as someone putting insulin in a hospital patient's saline drips, I suppose.

The man who created this device works for the IT security firm Macafee and had no intention of using it. I suppose it's a good thing that he has flagged this up, before some nutter gets hold of one. Let's hope Medtronic can fix this potential problem quickly.

Oct 31, 2011

Ahmentep 99 posts

Topic: General Discussion / Hi Everyone, new member

Hi Charlie,

Welcome to the club!

I've been a type 1 diabetic since 1978. It has not interfered with my life in any significant way. I have always tried to follow 'the rules' whatever they may have been at the time. To try to ignore them is stupidity in my opinion as it can only lead to disability and death. I have been following the DAFNE rules for about 18 months now and they have proved an enormous improvement on the earlier regimen. It allows much more flexibilty in your lifestyle so that the fact that you are diabetic can go almost unnoticed by others. Of course, those with whom you are in regular contact, friends, colleagues, family, should be made aware of your condition so that they can recognise the symptoms if you are having a problem and know what to do about it. If you are having a hypo you may not be able to tell them, and may resist their efforts to help. They need to know that they should continue those efforts no matter what you say at the time. Another problem is that people unaware of the condition can often assume that you are drunk and just leave you to 'sleep it off'. This is the worst thing they could do of course.
Don't be alarmed by this. If you maintain good control it may never happen; even if it does, it is not usually as bad as it sounds.
I have had quite a lot of bad hypos over the past thirty years, despite my best efforts, but I'm still here, everything is still present and still works. I think that if you are going to have something, diabetes is one of the best things to have.
Don't forget to notify the DVLA and your insurance company.

Kind regards,
Roger

Oct 31, 2011

leonard.8 7 posts

Topic: General Discussion / Hi Everyone, new member

Just wanted to introduce myself and thank you all, as the information I have learned from here is a great help.

I am a 41 year old male newly diagnosed type 2 about a month ago, went into hospital about a month ago kith a kidney stone and came out with diabetes. "Just my luck lol".

To say I was devastated at first finding out was an understatment it made me feel suicidal, not something I would ever follow through though. My mum and younger brother have type 2 but neither look after themselves, i on the other hand have always been very active and currently go to gym 3 times a week play football and squash on a regular basis and try to eat healthiy, never smoked drank or done drugs. I felt guilty that I have had 2 children whom my genetics have put at risk of developing this now.

I was given the option by the diabetic nurse I saw in hospital to try either tablets or insulin and decided on the insulin as it gives me more control.

With the passing of a little time I am a little more optimistic about the future and it seems that with a little thought and planning life might not be as bleak as I first thought.

I don't have the same control of my condition as some of you yet but I hope to get there soon it's been a steep learning curve with much yet to learn

Once again thanks to all who go to the trouble to help others on forums such as this.

Charlie

Oct 31, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Pump Users

Very real risks, but why would someone do it...........

Oct 31, 2011

Alan 49 284 posts

Topic: General Discussion / Pump Users

I don't want to spread alarm, but a fellow diabetic sent me this:

http://www.theregister.co.uk/2011/10/27/fatal_insulin_pump_attack/

Oct 28, 2011

KeithCl 43 posts

Topic: General Discussion / Android App

I'll fix this in the next few days, but at the moment if you input a corrected value such as "+4" then the app crashes when you try to upload the entry to the server. Inputting "0+4" instead will work and so is the work-around for now.

Thanks to Simon for tracking down the issue in the server logs.

Keith

Nov 4, 2011 Ahmentep 99 posts	Topic: General Discussion / How do i get on a DAFNE course I second that rosscortb.

Nov 3, 2011 DavidJ 23 posts	Topic: Questions for HCPs / Local Authority Changes PALS have replied and this is their response It is true that we have across the whole PCT looked to reduce the amount of BGTS we prescribe. We were one of the highest prescribers of BGTS in the country, literally in the top 3 nationally. We went about addressing this in a number of ways. We adopted a formulary so that whilst prescribers were able to prescribe whatever strip they wanted we did have a more limited recommendation of choices of strips. Again historically we prescribed every single strip that was on the market. Of course the manufacturers didnâ€™t help with any of this dumping free meters in as many paces as possible so patients ended up with two or even three different meters all of which needed different strips fuelling the problem further and not adding anything to clinical well being of patients. In fact despite being a high spending PCT on BGTS (and diabetes generally) we only had low average outcomes. All this is a bit of background really. The level of prescribing of strips has reduced to nearer to SHA levels however we do want patients have the strips they clinically need. To this end at the same time as putting the formulary in place we did issue expected levels of strip usage for different types of diabetic. So for example Type 1s , as per this patient, would be expected to test more frequently compared to Type 2s. If you let me have the patient & practice details Iâ€™ll make sure the practice has a copy sent again of the expected frequency of testing. This should help ensure that the patient is able to obtain the number of strips needed for his recommended testing regimen.

Nov 2, 2011 HelenP 218 posts	Topic: General Discussion / Meters My 2 cents worth! I have two Optium Xceeds. Great to use the same strips in both my meters. Handy to have a spare when travelling and only needing the same strips etc. Keep one beside the bed which I bring downstairs in the morning and have another in my bag which I take with me in the car. Also if I get the occasional bizarre reading can check on the other. Advantage in Australia is that we can buy as many strips as we like at about $AUD16/hundred (subsidized by govt). Sometimes I use 12+ a day! The Optium tests ketones but I find I rarely get sick enough to throw ketones and the strips go out of date before I have used the pack so have to buy a new box. I also have a ONETOUCH Verio (promotional) but found it a hassle to have to keep two different lots of strips. It has more functions. Helen

Nov 1, 2011 rosscortb 2 posts	Topic: General Discussion / How do i get on a DAFNE course Quick advice, if you get the chance to do dafne- do it...can't stress this enough

Nov 1, 2011 rosscortb 2 posts	Topic: General Discussion / Meters I did use the nano for a few yrs but now changed to a Glucmen lxplus. Reason was the nano over time just kept giving me to many E7 error messages which is a fault with the machine. Accu chek are aware of this when I phoned them and they will post you another one but had enough of the nano. See how you get on though. Ross

Nov 1, 2011 DavidJ 23 posts	Topic: Questions for HCPs / Local Authority Changes Hi Guys, I had this problem 2 years ago when I was only issued 100 strips/ month. Last month, I discovered my test strips had been removed completely from my repeat. I contacted PALS a week ago and so far they haven't replied. When I queried the removal at the reception desk I was given 2 options. First I could write my request for test strips on my next repeat and my GP would decide whether or not I could have any. Second, I could appeal directly by making an appointment with my GP in order to get the test strips re-instated. I have checked the averages on my meter and I used 150 during the last 30 days which I don't think is excessive at all.

Nov 1, 2011 leonard.8 7 posts	Topic: General Discussion / Insulin new user any tips welcome Thank you Christine, what you say makes sense and gives me some things to try. Will let you know how I get on

Nov 1, 2011 ChristineBat... 23 posts	Topic: General Discussion / Insulin new user any tips welcome PS I have shared my diary with you if you want to see how I do things and how I work things out....you may be surprised at my results? (top right hand tool box....)

Nov 1, 2011 ChristineBat... 23 posts	Topic: General Discussion / Insulin new user any tips welcome Considering you have little support I think you are doing very well. I have been diabetic for 32 years since the age of 10 and have just done a DAFNE course. First of all, your results are VERY good, believe me. Stop testing so much,ONLY test before each meal, or, if you feel hypo, or you are going to drive. (you must be 5mmol to drive) STOP testing and having insulin between meals, you will never get a pattern. Yesterday mornings insulin worked beautifully. You must work out how many units of quick acting insulin you need to match 10 carbohydrates or 1CP as Dafne says. Yesterday morning for breakfast you had 10 units for 2cps/20 carbohydrates, which saw you through to lunch time beautifully, so that ratio is 5:1 or 5 units per 10 carbohydrates/ 1 cp. I am not sure what ratio you used for lunch, 9 cps and 12 units, however, make it easier try 1.5 units of insulin per 1 cp. In which case yesterday for your 9 cps you could have had 13 units of insulin, which may have given you a slightly lower evening meal result. Last night you used a 2 unit per 1cp ratio, which again gave you a good result at 20.30, but I wonder what you were at bed time? Dafne says to start on a 1 unit per 1 cp ratio for meals, and increase half a unit at a time, and WAIT for patterns, suffer when you feel high, you must because if you have a shot of insulin to correct a high you will never understand what's going on. If you are unsure about which insulin needs changing, you can have a carbohydrate free luch for example (so have no quick acting insulin) and see if by your evening meal you have remained the same, if you have remained on target, your backgound insulin is fine and start working on fine tuning your quick acting. I have had huge problems waiting for patterns as I had been in the habit of having 'correctors' between meals to bring my glucose down. Good luck, you are doing very well and I wish I could get my results as good as yours!

Nov 1, 2011 leonard.8 7 posts	Topic: General Discussion / Insulin new user any tips welcome I was discharged from Hope hospital Salford about 3 weeks ago, went in with a kidney stone and came out type 2 diabetic. Whilst in there the diabetic nurse saw me and I chose to use insulin rather than try tablets because of the control it gives you. I came home from Hospital with a pen of Levemir and a pen of Novarapid and left to my own devices told to adjust my doses through trial and error and to see my G.P. for more supplies. However since my discharge from Salford I have had no follow up care as I live in Wigan, received couple of calls from the Salford diabetic nurse to see how I am going on and she thinks I am doing fine. I however think things could be a lot better. Both myself and the nurse from Salford have rang the Wigan diabetic team phone never been answered and we have both left messages which have not been replied to as yet. If this is the level of care I can expect rom the Wigan team I feel I may as well forget about them and get busy teaching myself. I have managed to get an appointment with the pactice nurse at my G.P. but that's not until 10th November. I am using Levemir and Novarapid. Any advice from those of you with more experience and knowledge than me would be appreciated

Oct 31, 2011 marke 686 posts	Topic: General Discussion / Pump Users I wouldn't worry too much, the end of the article says he wrote software for Meditronic so he was party to information on exactly how the devices communicate. This is not your 'average' hacker. It is also highly unlikely someone would spend the amount of time necessary to hack into the devices and reprogram them. There is no financial gain to be had from doing it which is the biggest reason by far for hacking. Its not comparible with sabotaging a saline drip that requires no great effort just access. Unfortunately there are always 'proof of concepts' like this being reported and the press often distort what is being said into a more 'interesting' story. Whilst there is ALWAYS a risk with any wireless device, you have to weigh up the benefits and the risks. The benefits are potentially high and the risks are very low.

Oct 31, 2011 ChristineBat... 23 posts	Topic: General Discussion / Hi Everyone, new member Hi Charlie, nice to have another new member. Like Roger, I was diagnosed in 1979, at the age of 10years old! (32 years ago).... I'm almost the same age as you Charlie. Being diabetic hasn't stopped me doing anything in life, I've lived and travelled overseas and also had a baby, who, thank the Lord at the moment is NOT diabetic. Stay positive, you will have days when you want to bang your head of a brick wall but every day you will learn and just being engaged in your condition is a huge step in the right direction to eliminating complications. I haven't always been so careful, I was a complete rebel during my teenage years. However, most of the time since then I have done my best, and after 32 years I have no complications yet....Hang on in there and get support from fellow diabetics...we all understand eachother! Good luck

Oct 31, 2011 Alan 49 284 posts	Topic: General Discussion / Pump Users Who knows? Same reason as someone putting insulin in a hospital patient's saline drips, I suppose. The man who created this device works for the IT security firm Macafee and had no intention of using it. I suppose it's a good thing that he has flagged this up, before some nutter gets hold of one. Let's hope Medtronic can fix this potential problem quickly.

Oct 31, 2011 Ahmentep 99 posts	Topic: General Discussion / Hi Everyone, new member Hi Charlie, Welcome to the club! I've been a type 1 diabetic since 1978. It has not interfered with my life in any significant way. I have always tried to follow 'the rules' whatever they may have been at the time. To try to ignore them is stupidity in my opinion as it can only lead to disability and death. I have been following the DAFNE rules for about 18 months now and they have proved an enormous improvement on the earlier regimen. It allows much more flexibilty in your lifestyle so that the fact that you are diabetic can go almost unnoticed by others. Of course, those with whom you are in regular contact, friends, colleagues, family, should be made aware of your condition so that they can recognise the symptoms if you are having a problem and know what to do about it. If you are having a hypo you may not be able to tell them, and may resist their efforts to help. They need to know that they should continue those efforts no matter what you say at the time. Another problem is that people unaware of the condition can often assume that you are drunk and just leave you to 'sleep it off'. This is the worst thing they could do of course. Don't be alarmed by this. If you maintain good control it may never happen; even if it does, it is not usually as bad as it sounds. I have had quite a lot of bad hypos over the past thirty years, despite my best efforts, but I'm still here, everything is still present and still works. I think that if you are going to have something, diabetes is one of the best things to have. Don't forget to notify the DVLA and your insurance company. Kind regards, Roger

Oct 31, 2011 leonard.8 7 posts	Topic: General Discussion / Hi Everyone, new member Just wanted to introduce myself and thank you all, as the information I have learned from here is a great help. I am a 41 year old male newly diagnosed type 2 about a month ago, went into hospital about a month ago kith a kidney stone and came out with diabetes. "Just my luck lol". To say I was devastated at first finding out was an understatment it made me feel suicidal, not something I would ever follow through though. My mum and younger brother have type 2 but neither look after themselves, i on the other hand have always been very active and currently go to gym 3 times a week play football and squash on a regular basis and try to eat healthiy, never smoked drank or done drugs. I felt guilty that I have had 2 children whom my genetics have put at risk of developing this now. I was given the option by the diabetic nurse I saw in hospital to try either tablets or insulin and decided on the insulin as it gives me more control. With the passing of a little time I am a little more optimistic about the future and it seems that with a little thought and planning life might not be as bleak as I first thought. I don't have the same control of my condition as some of you yet but I hope to get there soon it's been a steep learning curve with much yet to learn Once again thanks to all who go to the trouble to help others on forums such as this. Charlie

Oct 31, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Pump Users Very real risks, but why would someone do it...........

Oct 31, 2011 Alan 49 284 posts	Topic: General Discussion / Pump Users I don't want to spread alarm, but a fellow diabetic sent me this: http://www.theregister.co.uk/2011/10/27/fatal_insulin_pump_attack/

Oct 28, 2011 KeithCl 43 posts	Topic: General Discussion / Android App I'll fix this in the next few days, but at the moment if you input a corrected value such as "+4" then the app crashes when you try to upload the entry to the server. Inputting "0+4" instead will work and so is the work-around for now. Thanks to Simon for tracking down the issue in the server logs. Keith