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Sep 6, 2011
MSW
2 posts
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Topic: General Discussion / Help! Ratios moving around very erratically I agree with what novorapidboi26 has said. I have also found that my ratios change over time for no apparent reason. As far as I can tell there is no harm in this as long as you adjust your insulin doses accordingly. Good luck with this. |
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Sep 6, 2011
swirlygirly
3 posts
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Topic: Questions for HCPs / Menstrual Cycle, BI Hi AntheaMay I ask which week you have sorted? I find the week during and just after menstruation the easiest. The week running up besides the REALLY bad PMT I find a struggle. I exercised this morning usually a locked down insulin to food ratio for me and I end my workout with a Glucose of 4.5, well today usual food usual dose but my Glucose went up instead of down and at the point in my routine where I check and would be at around 10 I was at 22.4...so I had an adjustment which I would normally never dare do during exercise if it was not the week before my period and I only gotmthem down to 17.3......It is like I am insulin sensitive for the majority of the time but the week before a period I lose all sensitivity and I would even go as far as saying I have quiet sever insulin resistance. Do you ,or anyone else for that matter know if this would be due to Estrogen dominance?????? I'm not that up on Cycle hormones.I do wonder if this is the case that progesterone supplemented would help to stabilise things for us???? I do know I need to see my GP about this because I have got to the stage where I feel Quiet poorly and run down the week before and my moods are terrible...then it's like I'm a new person when my period starts . It really is not just effecting my Diabetes it has a negative effect on mu life overall really. Thanks Anthea for bringing this up and thanks the DAFNE people for taking this on board. SG xx |
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Sep 6, 2011
Chris loughrey
21 posts
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Topic: General Discussion / Help! Ratios moving around very erratically
Thanks for the advice, funny how after 10 years there's always more to learn! I think I mostly need to beat the idea that "more insulin=bad", you get into a cycle of thinking toy should take as little as possible but there isn't really any logic behind it, I need as much as I need. And I figured my ratios were low anyway, with any luck having a pump ( when I reach the top of the list!) will be a big help too. Thanks again for your thoughts, it's been a great help. |
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Sep 6, 2011
Chris loughrey
21 posts
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Topic: General Discussion / Help! Ratios moving around very erratically
Thanks for the advice, funny how after 10 years there's always more to learn! I think I mostly need to beat the idea that "more insulin=bad", you get into a cycle of thinking toy should take as little as possible but there isn't really any logic behind it, I need as much as I need. And I figured my ratios were low anyway, with any luck having a pump ( when I reach the top of the list!) will be a big help too. Thanks again for your thoughts, it's been a great help. |
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Sep 6, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Help! Ratios moving around very erratically Is it possible with no obvious reasons, hell yeah, that's diabetes at it s best............As you are very active I would imagine that your insulin requirements would remain on the low side..........your ratios previously in my opinion were on the very low side, any lower and you would of needed a pump...........so although it may be discouraging to realize you need more, its still is not that much..........I am not very active, I do moderate exercise twice a week, but my morning ratio is still 3:1............  ..........This could just be a phase, or a sign of illness................as ling as you keep active and remember to make sure your getting a consistent pattern of results before making changes all will be well....... If it is the BI that's good, as the livers output of glucose is not effected by activity levels as far as I am aware, so the liver might just be producing more glucose, making you think you need more units for each carb portion......... good luck and keep us posted............. |
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Sep 6, 2011
Chris loughrey
21 posts
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Topic: General Discussion / Help! Ratios moving around very erratically I've been diagnosed 10 years.first time I've had such a fast change in ratios though.I was using maximum of 1.25:1 previously and now I'm just heading upwards at all times of the day!I'm testing BI today but I'm fairly sure it's the ratio needing to go 1.5:1 or more. Just having trouble with the idea of more & more QA being needed. I'm very active and exercise 4-5 days per week without fail(I'm a fitness trainer and sports coach) that's why I'm having trouble understanding the rapid decrease in sensitivities. If anything it should be the opposite. A week or 2 ago I was using 4-5 units at lunch (0.75:1) and now that's seemed to double, is that possible with no obvious reason? |
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Sep 6, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / dafne app/carb calculator for Blackberry phones I believe there are some apps on there for this purpose, a quick search for diabetes may give you some results...............good luck............ |
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Sep 6, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Help! Ratios moving around very erratically The background could be out, only way to check is with carb free meals, or missing a meal, which can much more difficult........But it could be the ratios..............sometimes you just start to need more, to help keep the ratios down being active helps a it decreases insulin sensitivity......... How long have you been diagnosed..........? |
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Sep 6, 2011
Lizzie
87 posts
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Thanks Marke. I am on a single dose of Lantus which I take before bed. |
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Sep 5, 2011
Geofftrez
22 posts
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Topic: DAFNE Online Mobile / Feedback from Android beta testing On reflection I'm unsure that my first suggestion is correct. The QA:BG ratio is used for corrections. The CP:QA ratio is a measure of insulin resistance. I don't think CP:BG is actually needed. |
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Sep 5, 2011
marke
681 posts
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Topic: DAFNE Online Mobile / Feedback from Android beta testing I agree with Geoff, although I do understand the concept of litigation I hadn't realised that Simon had mentioned it himself. I believe the answer is to add a big disclaimer to the app, making it clear that it does NOT provide medical advice and is used at the users risk. We are not medic's and the app cannot and should not makeclaims or give the impression that it does provide medical information. |
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Sep 5, 2011
marke
681 posts
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Topic: General Discussion / Can someone please remind me... Well the first step is to work on your BI as this is the key to the rest of it. You don't say if you are on a single dose or split dose, the principle is the same for both however the way to check is slightly different. The theory is if you don't eat and just use BI your BG should stay roughly the same. So of you inject before bed and test then don't eat again until morning your BI should be pretty much the same. If you are on a split dose and inject BI in the morning and skip lunch again your BI should be roughly the same before dinner. Of course its not always as simple as this but that is the basic principle.If your BI is right and stable then your QA should only be needed to work on the food you eat. Therefore you should be able to inject the QA to match your CP's, if this doesn't have the effect expected then you increase the ratio of QA to CP's. However you need to base this decision on more than one meal, it needs to be done over a period of days to remove one-offs. Also remember that ratio's may vary at different times of day e.g a lot of people need a higher ratio in the morning to the mid-day or dinner ratio. Hope that all makes sense, it is in the online handbook somewhere, I probably should know having just converted it to the online version 
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Sep 5, 2011
marke
681 posts
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Topic: General Discussion / DAFNE Myths
Sadly this is true in a lot of centres, mainly due to lack of funding for follow-up sessions. The DAFNE programme management is aware that this is an issue but there is no easy answer. I will raise the point with the DAFNE User Group though as it is an area that i think they ( myself included) should be looking into. I agree a central update mechanism would be a good idea and DAFNEOnline would be more than happy to help with this if we are asked too, however we can only publish the information we are provided by the DAFNE programme. I suspect the answer will be that DAFNEOnline too strongly favours those with Internet access and the interest to sign-up, it is however at least a quick and easy way of getting information to Graduates. It should NOT be used as a replacement for proper DAFNE follow-on meetings however in the abscence of funding anything is better than nothing and it is at least one way of getting information to graduates. |
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Sep 5, 2011
MSW
2 posts
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Topic: General Discussion / Help! Ratios moving around very erratically
Have your exercise levels changed? I find that if I take less exercise over a period of a few days, my ratios go up and conversely, more exercise means lower ratios. Sometimes I find that ratios change without any explanation and it is just a question of adjusting ratios accordingly. |
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Sep 5, 2011
Athena
52 posts
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Topic: General Discussion / DAFNE Myths I agree with Lizzie in that it would be great if we could get updates on what is new. Things have changed with the DAFNE course over time and the educators get together once in a while and receive more updated info. My hospital is good at having DAFNE mornings which are basically a refresher of the course, but we did get told one time of a new thing. think it was the 12 hour split doesn't work for everyone thing. Anyway, it would be great if this new information was available to us all after each meeting. An alert could go out via this site and we could find out what the latest updates are. Otherwise a lot of us are never going to know the new information until a new hand book comes out and we can view it. |
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Sep 5, 2011
Athena
52 posts
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Topic: Questions for HCPs / Menstrual Cycle, BI Hi Swirly girly, thanks for your post. I too am delighted that this is going to be part of future courses. It would be really helpful for people to learn how to cope with this . One girl mentioned it on my course too but nothing was said about it. It is fab that the educators have decided to include it in the next course handbook and in future courses. good luick with your bg's. We all know it is really difficult to track. I have at leaset got one week sorted although stilln ot got definitive doses for the rest of the month. Will have secveral BI's by the time I have tried and tested different ones at different times. take care. |
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Sep 5, 2011
graham burton
14 posts
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Topic: General Discussion / dafne app/carb calculator for Blackberry phones i am looking for an app where i can record the information on to my blackberry like in the dafne diarydoes anyone know of anything. |
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Sep 5, 2011
Chris loughrey
21 posts
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Topic: General Discussion / Help! Ratios moving around very erratically Hi there,Having problems with my midday thru afternoon readings. My ratios just seem to keep going up and nothing is working.3 weeks ago it was around 0.75:1 and I'm now up on 1.25:1 and that isn't working either (even tho yesterday it did)I'm very confident that my carb counts are correct and my BI insulin is also good. any advice would be appreciated, do I just keep moving the ratio up until it's right? Or is it the BI? Seems every time I increase the QA ratio at 12pm it is hit and miss (more miss) so could the levemir dose at 8am be too small, even though its probably only kicking in at 9:30-10am? Frustrated! 
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Sep 5, 2011
Chris loughrey
21 posts
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Topic: Questions for HCPs / Help!! Hi there,Having problems with my midday thru afternoon readings. My ratios just seem to keep going up and nothing is working.3 weeks ago it was around 0.75:1 and I'm now up on 1.25:1 and that isn't working either (even tho yesterday it did)I'm very confident that my carb counts are correct and my BI insulin is also good. any advice would be appreciated, do I just keep moving the ratio up until it's right? |
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Sep 5, 2011
Lizzie
87 posts
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Topic: General Discussion / Can someone please remind me... how to work out if your ratios and BI are correct? My DAFNE course was several years ago and I can't remember and am in a right pickle trying to correct highs and lows (mostly highs).Thanks |
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Sep 5, 2011
Lizzie
87 posts
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Topic: General Discussion / DAFNE Myths Ok so the consensus seems to be that these things are not actually total myths or misconceptions since they differ for each person. If this is the case then I wish medical professionals would teach it that way rather than saying first of all "this is *always* the case" and later on "whoops in fact it is a myth and it *never* happens".It might be helpful if people who had gone through DAFNE maybe 5 years ago or something like that could be automatically recalled. My clinic was OK on arranging updates directly after the course but these seem to have dried up. And even when offered, the number of places available was inadequate, they were snapped up almost immediately and by the time I had organised a day's leave and my manager got back to me approving it, there were no spaces left. And since it was one day only, you could only choose 2 sessions to attend so you did not get a thorough update on everything that had changed. I realise updates and suchlike are the responsibility of the individual clinic however it would be nice if there was some sort of central DAFNE mechanism to keep us updated if our own clinic does not do so. I just feel graduates of DAFNE should be kept updated with the latest knowledge and way of teaching the course. It is all very well going to it but after a few years the knowledge is old and begins to fade and is changed and updated and you are out of touch. |
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Sep 5, 2011
Geofftrez
22 posts
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Topic: DAFNE Online Mobile / Feedback from Android beta testing Suggestions for Simon:1. add data fields in the targets section (for each mealtime/incident) for ratio CP:BG default 1:2.5 QA:BG default 1:2.5. I would have thought that these field together with the QA:CP ratio should cover most of the user population. 2. Ensure that the autocalc result has to be overtyped and defaults to a null value otherwise. 3. Incorporate a standard disclaimer for the autocalc function which is triggered if the autocal setting is chosen with a tick box for the user to acknowledge "autocalc is a suggestion only based on the data values you have inserted in the targets section and is not a medical recommendation. The autocalc may not function correctly for every user and is intended simply as an approximate check sum to compare against your own calculated insulin dose. If you chose to rely on this autocalc function then you do so against our recommendation and at your own risk etc etc" |
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Sep 5, 2011
Simon
578 posts
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Topic: DAFNE Online Mobile / Feedback from Android beta testing
Litigation = getting sued. I'm not normally one for saying no to new feature requests as I want the app/site to be the best they can be. That said, in this age of 'no win no fee' PI claims, and the fact that we are a very small group of people working on this without profit in our spare time, I don't want to set us up as a target of a lawsuit. Having said that, if we could come up with a solution which implemented this function, and protected us from getting sued, I'd get working on it straight away. So if anyone has ideas on how to protect us and add this feature then let me know 
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I have experimented with this just to prove it is my cycle and have stuck religiously to the same foods day in day out ,with the same level of exercise for a couple of Months (gosh that was boring), to try and limit variables. But my control is so obviously effected by my Monthly cycle, in fact I would go as far as to say it is ruled by my Monthly Cycle 
....So even though the DAFNE course is great. I do still struggle with this issue and it would be good if it was covered for us Ladies who do struggle with this issue.
