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Aug 4, 2011
Chris loughrey
21 posts
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Topic: General Discussion / post dinner highs? Hi Anele,Thanks for your feedback. I had a chat with my Dafne tutor yesterday and they agreed with our thoughts as well So I'm sticking with 1:1 this evening and seeing how it goes before possibly moving to 1.25:1 tomorrow if needed. But no issues with hypos as the diary shows. It's nearly there, just a couple more tweaks and hopefully I'll have the structure settled-- for now! |
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Aug 4, 2011
Damien Carr
1 post
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Topic: DAFNE Online Mobile / Android app Just joined the site,Any more developments on the android topic? Damien |
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Aug 4, 2011
dsurtee
3 posts
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Topic: DAFNE Online Mobile / Bugs in using the iPhone App The Specify Targets Section - Does not like half ratios. eg. 1.5:1 (This does not save and reverts back to 1:1. However 2:1 will save.)Entering Results and Doses. - The app should be clever enough to calculate the number of units of QA using the info from Specify Targets. In the ratio section within Specify targets QA:CP. I have a 2:1 but when this is entered the values are swapped over (1:2). Any info when these small bugs will be fixed or reviewed. It is a great app for people on the go. (Would be better with these fixes or a bit of guidance if I am using it incorrectly) |
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Aug 4, 2011
Anele46
109 posts
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Topic: General Discussion / post dinner highs? Hi Chris,I would be inclined to agree with your ratio for your dinner is too low and would maybe need to be increased as when you increased it from 0.7:1 to 1:1 your bedtime BG had dropped from 13.2 to 8.3. Difficult to say for sure with only a few days of data but given that the rest of your BGs seem fine my guess would be to up your dinner ratio by a little more and see what happens. The only thing I would be concerned of is you are low in the morning and wouldn't want to risk hypos through the night/early morning. I would do a 3am BG check to be on the safe side. How did you get on yesterday and today? Did you have a hypo yesterday morn as you went from 13.2 to 4.6 on tue with a dinner ratio of 0.7:1 and then was 8.3 at bedtime on wed night and you upped your dinner ratio to 1:1? The other option would be to increase your evening BI by 1 unit but again you would need to be careful of hypos through the night, would advise doing a 3am check if you choose to increase either your dinner ratio or BI. I would try making one small change and see how you progress over a few days. You seem to have tight control for most of the day which doesn't leave much room for making big changes. You may want to seek advice from your DAFNE tutor or DSN before making any changes? Good luck!  Cheers, Anele. |
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Aug 4, 2011
Garry
328 posts
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Topic: General Discussion / Birth Announcement See I have even put my typo right in the last post..... and changed captures to captured Regards Garry |
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Aug 3, 2011
Anele46
109 posts
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Topic: General Discussion / Birth Announcement
Thanks Garry, much appreciated Cheers, Anele. |
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Aug 3, 2011
Chris loughrey
21 posts
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Topic: General Discussion / post dinner highs? Hi guys,Just looking for some feedback regarding the highs I've had post-dinner on monday & tues. I've narrowed it down to one of two things: 1) bad CP count. Meal on monday was: 50g pasta(dry weight)= 3.5cp salad (minimal cp) chicken breast apple (1.5cp) + blueberries (tiny amount)+ 3 dessert spoons of natural yoghurt (1cp) Tuesday: 3 egg sized new potatoes (3cp) fishcake (1.5 cp) salad fruit salad as monday That seems right to me but I'm open to correction, maybe i've missed something? The other possibility is a bad ratio. I'm judging it to be around 0.75:1 but it looks otherwise. The only thing that makes me have doubts is that if I use the same ratio for supper before bed, it works no problem. IS it possible for sensitivity to move around so much late in the day? BI has been checked using nighttime tests and zero carb meals and it looks correct from where I'm sitting. So any suggestions from anyone would be welcome. |
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Aug 3, 2011
Garry
328 posts
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Topic: General Discussion / Birth Announcement I have goofed in the past... but if you have made a mistake or the system has captured two identical replies you can edit or delete your reply using theEdit post link beneath the green Reply icon. Regards Garry |
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Aug 3, 2011
Anele46
109 posts
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Topic: General Discussion / Birth Announcement Sorry, didn't mean to reply twice!!
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Aug 3, 2011
Anele46
109 posts
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Topic: General Discussion / Birth Announcement
Hi Caroline, Thanks again for your advice, glad you didn't have to use the sick day rules! All the best with your bundle of joy, Lilia  Anele x |
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Aug 2, 2011
seanquinn37
1 post
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Topic: Questions for HCPs / dairy how do i get hold of new paper dairies |
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Aug 2, 2011
Caroline
29 posts
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Topic: General Discussion / Birth Announcement Hi, I did suffer with morning sickness... usually was sick at 8am, 4pm and 10pm. I think I was advised by my Dafne Dietician to just take 1/2 to 1 cp... I found a ginger nut biscuit helped.My sickness was not bad enough to warrant using the sick day rules. I think I felt nausea most of the time rather than being sick itself. I did find that my blood sugars seemed more settled and controlled being pregnant. I wish it was the case now with breastfeeding lol. I have had a lot of HIs and LOWs with breastfeeding and I cannot seem to find a pattern to follow. Breastfeeding on demand, sure has taken it out of me. I have given it a good go, but have ditched the breast for bottle feeds now. Good luck and do keep me posted on what your experienced are. Caroline x |
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Aug 2, 2011
Anele46
109 posts
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Topic: General Discussion / Birth Announcement
Thanks very much Caroline, I really appreicate your advice (especially when you must be so busy with baby Lilia!) I will contact my DAFNE tutor to get the updated Breastfeeding info. Did you suffer from Hyperemesis (Morning Sickness)? This scares me a little and managing my diabetes using the sick day rules as haven't had to employ them yet. All the best, Anele x |
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Aug 1, 2011
Orangette
1 post
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Topic: Questions for HCPs / Exercise and High BG If competing I trying to run my bg around 7 / 10 ( Mr Redgraves recommendations ) and am monitoring well before I exercise to try and set off around this mark !!!So in a 3 day event day one is a short 2 lap blast on mountain bikes around a set coarse. It is day one that I would like to tell you about my bg was 7.7 . My race partner and I set off to the start at 5pm evening event bg all day was good there was no pressure and you could start in your own time as each section is timed. On arriving at the start 20 mins later I was 13.6 so took 1.5 units of QA as new the race should only take us between 30 to 45 mins and didn’t want to go any higher ( I always have torq gels as hypo stops if needed which is a quicker fix than high bg ) off we go up a slight hill it could only of been minutes and instantly felt for a better word knackered heavy legs everything working overtime burning lungs ect I knew High !!! so after a hard frustrating 47 mins finished and had a bg of 24.6 ???? On longer races when this happens I have more patience and can make up for it at the end – I continually get readings in the 20’s. So just woundered if you might have any other suggestions for me to try. Dafne is working really well when I am Dafne for example through the week at work I am 5’s 6’s and 7’s yay yes of cause there are highs and lows but I stick to my ratio’s and use the adjustment guidelines ect. |
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Aug 1, 2011
HelenP
218 posts
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Topic: General Discussion / Hypoglycaemia post flights with insulin pumps In my latest e version of U-TURN newsletter from Diabetes Queensland there is reference to research by a Dr King (paediatric endocrinologist) after anecdotal evidence of hypos post flights for those on pumps. <[email protected]>Dr King recommends: disconnect the pump during take off, the cartridge ought to contain only 1.5mL of insulin, at cruising altitude check line and cartridge for bubbles and reconnect, during flight emergencies put on oxygen mask as instructed and disconnect pump -after emergency check line and cartridge for bubbles and reconnect,after landing disconnect pump and prime line with 2 units of insulin and reconnect. The contact for more info is: [email protected] Sorry I can not put this in a more accessible form...not technologically savvy enough. Helen |
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Jul 31, 2011
melpessoa
7 posts
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Topic: General Discussion / Birth Announcement Hi Caroline! As a Dafne graduate I am very proud of you! all the best for your little lovely baby! take care, mel |
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Jul 30, 2011
Karl
83 posts
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Topic: General Discussion / Help with adjustments post DAFNE I would agree to the 1.5:1 RatioKarl |
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Jul 30, 2011
Caroline
29 posts
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Topic: General Discussion / Birth Announcement HI It may be worth talking to the consultants at both hospitasl first, to see what support they have in place for Diabetics who follow the Dafne programme. My care was through the same hospital I received my Dafne training, so I had regular appointments with them to change any ratios etc. I would have had regular appointments even if I hadnt completed the Dafne course. I had a Diabetic Midwife who contacted me weekly to see how I was doing. She was not Dafne trained and I felt happy to adjust my ratios myself, although it was comforting to know she was at the end of a telephone line should I had needed her. If I did have a query she would forward it on to the Dafne Tuitor, however I could have called the Tuitor directly myself if I felt the need.When I went into hospital with Pre Eclampsia, the midwifes did not know anything about Dafne and so they were happy for me to deal with my diabetes myself. I didnt eat from the Diabetic Menu but I did take in my weighing scales! The Diabetic Team did help me to adjust my ratios after the birth and whilst im breastfeeding. They have amended the Dafne course book now to include more on breastfeeding, so if you thinking of this route later, you may wish to contact your Dafne Course Tutor and obtain the appropriate pages. I would think it doesnt matter if a hospital is Dafne Trained, from my personally opinion, however, I think you should have contact numbers of your Dafne Course Tuitor should you encounter any problems or just to keep in regular touch regarding your pregnancy. I hope the above helps. Good luck. Caroline x |
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Jul 29, 2011
chrisinbrum
41 posts
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Topic: General Discussion / Help with adjustments post DAFNE I'm not sure I agree that the BI is the first thing to change...Looking at your results you are 'reasonably' stable with your BG readings...although obviously you would want to be stable between approx 4 and 7. But you are stable (roughly) between 10-14. I would say that if you're fairly level throughout the day then your BI might be ok, and once you should work on getting one result down to the DAFNE target range. Then your current BI should keep you there. I'd pick one of your meals (breakfast maybe) and look at that. You always correct there so the 1:1 ratio needs adjusting in my opinion. If you look at the correction you take most of the time you are close to a 1.5:1 ratio, so I'd just change your ratio to that. That seem to keep you level for the lunch BG test, so maybe you should correct more with the breakfast QA, slowly though so you don't drop too much. Try to get the breakfast dose of QA right and if you come into target for lunch then you might stay in target following that maybe. Am I on completely the wrong track here? I thought DAFNE said to look at where there is a pattern in corrections being taken and work on those. To me, the fact you are fairly stable (although high) throughout the day suggests the BI might be ok. Does anyone agree or have i confused myself and got it wrong?? |
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Jul 29, 2011
Garry
328 posts
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Topic: General Discussion / Help with adjustments post DAFNE I like the way we are able to help one another.Seems to me that you have been given good advice about your BI probably being at the root of your current control. Please bear in mind that BI changes though - for the vast majority us anyway – normally take 3 days to show any result. These types of insulins have a long term impact on our physiology and I know it’s difficult when you want to see an immediate improvement - but you must have good control of the changes - or you will never be able to understand what is happening. Our bodies are not machines....and slow change helps us better understand the results of improved background control. So please do it the DAFNE way. Slow and controlled. Only changing one thing at a time and waiting for results to help you move in the right direction. If you are confident enough, continue posting your results and I like to think that there are many type 1 diabetics, with long term first person experience with your insulin combination, that can offer support. Regards Garry |
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Jul 29, 2011
Anele46
109 posts
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Topic: General Discussion / Help with adjustments post DAFNE Hi Sugarplum,Well done with your 6.7 this morn I have only been a diabetic for a year and a half so my body is still producing BI as I am only on 7U of BI (Lantus) at night. The fact that you're having to correct at every meal would make me think it is your BI that is insufficient. Once you start getting lower BGs then I would look at your QA ratios. My BGs before bed (and taking ny BI) were creeping up to >10 when they were never as high as that when I was on Humulin M3 twice a day (but again I was and still am a little, in my "Honeymoon phase". As it was only my before bed BGs that were high (lunch I tend to be low) led me to assume that my BI is fine and it is just running out as it gets to close to the 24 hrs. I have confirmed this by having carb free dinners and lunches and they show my BI is ok (at the moment!). That's what led me to up my dinner QA ratio as the rest of mt BGs are mostly on target. I would be intrested to hear what other DAFNE graduates and HCPs thoughts are on your stata as I am fairly new to diabetes unlike yourself with 13 years experience. Will be interesting to see what happens the rest of today and once you up your morning BI. Good luck! Anele x |
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Jul 29, 2011
sugarplum
9 posts
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Topic: General Discussion / Help with adjustments post DAFNE Hi AneleThank you for your reply. That’s what I am finding hard to grasp about the BI, it is so tempting to just up my QA like I always have. This morning my reading was 6.7, my only one in target this week. I think I will try the carb free lunch today and 3am check, thanks for reminding me of this. I was going to increase my morning BI today but I forgot, I will do that tomorrow. Before DAFNE I was taking 26 Lantus at 9pm and Novorapid varied, I was doing a rough estimate of approx 2.5:1 and 3:1 ratio but my last HBA1c was 9.3 so that wasn’t working either. I feel as if I am not allowed to change my ratio, at what point can I decide it’s that and not the BI? I was so confident when I finished the course and now I seem to be swamped with it all and can’t remember anything! I have been advised to get 3 months in target HBA1c results before conception and it feels like the starting posts are moving every day.
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Jul 29, 2011
Anele46
109 posts
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Topic: General Discussion / Help with adjustments post DAFNE Hi Sugarplum,It looks as though you are doing corrections at ever meal and from what I remember from my DAFNE course it would suggest that your BI is too low as you are having to make corrections at every meal. You could have a Carb free lunch or dinner and do a 3AM BG check as this will help show how your BI is working or not as the case may be  Going with the stepwise approach DAFNE recommends you wait for a pattern and do not make more than one change within a few days to allow you to see if things stabilise or a pattern emerges. Would be interesting to see the rest of your results for this week. I see you increased your BI on Wed from 12 to 14 but from looking at Thu BGs they are still high during the day (even after corrections), I would look at increasing your morning BI also. How much QA and BI were you on before your DAFNE course? I am on Novorapid and Lantus which I take once a day at night (22:00) and found I had to increase my dinner ratio as my BI was running out but given that you have split your Levemir this prob won't be the case for you. Also don't know much about Levemir. I can totally understand your frustrations and need for urgency given you want to start a family and obviously need your BG to be as low as possible and stable. Keep at it and always look for patterns, remembering when looking at your BG and Insulin, the event prior to the data you are looking at should help you identify where to start looking at changes (e.g. If your lunch BG is high or low look at the previous amount of Insulin you took - does this need adjusting?). Cheers, Anele. |
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Jul 29, 2011
jules1
3 posts
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Topic: Questions for HCPs / Fitting when hypo Thank you very much simon that makes alot of sense. I am still waiting to go on the DAFNE course, I received a letter on 04th may advising I have been added to the waiting list and I am still waiting. In the meantime I keep reading the Q&A's here to try and learn. |
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Jul 29, 2011
Anele46
109 posts
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Topic: General Discussion / Birth Announcement Congratulations Caroline!!b That is wonderful news. I was wondering if you could offer any advice as my husband and I are going to try to start a family? I have only been a diabetic for a year and a half and completed my DAFNE course in March this year which has really helped controlling my BG which I know is extremely important in pregnancy. Would you recommend going to a hospital that is DAFNE trained, as I used to live in Glasgow hence doing my DAFNE course at the Southern General but I have moved to Paisley and the RAH is within walking distance but the DAFNE course does not run there. Any advice would be gratefully received Thanks, Anele. |