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Jun 21, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Some advice please I seen that alleged myth in the myth slideshow, but I believe its valid to test at this time.................especially if the dawn phenomenon is at work as anytime after this is when the glucagon release will start........so the 3am test will confirm if that dose of BI is right, or would have been right without the DP.......I think it was a misconception actually, so purely a misunderstanding of an existing principal................oh yeah.... 
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Jun 21, 2011
JayBee
587 posts
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Topic: Questions for HCPs / Menstrual Cycle, BI
Yay for familiarity! I'm so happy to know this - it's so morale knocking... but still we carry on! I have been continuing to apply the 2 day rules for QA and 3-4 days for BI adjustments myself (BI was after advice from my DAFNE team). I'm on Humalog and Levemir for the comparison. I'm not convinced that I responded correctly last month by putting BI down first then QA so now (I've just had the dreaded "dropping monday" yesterday) I'm trying adjusting just my QA.... I will post up my progress shortly... |
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Jun 21, 2011
JayBee
587 posts
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Topic: General Discussion / local meetings Oh okay... how weird considering I'm familiar with BB code! Thanks for fixing it. ^_^; |
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Jun 21, 2011
marke
681 posts
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Topic: General Discussion / local meetings JWo and others your link in the previous post didn't work because you put speech marks around the website link, you don't need them and indeed they stop the link working. I have fixed your post so that it works but for future reference you need url=<website link> without speech marks around <website link> |
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Jun 21, 2011
marke
681 posts
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Topic: General Discussion / Some advice please Its interesting what you say about Humilin, at the DAFNE collaborative it was suggested that it is probably more effective as a 4 times a day injection but they felt people would not be prepared to do this. My view was a few more injections wouldn't make much difference either way. Apparently 4 times give optimum control becasue of the 'duration' of Humilin, originally it was used as a 'long' lasting once a day insulin but it is not as effective if used only once a day. This is the kind of information that is lacking about Lantus/Levemir becasue there is not the body of evidence built up over time.With regard to high BS in the morning the opininon was as per Novarapidboi i.e inject as close to bedtime as possible to get the best effect on morning BS. Although they still insist that Lantus IS a 24 hour insulin and care should be taken if you overlap a split dose. I can't comment on that as I'm on Levemir. I'm not sure about the 3am testing though, I thought that was a DAFNE Myth
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Jun 21, 2011
Athena
52 posts
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Topic: Questions for HCPs / Menstrual Cycle, BI
Hi JWO, it looks as if you are having the same pattern as I am. I drop my BI immediately at menstruation and a little bit in the few days prior to it. I am not sorting anything using QA at all yet, but may do as I find getting the rest of the month sorted not good. Interestingly, I have the dawn phenomena, and actually have to put this dose up when my BI goes to its lowest point during menstruation. I suppose I need some more QA to compensate for the lower BI. Sound like you are following the same sort of pattern. I fid that that is the easy bit. The step -wise approach is too slow to work with the gradual rise in insulin requirements up to the premenstrual time. I am now abandoning this and using a change after 1 day approach , rather than waiting for a pattern to see if that helps. I habve tried the step - wise approach for over a year now and as i feel really ill on DAFNNE, I don't want to continue with it to sort this out. As I know when requirements are rising and falling I can do this ok. takekcare |
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Jun 21, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Some advice please So are you saying you are going to take your 32 units of evening Lantus earlier than 22:30pm?This would mean your 32 units would need to last longer, if in fact this is actually the issue. If it wasn't lasting as long as you want, then injecting as close to the morning as possible is best, so in your case, immediately before bed. If you are going ahead with this change, remember to do 3 am blood tests, each time you change the time or amount of your BI dose... Do you understand my point about timing............? 
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Jun 21, 2011
derekh1965
90 posts
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Topic: General Discussion / Some advice please HiWas on Humilin I for 17 years (since diagnosis) and BS was always high in the mornings. The Hospital put me on Lantus the latter part of last year and the morning BS improved immensely but I started feeling really tired and depressed. Looked up side effects of Lantus and read some people suffered those effects whilst using Lantus. Asked the hospital to put me on animal insulin because I read some people felt a lot better on animal insulin.. I felt no different so went back onto Humilin I and the high morning BS. Now I have went back onto Lantus. I used to take 1 injection of Humilin I at dinnertime and just remembered I took the Lantus at the same time. Used to only take a max of 18 units of Isophane because the BI insulins function was never explained to me so I thought the more I took the lower my BS would go. They just told me it was a long acting insulin. I took 1 32 unit injection of Lantus yesterday at 10:30 and woke this morning with a BS of 13.7 again which makes me think the lantus has run out by morning so will take my injection at dinnertime and hopefully it should last until breakfast time. Just noticed you don't have to keep adding a new diary to posts. It automatically updates, cool. (small minds are easily amused, lol) |
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Jun 20, 2011
sphillips
24 posts
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Topic: Questions for HCPs / Newer Insulins under pressure from QIPP Hi I'd like to add my support to what Carolin is saying. In my 9 years experience as a DAFNE educator in a centre that has tended towards analog BI's we are now reviewing this based on the evidence gathered from the DAFNE database and our clinical experience. We are seeing the benefits of NPH insulin, especially for those who exercise a lot, work shifts, like to drink alcohol (!) and in some cases it has been more beneficial than glargine in dealing with the dawn rise. I think we are right to be sceptical about issues around funding and insulin and protecting peoples choice but there is a lot of good evidence in support of NPH. |
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Jun 20, 2011
JayBee
587 posts
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Topic: Questions for HCPs / Information on menstrual cycle Discussion continues here... |
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Jun 20, 2011
JayBee
587 posts
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Topic: General Discussion / local meetings Well, still trying for a Norwich meal out.... still waiting for any decent interest to make itself known though. (If the link doesn't work, it's this: http://www.dafneonline.co.uk/forums/1/topics/755 - it's on page 3 of the General Discussion forum section) As for any other projects... not heard of anything. |
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Jun 20, 2011
sphillips
24 posts
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Topic: General Discussion / local meetings Hi Just wondered how people were getting on with the local meeting idea? Has anyone got anything going yet? I'd be grateful for any feedback. thanks. |
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Jun 20, 2011
JayBee
587 posts
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Topic: Questions for HCPs / Menstrual Cycle, BI That is disappointing news... it's stupid considering for years it's been common for even HCPs to say "your BGs rise on your period".At the moment I seem to need to drop my dose during the actual period week... very annoying to cope with. I did think it was caused by the recovery of illness before but considering it's that time again and I'm hypoing again... I'm not convinced now that it was just a simple case of illness recovery... T_T On that note, I didn't just put down my BI by two units on both sides of the split, but I found I had to put my ratios back down by 0.5 (I'm normally 1.5:1 for breakfast and dinner; 1:1 for lunch - so they were all put down). In other news, I'm now off the pill and using a non-hormonal "coil" which I'm sure will result in interesting times to come now my body can be more natural again... shall see. Haven't been reporting back because these changes of course. I haven't been keeping track of temp since being ill... I probably should start that up again with these changes.... |
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Jun 20, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / DAFNE Myths WOW, good presentation, definitely issue that need raised..........all of the misconceptions in there to me are not from DAFNE, I dont think any literature connected with DAFNE has resulted in them, maybe some item missed during the teaching process maybe............. for example from the handbook: As a general principle: 1 unit of quick-acting insulin lowers blood glucose by 2-3mmol/l. For blood glucose levels above 11mmol/l this rule does not necessarily apply. This clearly states that with higher BG you may need more insulin to correct, resulting in a higher dose than 4 units.....dismissing the misconception that 4 is the maximum, however it is only a misconception, so misunderstood is all.... This has always been clear to me........ I look forward to hearing what else comes from this..............as there is no doubt myths and misconceptions out there....... 
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Jun 20, 2011
marke
681 posts
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Topic: General Discussion / DAFNE Myths On the 10th June the Annual DAFNE Collaborative was held. This is the DAFNE get-together of all educators, programme management etc. I wasfortunate enough to be there as a DAFNE User Action Group rep. One presentation that really caught my ear that I can now share with you was about DAFNE Myths and Misconceptions. If you click here you can read the presentation in PDF form. Remember it is being said that ALL the things in the presenation are myths. Have a read and post your views here ! Its bound to cause some controversy, which is why I'm posting it here to see what peoples views are. |
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Jun 20, 2011
chrisinbrum
41 posts
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Topic: General Discussion / Eye Screening
I had a referral to my local eye clinic and it turned out not to be serious, but just because the person who did my annual eye test/check wasn't sure if what he saw was significant or not. I think it's natural to be a bit concerned when you get a referral like that, but it could well be just to check your eyes a bit more carefully like it was for me. After a few appointments just to make sure there were no changes or problems my appointments at the eye clinic have stopped. The changes your letter mentions might just turn out to be minor and they could sort themselves out like other people have mentioned. Just make sure you ask any questions if you're worried when you get to the clinic. The specialist i had for my first appointment barely uttered a word or explained anything until I didn't leave at the end of the appointment and started asking what was going on and what he'd seen after staring at the back of my eyes! |
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Jun 20, 2011
Third Lanark
3 posts
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Topic: General Discussion / Alternative medicines Hi guys,I was wondering if any of you had taken any alternative medicines with ahving diabetes. Obviously the main point we always must remember is that we must continue to take our Insulin, tablets etc What I was meaning was I was thinking about taking something like Gingko Bilbo (I think thats how you promounce it) to help boost my circulation or Bilberry fruit which I am told is good for eyesight. Was just wondering if any of you guys had tried these alternatives medicines or other ones and if you had noticed any effect on your diabetes good or bad? Thanks guys |
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Jun 20, 2011
Third Lanark
3 posts
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Topic: General Discussion / Eye Screening Guys,Thank you both for your warm welcome to the forum and for your very helpful comments and information and also for sharing your experiences. Its much appreciated and not only has it helped given me a better understanding of retinopathy it has also made me fe a bit better about the whole thing. Thanks again |
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Jun 20, 2011
Brum_Taffy
13 posts
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Topic: Questions for HCPs / Newer Insulins under pressure from QIPP We seem to have gone into a blind alley, as can sometimes happen The only way to decide a 'Which is better?' argument is the Harry Hill method, IMO  Instead, I am still hoping to get some observations from people with type 1 diabetes in the forum: what you think, what you experience each day, how things are today, compared with how you used to use insulins previously. In essence, Lance Armstrong famously said "It's not about the bike"- do you experiences agree? 
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Jun 20, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Some advice please High again, and that was with 32 units at 2230 or there abouts.................If it was me, I would continue with this dose till Wednesday night, if still high in the mornings, add 2 units at night, repeat the process...........3 am test to confirm its working or not and to avoid hypo........ What were you on before going back to Lantus..........? |
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Jun 20, 2011
derekh1965
90 posts
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Topic: General Discussion / Some advice please HiThanks for your replies. I was on Lantuis for a few months and only stopped taking it maybe 3 months ago. I am pretty sure I was oin 1 injection of 32 units in the morning so I have taken my 32 this morning and will leave it until tomorrow morning to see the results. When I was on it before my morning results were good. Stopped taking it because started feeling more tired, depressed, no energy and read sometimes lantus caused those side effects for some people. Been off it for 3 months and feel no different. Still tired and depressed lol. My BS was 13.7 this morning. |
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Jun 20, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Advice if possible.
What you are describing here is the dawn phenomenon, the sharp rise over a short period of time is the hormonal response, so it may also be your BI running out combined with the DP, but even if your BI lasted past this time, this effect would still happen............taking your dose later is a good strategy, one which I adopt, and means your are giving yourself more BI at that specific time in the morning when your pancreas starts spitting out the glucagon...... I only moved it to the later time after I had upped my BI dose to the correct one, as I was not taking enough...... |
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Jun 20, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Some advice please The 50-50 split is always a good place to start if you are going from one dose, usually Lantus, to two doses, usually Levemir or Humulin I.......But I think its apparent you need more at night that you do during the day, at least that's what it looks like.......Karen makes a good point though, try the dose out for 3 consecutive nights, tweak if needed, then move on to your daytime BI and QA... And if the DP does cause you problems in the morning, giving your 22 dose when you wake is best...........its not a 12-12 hours split, but Lantus and Levemir last longer than this in the majority of people..... Look forward to seeing this weeks results..............your doing well..........
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