Recent Posts - DAFNE Online

Jun 16, 2011

JayBee 582 posts

Topic: Questions for HCPs / Newer Insulins under pressure from QIPP

I haven't a clue for the first question lol. Smile

Brum_Taffy said:
2. do people with type 1 diabetes generally believe/feel they get extra benefits with modern analogues, compared to older human and/or animal insulins? What is your experience?

With the lack of education I had when I was on Humalin I before DAFNE, it is difficult for me to compare it now. Sad

That was a very very long time ago.

With how well Lantus and Levemir respond though in comparison to some of the results I've seen from other diabetics on this forum, I feel that it would be a good thing to move on from the older insulins because they don't seem to perform as well as more up to date insulins (which makes sense really).

The key thing that gets in the way of this logic is knowing that if someone has found something works for them, then they do - no, should - have the right to stick at it if they want to.

3. If someone tried to take away your 'Daz' and give you 2 packets of another soap powder, how would you react? How important is choice of insulin to you?

Freedom is very important to me. I would not be a happy bunny if my medication was changed just because it suited the funds better now. I have changed insulin at least once since starting DAFNE (changed from Lantus to Levemir). It was not a straight forward change for my condition's control but very worthwhile - but it was a choice I made, not something that was forced on me.

As for soap stuff... well, I'd give it a go lol. That example just doesn't compare well really for me. ;)

Jun 16, 2011

Brum_Taffy 13 posts

Topic: Questions for HCPs / Newer Insulins under pressure from QIPP

I guess they should be public. As it is a gov agenda such plans could be said to be 'only following orders'.
Which PCT do you come under?

On my patch (west of Brum) I have heard rumblings that restrictions may be coming, but have seen no documents to that effect. I have taken the view it is better not to ask, in case this moves into the cross-hairs!

Jun 16, 2011

chrisinbrum 41 posts

Topic: Questions for HCPs / Newer Insulins under pressure from QIPP

Are PCT QIPP plans publically available documents or would you need a freedom of information request to get hold of them and check what's going on?

Jun 16, 2011

Brum_Taffy 13 posts

Topic: Questions for HCPs / Newer Insulins under pressure from QIPP

A government programme aimed at cutting costs (Quality Innovation Prevention and Productivity, or QIPP) means that many PCTs and commissioners are scrutinising the use of insulin analogues.

In particular, the use of Lantus in type 2 diabetes is under the microscope- the suggestion is that professionals should use older, cheaper long-acting insulin and then only switch to the more expensive choice if/when people get hypoglycaemia.

This could have knock on effects for people with type 1 diabetes- we know not all 1e care teams think differently in type 1 vs type 2!

I've observed published safe DAFNE target levels coming down over the years, I believe because modern analog insulins are more 'predictable' [some may say as predictable as a teenager, rather than old NPH being as predictable as a toddler Surprised

].

My questions are:

1. is there research evidence of an improved safety record for analogues compared with old NPH/soluble insulins, from the DAFNE database? [one for DAFNE top brass!]
2. do people with type 1 diabetes generally believe/feel they get extra benefits with modern analogues, compared to older human and/or animal insulins? What is your experience?
3. If someone tried to take away your 'Daz' and give you 2 packets of another soap powder, how would you react? How important is choice of insulin to you? Cool

Each PCT has a QIPP programme- attacking analog insulins may not feature in them all, but if you have had your choice of insulin questioned, it would be interesting to hear about it.

Ta Smile

Jun 16, 2011

Michaela 13 posts

Topic: General Discussion / Carbs v Cals

All very sensible JWO. For me veganism isn't a diet like say low-carb was. It was a little bit of a lifestyle change but actually it hasn't changed much except what I eat and how I feel. Which is the important part. It seems to fit in with my lifestyle so far. And because I am not doing it as die-hard as people who might do it for the animal reasons I am a little bit more flexible.

However, I do stick to the principles as much as possible because I do actually believe that there is too much industrialisation, environmental damage and cruelty in our food production these days. Even though it wasn't my main reason for going vegan. That was to help my health. The weight loss is an added bonus. I don't see it as a diet at all. It's a 'way of eating' and as I've said before I am not deprived.

I have a much healthier relationship with food in general than I did many years ago and it's because of the right mindset I am able to do it without it being a chore or difficult for me. If you have food issues any change is going to cause you problems.

Jun 16, 2011

novorapidboi26 1,816 posts

Topic: Questions for HCPs / DAFNE and Retinopathy

I hope so too.......

Well explained Simon.....

Jun 16, 2011

Welshmapleleaf 19 posts

Topic: Questions for HCPs / DAFNE and Retinopathy

Thanks Simon. It's almost a week sice I graduated, and although I can't say all my readings are within target yet, they will most certainly be lower than pre-DAFNE, hence my concerns. Hopefully in the longer term, sticking to DAFNE principles will preclude the need for further treatment. Very Happy

Jun 16, 2011

novorapidboi26 1,816 posts

Topic: Carbohydrate Counting / Jacket Potato

I thought the OP was having problems with hypos early on after eating one............as opposed to counting the CPs, thats the easy part..... Smile

Jun 16, 2011

Simon Heller 46 posts

Topic: Questions for HCPs / DAFNE and Retinopathy

Diabetic eye disease may worsen temporarily if someone improves their blood glucose control dramatically over a short time period. It is probably because high blood glucoses tend to lead to increased blood flow to various part of the body. Since improving control will result in reduced blood flow (a good thing in the longterm) this reduced oxygen delivery and so the affected area loses oxygen which can aggravate diabetes eye trouble. So if you have eye changes to start with they can get worse. By 12 months the good effect is outweighing the short-term bad effect. So the message is that it only affects people who already have significant changes and by 12 months the worsening effect has worn off and the trend towards progressive changes can be reduced or perhaps even reversed.
ATB
Simon

Jun 16, 2011

Simon Heller 46 posts

Topic: Questions for HCPs / Metformin /Type 1

The evidence that metformin makes a difference in Type 1 diabetes is not strong but some professionals use it to reduce insulin dose, weight gain etc There is some evidence of benefit for PCOS. It appears to be very safe but with some pretty unpleasant side effects of diarrhoea, abdo pain and anorexia for some people! The slow release preparation is better tolerated generally.
Simon

Jun 16, 2011

Garry 328 posts

Topic: Questions for HCPs / Metformin /Type 1

Don't get me wrong, Metformin hasn't had any laxative effect on me. But they do have another pretty common side effect.....they are nicknamed 'Metfartin' for good reason.
Regards
Garry

Jun 16, 2011

Karen Westwood 38 posts

Topic: Carbohydrate Counting / Jacket Potato

I agree with JWo on this one. Had the same problems with jacket spuds and asked at my DAFNE refresher course. I was told to weigh the potato raw and work out the carbs from that weight. This has worked for me since.

Good luck Smile

Karen x

Jun 16, 2011

novorapidboi26 1,816 posts

Topic: General Discussion / Great

Cooked weight would only apply if you were only have some,of what is there......so weighing the amount of fried rice from the Chinese your going to have for example.........

I always have the full amount so unlocked weights also suit me....

Jun 15, 2011

AllanR 15 posts

Topic: Carbohydrate Counting / Jacket Potato

Basically just going to keep on doing as at the beginning....half the normal dose for it, and anything need fixing, fix it later. Seems to work fine so far really with very little fixing needed. Not a perfect fix, but a good enough one which works for me and you don't have a set of scales when your in town getting lunch.

Jun 15, 2011

Linda S123 8 posts

Topic: Questions for HCPs / Metformin /Type 1

Wow ! Im beginning to think that the reason it is used for weight loss is because nothing stays inside for long enough !!! The weight loss side would be of benefit, but Insulin resistance has been suggested as I have been IDD for coming up for 40 years and have highs where I shouldnt have. I appear to have the dawn phenomenon around lunch ( always was a late starter ! )

Jun 15, 2011

JayBee 582 posts

Topic: Carbohydrate Counting / Jacket Potato

Have either of you actually looked at weighing the spud raw and going on that like Carolin was saying?
I have and it works out great for me. No problem (even eating the jacket to make sure). Why are you over complicating it?

Jun 15, 2011

JayBee 582 posts

Topic: General Discussion / Great

We are not talking about the CPs changing - it's the weight that is changing due to the water absorption (or loss)!

If you usually cannot weigh stuff like pasta or rice before cooking then you're going to be looking at risk every time. I've found cooked weight to be so very unreliable so I always trust the uncooked weight. You just don't know how much the water it was cooked in is effecting the weight so it is a risk every time. This is why so many have so much trouble with these foods!

In another discussion about jacket potatoes in particular on this forum (Please take particular note of what Carolin the HCP says), they are also something to be wary of because they're not processed before hand.... therefore, when the water content changes when it's prepared in whatever way it is, you just cannot rely on the idea that it will be the same every time after cooking. Best to weigh it before cooking to get the more reliable CP total.

On the note of already processed stuff - like a microwavable pasta meal - I would believe the labelling on the packaging personally because it's likely that the water has already been sorted out for you.

Jun 15, 2011

JayBee 582 posts

Topic: General Discussion / Carbs v Cals

Sorry, I wasn't able to add the links earlier... I remembered wrong - it was how active fat can cause Type 2 diabetes... Here's a link to the clip I meant (From Diabetes UK). When I watched all four episodes, it was just frightening to see it in action. Sad

I think when you try to apply life style changes, you really have to work out what is best for you as an individual. I do have suggestions but most of them are summarised by simply remembering "small goals work towards the main goal". You do not have to cut anything completely out of your life (unless it's stuff like smoking of course) - you just have to remember that moderation is key (even for things like exercise - as I learnt while trying to do push ups with no prior training! I do not recommend this lol, start with wall pushes definitely lol). ^_^;

Jun 15, 2011

dafne-dude 11 posts

Topic: General Discussion / Advice if possible.

Hi Deanna,
Yeah i've noticed some changes in my ratio but only at breakfast and only at the w/end normally i'am 1:1 ratio for all meals but just recently i've had to up that to a 1:2 for breakfast but like i say only at w/ends?? it's weird...

When you say burning- do you mean while injecting or after?? i've noticed some injections sting a little more than others...

Jun 15, 2011

Garry 328 posts

Topic: General Discussion / Advice if possible.

Use and post your on-line diary occasionally and people will try to assist.
DAFNE teaches ratios in QA:CP or in your case mentioned a 3:1 ratio.
Don't get stressed about your ratios changing as it happens to us all at different times during the year...infection...activity levels...work stress...lot of things have a quite dramatic affect upon our resistance to insulin.
Don't worry about it.
Just keep up the discipline and things will work out for you.
We are all looking to live as normal a lifestyle as possible and yet avoid some of the long term effects that being a diabetic infers.
Follow the established rules and live life to the full Very Happy

Regards
Garry

Jun 15, 2011

Garry 328 posts

Topic: Questions for HCPs / Metformin /Type 1

My consultant's approach was to help aid a reduction in ratios.
Has not had the desired effect for me at this dosage. I'm not really willing to up it though, as I suspect that it will have other undesirable impacts upon digestion!
Regards
Garry

Jun 15, 2011

deanna 8 posts

Topic: General Discussion / Advice if possible.

Ive been diabetic over 2 years now.
Has anyone got any ideas why, unitl recently, i was on a 1:1 ratio for all meals, for this to change in a matter of months ?
First to go was breakfast - im now on a 1:3 ratio, my CPs are 10 = 30QA

Slowly but surerly came tea time - im now on a 1:2 ratio but ive got a nagging hunch that this is increasing at least to 1 : 2 1/2 ratio.

At the moment lunch is still an unsteady 1:1 ratio

With increasing awareness on my part, eating after 3oclock in the day results in a 1:2 ratio (worryingly similar to evening tea)

This is very worrying for me as i am having other difficulties with my diabeties at the moment such as morning high BG without night hypos, burning under the skin from my insulin, and a number of other physical symptoms like headaches and nausea.
With this ever-increasing rise in my need for more insulin i am starting to freak out as to what further side-effects are in store for me and if i can handle them.

Please, any opinions would be good x

Jun 15, 2011

deanna 8 posts

Topic: General Discussion / Great

Hi everyone.
Ive only been diagnosed 2 n a half years now. The dafne course was brilliant for me, i took it about 7months after i first got diagnoed. Dont know where id be without it. I think it really helped learning about CPs and correction from the get-go, id recommend that everyone with diabetes go for this course as soon as they can.

For me i try to stay away from foods like take-away rice and pasta because you never know how they make them, the portions size or anything. Pizzas loads easier to work out. Or if your set on rice and pasta, the trick is to look on the back of the packaging (microwaveable) when your in the store, look at a couple with different sauce etc so you get a good visual, especially if youve had one before because then you know the portions size for when you get a take-away.
Believe me this works Very Happy

But to be honest i did a lot of guess work when i first go diagnosed until i took enough insulin for the food i was having, while i tried to stick with same meals and portions.
While this worked somewhat successfully, carb counting, wow... when youve got the general principles set in your head you know it all Very Happy

I can now just look at a plate of food in front of me and know the CPs and the amount of QA i need to take. Its bril. So yes carb counting gets way easier as time goes on, i havnt picked up my CP book in ages x

Jun 15, 2011

Karen Westwood 38 posts

Topic: General Discussion / Hb1Ac results

Thanks for that Sarah, think I might have a look into it.

Like your comment about the lie detector machine, how true is that!! Its good to see that others have ups and downs too. 30+ years is a long time to be good all the time isn't it Wink

I managed to get my HbA1 down to 6.7 following my DAFNE course 2 years ago and this was classed as a normal level but now it has crept back to 8.1 which I am told is only 'average'. To be honest I think that the guidelines have definately reduced over the years and they are now asking for lower levels to be maintained (in an ideal world!!). You seem to be doing well at the moment though so keep up the good work. I am back to blood testing before each meal in the quest to reduce my HbA1 further and become 'normal' again lol!

Good luck Very Happy

Karen x

Jun 15, 2011

novorapidboi26 1,816 posts

Topic: General Discussion / Carbs v Cals

What lifestyle choices do you make that you think benefit you most....

Jun 16, 2011 JayBee 582 posts	Topic: Questions for HCPs / Newer Insulins under pressure from QIPP I haven't a clue for the first question lol. Brum_Taffy said: 2. do people with type 1 diabetes generally believe/feel they get extra benefits with modern analogues, compared to older human and/or animal insulins? What is your experience? With the lack of education I had when I was on Humalin I before DAFNE, it is difficult for me to compare it now. That was a very very long time ago. With how well Lantus and Levemir respond though in comparison to some of the results I've seen from other diabetics on this forum, I feel that it would be a good thing to move on from the older insulins because they don't seem to perform as well as more up to date insulins (which makes sense really). The key thing that gets in the way of this logic is knowing that if someone has found something works for them, then they do - no, should - have the right to stick at it if they want to. 3. If someone tried to take away your 'Daz' and give you 2 packets of another soap powder, how would you react? How important is choice of insulin to you? Freedom is very important to me. I would not be a happy bunny if my medication was changed just because it suited the funds better now. I have changed insulin at least once since starting DAFNE (changed from Lantus to Levemir). It was not a straight forward change for my condition's control but very worthwhile - but it was a choice I made, not something that was forced on me. As for soap stuff... well, I'd give it a go lol. That example just doesn't compare well really for me. ;)

Jun 16, 2011 Brum_Taffy 13 posts	Topic: Questions for HCPs / Newer Insulins under pressure from QIPP I guess they should be public. As it is a gov agenda such plans could be said to be 'only following orders'. Which PCT do you come under? On my patch (west of Brum) I have heard rumblings that restrictions may be coming, but have seen no documents to that effect. I have taken the view it is better not to ask, in case this moves into the cross-hairs!

Jun 16, 2011 chrisinbrum 41 posts	Topic: Questions for HCPs / Newer Insulins under pressure from QIPP Are PCT QIPP plans publically available documents or would you need a freedom of information request to get hold of them and check what's going on?

Jun 16, 2011 Brum_Taffy 13 posts	Topic: Questions for HCPs / Newer Insulins under pressure from QIPP A government programme aimed at cutting costs (Quality Innovation Prevention and Productivity, or QIPP) means that many PCTs and commissioners are scrutinising the use of insulin analogues. In particular, the use of Lantus in type 2 diabetes is under the microscope- the suggestion is that professionals should use older, cheaper long-acting insulin and then only switch to the more expensive choice if/when people get hypoglycaemia. This could have knock on effects for people with type 1 diabetes- we know not all 1e care teams think differently in type 1 vs type 2! I've observed published safe DAFNE target levels coming down over the years, I believe because modern analog insulins are more 'predictable' [some may say as predictable as a teenager, rather than old NPH being as predictable as a toddler ]. My questions are: 1. is there research evidence of an improved safety record for analogues compared with old NPH/soluble insulins, from the DAFNE database? [one for DAFNE top brass!] 2. do people with type 1 diabetes generally believe/feel they get extra benefits with modern analogues, compared to older human and/or animal insulins? What is your experience? 3. If someone tried to take away your 'Daz' and give you 2 packets of another soap powder, how would you react? How important is choice of insulin to you? Each PCT has a QIPP programme- attacking analog insulins may not feature in them all, but if you have had your choice of insulin questioned, it would be interesting to hear about it. Ta

Jun 16, 2011 Michaela 13 posts	Topic: General Discussion / Carbs v Cals All very sensible JWO. For me veganism isn't a diet like say low-carb was. It was a little bit of a lifestyle change but actually it hasn't changed much except what I eat and how I feel. Which is the important part. It seems to fit in with my lifestyle so far. And because I am not doing it as die-hard as people who might do it for the animal reasons I am a little bit more flexible. However, I do stick to the principles as much as possible because I do actually believe that there is too much industrialisation, environmental damage and cruelty in our food production these days. Even though it wasn't my main reason for going vegan. That was to help my health. The weight loss is an added bonus. I don't see it as a diet at all. It's a 'way of eating' and as I've said before I am not deprived. I have a much healthier relationship with food in general than I did many years ago and it's because of the right mindset I am able to do it without it being a chore or difficult for me. If you have food issues any change is going to cause you problems.

Jun 16, 2011 novorapidboi26 1,816 posts	Topic: Questions for HCPs / DAFNE and Retinopathy I hope so too....... Well explained Simon.....

Jun 16, 2011 Welshmapleleaf 19 posts	Topic: Questions for HCPs / DAFNE and Retinopathy Thanks Simon. It's almost a week sice I graduated, and although I can't say all my readings are within target yet, they will most certainly be lower than pre-DAFNE, hence my concerns. Hopefully in the longer term, sticking to DAFNE principles will preclude the need for further treatment.

Jun 16, 2011 novorapidboi26 1,816 posts	Topic: Carbohydrate Counting / Jacket Potato I thought the OP was having problems with hypos early on after eating one............as opposed to counting the CPs, thats the easy part.....

Jun 16, 2011 Simon Heller 46 posts	Topic: Questions for HCPs / DAFNE and Retinopathy Diabetic eye disease may worsen temporarily if someone improves their blood glucose control dramatically over a short time period. It is probably because high blood glucoses tend to lead to increased blood flow to various part of the body. Since improving control will result in reduced blood flow (a good thing in the longterm) this reduced oxygen delivery and so the affected area loses oxygen which can aggravate diabetes eye trouble. So if you have eye changes to start with they can get worse. By 12 months the good effect is outweighing the short-term bad effect. So the message is that it only affects people who already have significant changes and by 12 months the worsening effect has worn off and the trend towards progressive changes can be reduced or perhaps even reversed. ATB Simon

Jun 16, 2011 Simon Heller 46 posts	Topic: Questions for HCPs / Metformin /Type 1 The evidence that metformin makes a difference in Type 1 diabetes is not strong but some professionals use it to reduce insulin dose, weight gain etc There is some evidence of benefit for PCOS. It appears to be very safe but with some pretty unpleasant side effects of diarrhoea, abdo pain and anorexia for some people! The slow release preparation is better tolerated generally. Simon

Jun 16, 2011 Garry 328 posts	Topic: Questions for HCPs / Metformin /Type 1 Don't get me wrong, Metformin hasn't had any laxative effect on me. But they do have another pretty common side effect.....they are nicknamed 'Metfartin' for good reason. Regards Garry

Jun 16, 2011 Karen Westwood 38 posts	Topic: Carbohydrate Counting / Jacket Potato I agree with JWo on this one. Had the same problems with jacket spuds and asked at my DAFNE refresher course. I was told to weigh the potato raw and work out the carbs from that weight. This has worked for me since. Good luck Karen x

Jun 16, 2011 novorapidboi26 1,816 posts	Topic: General Discussion / Great Cooked weight would only apply if you were only have some,of what is there......so weighing the amount of fried rice from the Chinese your going to have for example......... I always have the full amount so unlocked weights also suit me....

Jun 15, 2011 AllanR 15 posts	Topic: Carbohydrate Counting / Jacket Potato Basically just going to keep on doing as at the beginning....half the normal dose for it, and anything need fixing, fix it later. Seems to work fine so far really with very little fixing needed. Not a perfect fix, but a good enough one which works for me and you don't have a set of scales when your in town getting lunch.

Jun 15, 2011 Linda S123 8 posts	Topic: Questions for HCPs / Metformin /Type 1 Wow ! Im beginning to think that the reason it is used for weight loss is because nothing stays inside for long enough !!! The weight loss side would be of benefit, but Insulin resistance has been suggested as I have been IDD for coming up for 40 years and have highs where I shouldnt have. I appear to have the dawn phenomenon around lunch ( always was a late starter ! )

Jun 15, 2011 JayBee 582 posts	Topic: Carbohydrate Counting / Jacket Potato Have either of you actually looked at weighing the spud raw and going on that like Carolin was saying? I have and it works out great for me. No problem (even eating the jacket to make sure). Why are you over complicating it?

Jun 15, 2011 JayBee 582 posts	Topic: General Discussion / Great We are not talking about the CPs changing - it's the weight that is changing due to the water absorption (or loss)! If you usually cannot weigh stuff like pasta or rice before cooking then you're going to be looking at risk every time. I've found cooked weight to be so very unreliable so I always trust the uncooked weight. You just don't know how much the water it was cooked in is effecting the weight so it is a risk every time. This is why so many have so much trouble with these foods! In another discussion about jacket potatoes in particular on this forum (Please take particular note of what Carolin the HCP says), they are also something to be wary of because they're not processed before hand.... therefore, when the water content changes when it's prepared in whatever way it is, you just cannot rely on the idea that it will be the same every time after cooking. Best to weigh it before cooking to get the more reliable CP total. On the note of already processed stuff - like a microwavable pasta meal - I would believe the labelling on the packaging personally because it's likely that the water has already been sorted out for you.

Jun 15, 2011 JayBee 582 posts	Topic: General Discussion / Carbs v Cals Sorry, I wasn't able to add the links earlier... I remembered wrong - it was how active fat can cause Type 2 diabetes... Here's a link to the clip I meant (From Diabetes UK). When I watched all four episodes, it was just frightening to see it in action. I think when you try to apply life style changes, you really have to work out what is best for you as an individual. I do have suggestions but most of them are summarised by simply remembering "small goals work towards the main goal". You do not have to cut anything completely out of your life (unless it's stuff like smoking of course) - you just have to remember that moderation is key (even for things like exercise - as I learnt while trying to do push ups with no prior training! I do not recommend this lol, start with wall pushes definitely lol). ^_^;

Jun 15, 2011 dafne-dude 11 posts	Topic: General Discussion / Advice if possible. Hi Deanna, Yeah i've noticed some changes in my ratio but only at breakfast and only at the w/end normally i'am 1:1 ratio for all meals but just recently i've had to up that to a 1:2 for breakfast but like i say only at w/ends?? it's weird... When you say burning- do you mean while injecting or after?? i've noticed some injections sting a little more than others...

Jun 15, 2011 Garry 328 posts	Topic: General Discussion / Advice if possible. Use and post your on-line diary occasionally and people will try to assist. DAFNE teaches ratios in QA:CP or in your case mentioned a 3:1 ratio. Don't get stressed about your ratios changing as it happens to us all at different times during the year...infection...activity levels...work stress...lot of things have a quite dramatic affect upon our resistance to insulin. Don't worry about it. Just keep up the discipline and things will work out for you. We are all looking to live as normal a lifestyle as possible and yet avoid some of the long term effects that being a diabetic infers. Follow the established rules and live life to the full Regards Garry

Jun 15, 2011 Garry 328 posts	Topic: Questions for HCPs / Metformin /Type 1 My consultant's approach was to help aid a reduction in ratios. Has not had the desired effect for me at this dosage. I'm not really willing to up it though, as I suspect that it will have other undesirable impacts upon digestion! Regards Garry

Jun 15, 2011 deanna 8 posts	Topic: General Discussion / Advice if possible. Ive been diabetic over 2 years now. Has anyone got any ideas why, unitl recently, i was on a 1:1 ratio for all meals, for this to change in a matter of months ? First to go was breakfast - im now on a 1:3 ratio, my CPs are 10 = 30QA Slowly but surerly came tea time - im now on a 1:2 ratio but ive got a nagging hunch that this is increasing at least to 1 : 2 1/2 ratio. At the moment lunch is still an unsteady 1:1 ratio With increasing awareness on my part, eating after 3oclock in the day results in a 1:2 ratio (worryingly similar to evening tea) This is very worrying for me as i am having other difficulties with my diabeties at the moment such as morning high BG without night hypos, burning under the skin from my insulin, and a number of other physical symptoms like headaches and nausea. With this ever-increasing rise in my need for more insulin i am starting to freak out as to what further side-effects are in store for me and if i can handle them. Please, any opinions would be good x

Jun 15, 2011 deanna 8 posts	Topic: General Discussion / Great Hi everyone. Ive only been diagnosed 2 n a half years now. The dafne course was brilliant for me, i took it about 7months after i first got diagnoed. Dont know where id be without it. I think it really helped learning about CPs and correction from the get-go, id recommend that everyone with diabetes go for this course as soon as they can. For me i try to stay away from foods like take-away rice and pasta because you never know how they make them, the portions size or anything. Pizzas loads easier to work out. Or if your set on rice and pasta, the trick is to look on the back of the packaging (microwaveable) when your in the store, look at a couple with different sauce etc so you get a good visual, especially if youve had one before because then you know the portions size for when you get a take-away. Believe me this works But to be honest i did a lot of guess work when i first go diagnosed until i took enough insulin for the food i was having, while i tried to stick with same meals and portions. While this worked somewhat successfully, carb counting, wow... when youve got the general principles set in your head you know it all I can now just look at a plate of food in front of me and know the CPs and the amount of QA i need to take. Its bril. So yes carb counting gets way easier as time goes on, i havnt picked up my CP book in ages x

Jun 15, 2011 Karen Westwood 38 posts	Topic: General Discussion / Hb1Ac results Thanks for that Sarah, think I might have a look into it. Like your comment about the lie detector machine, how true is that!! Its good to see that others have ups and downs too. 30+ years is a long time to be good all the time isn't it I managed to get my HbA1 down to 6.7 following my DAFNE course 2 years ago and this was classed as a normal level but now it has crept back to 8.1 which I am told is only 'average'. To be honest I think that the guidelines have definately reduced over the years and they are now asking for lower levels to be maintained (in an ideal world!!). You seem to be doing well at the moment though so keep up the good work. I am back to blood testing before each meal in the quest to reduce my HbA1 further and become 'normal' again lol! Good luck Karen x

Jun 15, 2011 novorapidboi26 1,816 posts	Topic: General Discussion / Carbs v Cals What lifestyle choices do you make that you think benefit you most....