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Apr 25, 2011
JayBee
587 posts
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Topic: General Discussion / latest figures Definitely stop correcting within 24 hours of hypos (you did it on the 21/04 as well - well spotted later on though!)... your insulin sensitivity is increased during that time and therefore "breeds more hypos" (called the boomerang effect because your BGs bounce up and down as a result of the correcting for the hypo highs).Once you stop that sort of correcting, things might become a bit clearer.  Keep up the good work!
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Apr 25, 2011
JayBee
587 posts
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Topic: General Discussion / Help Okay, I've just done a bit of research on the Hypurin Porcine Neutral insulin... the DAFNE guidebook (pages 12 - 13) says it starts working within 30 minutes after the injection, peaks around 2-4 hours after and can affect you BGs up to 8 hours after. This does make things a bit awkward considering it doesn't work as efficiently as the QA Analogue Insulins (like I use.. I'm currently on Levemir, a split dose BI, and Humalog, a 5 hour working QA).It's because you're correcting so much that I really don't think your BIs are fine personally. I don't understand why you've been advised to have a cap on how much correction you should do on that note - you should be looking at how much 1 QA unit takes you up or down by, not restricting you to some set guideline. Considering you're on HPN though, it might be better to speak to a specifically to a DAFNE nurse (not just a DSN team member) about this. DAFNE is all about working out what your body specifically needs. DAFNE gives you so much power over your own condition and it can take some time to work out! There is some trial and error involved unfortunately.  Your BI is supposed to do most of the work so you're not having to correct so much.... unless you've taken the wrong insulin for your food, or have exercised, or are having a naturally produced high after a hypo because your liver released glucose to assist you. There can be other factors to consider like these. Try not to be afraid of hypos while you're working out your requirements. Hypos are a good sign that you've hit the top limit of what insulin your body wants and this should prove very helpful to you (I'm not sure now because of the animal insulin QA). ...and I've just noticed that novorapidboi26 has also said this! Kudos! ^_^ When you do hypo due to a change, you're allowed to apply the one day rule which states for you to reverse the change you made, eg, if you put your ratio up for lunch but found you hypo'd within the insulin working time, it's safe to assume that it was probably caused by the ratio put up so put it back down so you don't hypo again the next day. 8 hours is such a long time to have to wait... so much over lap... I understand about being uncomfortable with taking on so much insulin or being too afraid to let an old fear or habit go... It took me a year or two to stop myself from correcting after hypos because I was worried about going high. I was extremely worried about going high. Oh dear. Um, I personally would never do the Atkins diet because it encourages ketone production. It works like when you leave your sugar levels high. If you don't eat for long periods/do exercise, your body naturally produces a small (harmless) amount of ketones as a result of your body burning body fat. Ketones can be a harmful waste product of this particular process if in your system large quantities (it's why DAFNE gives us the sickday rules that are dependant on ketone amount) and diets like the Atkins encourages this larger production. It is a route I would avoid because it's harmful and not worth it IMO. If you look at your DAFNE guidebook, it is recommended that you use exercise to your advantage to get your insulin intake down and as a result, lose weight (see page 47 particularly). When you exercise, your body uses insulin a lot more effectively so you need less insulin than usual. It may not give quick fire results, but it will be a much healthier option in the long run.. your insulin demand will also change as you exercise, often resulting in your body being a lot better user of insulin as a whole. I can understand that with some carb free meals you still need insulin - you're not alone because I know there are others on this forum that also have to even count sausages (though I don't have that problem myself to be honest). As long as you don't go nuts with eating veg, the carbs are so slow releasing so you can usually get away with no insulin... but I know some people are different (such as the sausages situation) and find they do need the insulin with veg (though not much!). You do clearly have quite a puzzle on your hands, I hope the DSN call tomorrow gives you some better answers. Best of luck!...and to also add, as novorapidboi26 has hinted, you may need to consider the dawn phenomenon issue that some diabetics have, but considering your BGs are consistant from evening to morning, I'm not convinced that you need to look too much into the dawn phenomenon issue (but that's me). In all seriousness, I do hope you can get some answers from your DAFNE team.
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Apr 25, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / Help it looks like you use similar correction rules for higher blood sugars, like me, the aim should be to get your morning as close to good as possible, with dawn phenomenon, this might not be possible/easy, you should try upping your evening dose until you go hypo during the night or in the morning...then you know your have passed the correct amount.Another option I have tried and has given good results, is to move the evening BI dose forward a few hours, thus leaving more insulin in the system at the time of liver action.... just an idea, whatsd the action time of animal background..... |
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Apr 25, 2011
novorapidboi26
1,819 posts
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Topic: General Discussion / latest figures a lot of lows and your giving yourself more insulin, take a look at your BI again while your QA ratios are the same all day....... |
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Apr 25, 2011
Neil Brown
28 posts
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Topic: General Discussion / latest figures quite a few hypos but dealing with them better than before ! |
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Apr 25, 2011
derekh1965
92 posts
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Topic: General Discussion / Help Hi JWoThanks for replying. As I said I have been on Humalog for around 15 yrs and have always injected into the middle section of my body, I do rotae the injections always I injected into the buttocks for lunchtime and will try other sites from now on as you coulkd be right about the lumps, although threre are none I can seen or feel. I don't know if there is a long transition time from Humalog to anilmal insulin because I seem to need a lot more animal insulin. Went to see the dsn who done the dafne course last Thursday and she reckoned I needed a 4:1 ratio and was very resistant to insulin. She said the BI was fine because the BS's were consistent during the day, IOW lunch 12 and dinner still 12. Though it looks like she didn't take the corrections into consideration she did say I should go upto a max 0f 8 correcdtion and a 1:1. Looking at this mornings BG and amount of insulin and then higher at lunchtime is why I am so frustrated. For lunchtime I had 3 cps and should have taken 15+7 correction/22 units total, I only took the 15 as I have never taken as much insulin as that and my BS's are never as high as this so was a bit para about hypoing. I will phone the DSN tomorrow as they are on holiday and see what she said. On another note I mentioned I was trying low carbto try and lose weigt, both her and the dietitian didn't like that one bit. I read the Atkins diet and was getting carbs from vegetables but shake their head, no, no, no carbs in vegetables yet i still needed insulin. Their reason for this was because my body was crying out for glucose so was sending a signal to my liver to produce glucose. Your thoughtrs on this would be much appreciated. Best regards and have a nice day every day Derek |
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Apr 25, 2011
JayBee
587 posts
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Topic: General Discussion / Help I'm not sure what to say about the doses at the moment considering you've admitted to being overly dependant on your stomach area and being on animal insulin... but I will try.Firstly, you should be circulating your injection sites for your own good - because you're so reliant on your stomach, this may be why you're not seeing any effects of the new doses you're taking. Lumps can develop that are not always easy to spot and once you have them, they can hinder your insulin release. This can result in unexpected hypos or highs. It's almost always buttocks for my BI jabs but if I cannot, I do the sides of my thighs because this is where the fat is on the legs. I used to inject in the top/front of my thighs, but considering that's straight into muscle, this isn't a good practice which I soon got corrected when I did my DAFNE course. For most meals I try to use my thighs or my stomach. If I have to inject in the same spot more than once during a day, I try to keep the injection sites away from each other. If I get desperate, I'll inject my arms, but I don't have much fat to inject there. Try not to feel depressed, you can do this. The fact you're trying to work this all out is great progress! Don't be afraid to ask loved ones for help as well because sometimes they can help bring things into perspective as well.I find it very interesting that most times you're around the 11-12 BG range. This does suggest to me that you need more BI assistance (to stop all that correcting) rather than ratio adjustment, but I am speaking as a human insulin user. I have never used animal insulin through my 21 odd years of being a type 1. Considering you have also admitted to trying humalog for a day when you're on a different insulin - this will not help you because you should be leaving it at least two days of similar patterns to establish if it has worked for you. I'm not sure about animal insulin, but you must also realise that quite a few QA insulins can work up to 5 hours after you took the dose, so some of your blood tests are not giving you the clear picture you seek. If you plan to adjust your BI, my nurse recommended that I leave it longer than 2 days to see any changes because, well, your body needs time to process it. She recommended a week to me, but others may disagree with this. Also - avoid correcting after a hypo. When you hypo, your body's sensitivity to insulin increases and if you correct, can lead to another hypo (also known as the boomerang effect). I know you've not hypo'd again on these results you've posted, but you need to be aware of this. I think that if you stop and give your body a chance to use the insulin you're giving it, and circulate those injection sites, things will become much clearer. On that, trust me, you're not the first to have this trouble. I have been just as bad myself but luckily have managed to break some of the bad habit! ;) Keep your chin up, you'll get there! If it helps, look at getting hold of your DAFNE centre number so you can confirm yourself as a DAFNE graduate and get access to the DAFNE guidebook here on the DAFNE Online website if you don't have your own book. If you have any trouble with this (like, for example, you centre has shut down now), use the contact link at the bottom of this site page to contact the DAFNE Online team directly for assistance.
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Apr 25, 2011
derekh1965
92 posts
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Topic: General Discussion / Help HiI am a 46 yr old male, diabetic for approx 17 years. Been on Humalog and Humilin Isophgane for around 15 of those years. My blood sugars were always high before breakfast and was told to just up my Isophane which I was taking at dinnertime They tried me Lantus about 4 months ago to0 see if it would make any difference but I just didn't feel right on it and asked to try animal insulin. Have now been on Hypurin Porcine Neutral and Isophane for 3 weeks. The Isophane twice a day. I graduated from Dafne 2 weeks ago where I was on a 3:1 ratio. BS was runninjg high so they put me on a 4:1 last week and they are still running high, as you can see from my diary. I decided this morning I would try a 5:1 as the 4:1 wasn't doing anything considewring the amountn of correction dosages. No surprise to me this lunchtime I am higher despite taking a lot of insulin. I onjly had 1.5 cps for breakfast, 1 slice of wholemeal bread b(15g), boiled egg and tablspoon of mayonnaise. I need some help and hopefully somneone here can advise me. I am overweight and I hate it, hate being unfit, tired, depressed etc. My BMI is 43 (tested at hospital) and my waist size is 46",but I'm a nice guy lol. I use 5mm needles to inject into my stomach, should I maybe inject somewher else or use longer needles? Used to use 12mm ones and changed onto the 5mm 6 months ago. Appreciate any help you kind folk can give me. Best regards Derek |
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Apr 25, 2011
caroline15
45 posts
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Topic: General Discussion / Feet Problems Does it hurt more in the morning then wear off? I had Plantar Fasciitis which is sometimes known as a heel spur too (not sure why as there is no extra bone). The dr gave me voltarol which did the job. Hope it clears up soon. |
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Apr 25, 2011
JayBee
587 posts
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Topic: Questions for HCPs / Information on menstrual cycle I couldn't wait! After the work I've done for the past two weeks and today being my dreaded "bad hypo" time of my TOTM, I've taken my temp as well this morning! It was 35 C exactly!Here's an update on my progress:
I can't believe I've been on 10 MORN BI and 16 EVE BI for 2-3 weeks now! I've not had much luck with some of it though because I've been living life which has meant some guesswork with treats and the like... and my workplace routine changing yet again which did result in some hypos. >_< Very annoying but I've not had a hypo over night so 16 BI must be the magic number! Shall carry on checking! |
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Apr 25, 2011
vickyrees
6 posts
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Topic: General Discussion / Feet Problems Thanks HelenPYes I does appear to be what you suggested it could be. I have looked on a few websites and looked at some images and it is a pretty good match. The website suggest a few things to do to help the problem which I will give a go with some of them, otherwise if all else fails I am at my clinic in 2 weeks so I will be having my foot checked then. Thanks for you advice and I think you might have hit the nail on the head Regards Vicky |
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Apr 24, 2011
HelenP
218 posts
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Topic: General Discussion / Feet Problems Vicki,Have you thought of a heel spur? I'd be off to have it checked. Helen |
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Apr 24, 2011
Robby N.
7 posts
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Topic: Questions for HCPs / Fitting when hypo Hi Jules, when you skip lunch eyc do you take insulin, if you have no carbs at meal time you do not need to take insulin, hope you get on a course soon and get sorted out, I like you lost my hypo awareness but since I did Dafne 2 month ago, I have got my awareness back, I felt Dafne was quite intensive, but it was well worth it, even if just to get the awareness back. Oh and I have never fitted during a hypo, but it is not uncommon. Hope this helps. Rob. |
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Apr 24, 2011
jules1
3 posts
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Topic: Questions for HCPs / Fitting when hypo Thank you for your replies, since I saw the nurse who told me about DAFNE I am learning alot. The last time I had my Hba1c was 2007 it was 6.1, before on average it was 6.4 to 6.5. I'm not injecting the amounts I used to but my sugars are getting higher & higher, wake up 14 - 16. Just need help with ratios, plus I'm not a big eater, skip lunch, sometimes dinner, if im not hungry I struggle. |
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Apr 24, 2011
derekh1965
92 posts
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Topic: Questions for HCPs / Help with insulin and ratio HiMy name is Derek from Edinburgh, 46 yr old Type 1 for 17 years. Graduated from DAFNE over a week ago and I think it is great as previously I had never been told about carb counting or basal/bolus. I am very overweight and finding it really difficult to lose weight over the past few years. It was discovered I am very resistant to insulin and am on a 4:1 ratio and correction on a 1:1 upto a max of 8 units. As I can't contact the ospital until prob Tuesday I am hoping someone can give me some help with my insulin ratios etc because I have been running high despite taking a lot of corrections. I have been on Porcine neutral and Isophane for the past 3 weeks, prevfiously on Humalog and Humilin Isophane for about 15 yrs. The reasonh for change to animal insulin was because I was always high at breakfast, and they put me on Lantus to see if that would help but it made me feel crap. I had read on Diabetes uk how others felt the same on lantus and improved on animal insulin. Sorry if I seem to have gone on a bit lol. Derek |
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Apr 24, 2011
vickyrees
6 posts
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Topic: General Discussion / Feet Problems Has anyone experience a similar issue with their feet. I have (touch wood) pretty good feet and never had any issues until now, but I wanted to check if diabetes feet complications can be a pain thing as well as the obvious open wound sores.I have a pain in the skin of my foot around the heel area, the skin is not broken and there is no mark but it just aches. It feels like I am wearing shoes all the time with a big rock pushing into the flat of my foot near the heel. My husband thinks I might just have pulled a little muscle as he cant see anything wrong it but I have to say I do go on red alert when it comes to anything to do with feet having had diabetes for 19 years without little complications. Any similar stories please share Vicky Rees |
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Apr 24, 2011
JayBee
587 posts
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Topic: Questions for HCPs / Fitting when hypo I've never fitted, hypoing or otherwise, and hopefully never will.You all take extra care!
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Apr 23, 2011
novorapidboi26
1,819 posts
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Topic: Questions for HCPs / Fitting when hypo
I havent personally fitted, as I alway too high in the first 10 years of diabetes, my younger brother, who has had it 20 odd years has fitted though and been in a coma, he was very young though..... I would suspect a loss of hypo awareness due to the frequency you are having them, and this means you are on far too much insulin, DAFNE will teach you how to identify where you need less and how to adjust it on a few days basis...... I hope you get on one soon..... |
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Apr 23, 2011
Neil Brown
28 posts
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Topic: Carbohydrate Counting / Iphone Apps I use the DAFNE app on I phone it's is basic but gives enough info to get by |
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Apr 23, 2011
danilouise0104
1 post
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Topic: Questions for HCPs / Fitting when hypo Hi Jules,I have fitted 2 times and gone in to a coma with my diabetes, i have been type one for ten years now, i was asleep when my dad found me having a fit and foaming from the mouth, i then went in to diabetec coma i had this twice in a space of 3 weeks. It is common. I have just recently completed a DAFNE course and have found it so useful, it was a real eye opener to what you can do and the freedom you can have and to meet people who can also help you and advise you. I met a girl who was the same with her diabetes as me and she gave me some great advice and so did others in my group. I do think you will benefit from this course 
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Apr 21, 2011
JayBee
587 posts
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Topic: General Discussion / Travelling on a pump! In the 2011 issue one of Diabetes UK's Balance magazine it says that even pump insurance is hard to find because, to quote:
If this is a similar case with the flight stuff, it's not surprising that pump users are going to have to compensate for the lack of knowledge because they're currently part of a minority. Times will change I'm sure, but until then, best those with pumps now just simply get their doctor letter's updated (as Carolin points out)! |
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Apr 21, 2011
marke
681 posts
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Topic: Questions for HCPs / Fitting when hypo Hi, It has never happened to me, I will let others comment if it has happened to them. I would recommend the DAFNE course though and if your nurse is aware of it I would guess its available in your area. I did the course with someone who was hypoing regularly, as she said she knew all the ambalance crew by their first name At our 6 month re-union she hadn't had an ambalance since the course. It didn't totally stop every hypo but it did make a huge difference to her control and understanding of why it was happening. This is what DAFNE gives you NOT just carb counting.
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Apr 21, 2011
jules1
3 posts
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Topic: Questions for HCPs / Fitting when hypo Hi I have been type 1 since 1991 and I am 43yrs old, I have 2-3 hypos per day and 2 weeks ago fitted with a hypo, seconds before this happened I didnt even feel hypo. I saw my nurse at GP's who advised me to go on a DAFNE course. I am just woundering if any Type 1 diabetics have ever fitteed? |
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Apr 20, 2011
marke
681 posts
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Topic: General Discussion / Travelling on a pump! I would be interested to know if this is true. I have a number of issues with it. Firstly is this not discrimination ? Does it fall under the UK legislation for discrimination. Secondly what is special about a pump ? Because its electronic, like a phone or a handheld games console etc all of which are allowed on aircraft. Is it the insulin ? Ihave never had a problem with insulin and have never even been asked to produce the letter I carry. Agreed the time to challenge this is not at the airport, but in advance. If its true I would get Diabetes UK involved to challenge this attitude by Virgin and anyone else. I see no justification whatsoever to have to provide any details of the pump, if you have a letter to say you need one that should be it. 
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