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Apr 20, 2011 derekh1965 92 posts	Topic: General Discussion / Dawn Phenomenon Hi My name is Derek, from Edinburgh. Diabetic for 17 years. Should probably have introduced myself in the new users topic. Just completed my DAFNE last week. I was never told about CPs or ratios, just had to guess. Was on umalog and Humilkin I at teatime. I too for years had a high blood sugar in the morning. Doctor just told me to keep increasing my Humiilin I. I always eat a supper so would inject what I normally would for what I was eating and always woke up high. Sometimes I would wake up at 4:30- 5:00 hypo, take my sugar and couple of biscuits and then wake up high!! It wasn't until a few months ago a nurse told me about the "Peak" Isophane has between 4 - 6 hrs. So if I'm injecting at 6pm and having supper at say 11pm there's the Isophane peak plus my fast acting kicking in. I reduced my fast acting dramatically, never believed I could get away with taking so little, 14-16 down to 2 units and I was amazed to see I was normal in the morning. My supper was mostly no carb so don't follow my injections, but you could maybe try rreduciing your ratio to a 1:1? Then again I am no expert and don't know what insulin you take, it was what worked for me. Derek

Apr 20, 2011 JayBee 587 posts	Topic: Questions for HCPs / Information on menstrual cycle MelissaF said: J - I think that a thermometer is just a thermometer so I guess it doesn't really matter where you get one from. I got a kit from Boots for about Â£20 but I think that you're probably just paying for the little book that you get with it rather than anything special about the thermometer itself. I've not had a chance to look into it but if any thermometer is good, great. I have a thermometer at home. I plan to start my tracking next wednesday, so I start at my "normal" point.... Hopefully.

Apr 19, 2011 Carolin 83 posts	Topic: General Discussion / Travelling on a pump! Hi DAFNE Pumpers! I have heard recently that Virgin Atlantic (possibly others too?) are now asking for you to have the information about your pump manufacturer, model and serial number either provided to them at the time of booking, or on your doctor's letter. Forewarned is forearmed! Happy travels

Apr 19, 2011 MelissaF 56 posts	Topic: General Discussion / Hi All :) Hi Hayliee-Louise, I've just read your post and just wanted to say hi. You sound like you're in a bit of a scary place at the moment but, from what you've written, you seem to be moving everything in the right direction so just keep going with that. Diabetes is a bit of a pain in the a*se but there are many worse things out there and, if you spend a bit of time on it and learn about your own body then you can make life a lot easier for yourself. The more time and effort you put into your diabetes, the better it responds to you. Definitely get yourself onto a DAFNE course asap. They're completely invaluable in my opinion. Yes diabetes means that you have to think a bit more about what you're doing but that's not necessarily a bad thing. Your job sounds pretty frantic and stressful but DAFNE is designed for things like that. When I was first diagnosed (23 years ago) we were all given set doses of insulin that we weren't allowed to change ourselves and we were expected to eat the same amounts of carbs at the same times every day. Obviously no-one can really live like that. These days, with much better insulins and more research into regimes, we can be totally flexible. DAFNE is designed to fit around your own particular life and to maximise your control, whatever. It even gives you the flexibility to eat the sort of food that you like although, as with everyone, fats and sugars still aren't great things to live on! I work silly hours and have a young child. I'm not perfect by any means and it's something that I have to work on all the time but DAFNE has made life so much easier for me. Congratulations on your amazing weight loss - that's fantastic. You should be so proud of yourself. You must be feeling so much better already. Now you just need to get an idea of what's going on with your diabetes and you're well on your way. Are the other health problems linked to the diabetes or might they be something else? Obviously get those looked into asap as well for your own peace of mind. Stress is a great factor for me in bad sugar control so, once you can get answers for that, that should all help too. I don't actually think that your HbA1c is as bad as it could be either. You really haven't got that far to go... All the best with everything. Melissa

Apr 19, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / No change to HbA1c Melissa, I agree with purely testing before meal and not snacking, that is the DAFNE way and why were all here after all. Only when your doses are correct can/should you then investigate your in between meal spikes, that were the dose times come in, all foods digest at different rates and I suppose at differently at certain times of day. So trying to match that digestion with your QA 10, 20, 20 minutes before the meal can help in my experience.......

Apr 19, 2011 MelissaF 56 posts	Topic: Questions for HCPs / No change to HbA1c Hi Vic, Interesting to hear that you're having similar problems with your HbA1c. I would suggest to maybe cut down on your testing between meals for a few days and to just test as DAFNE dictates before each meal and see where you are then. My HCP said that it's really hard to apply the DAFNE rules when you're testing throughout the day as the DAFNE rules tell you not to. This may have changed since I had the conversation with her though so please feel free to correct me. Maybe see how your results look from there and then look at BI levels and meal ratios to see what needs correcting by the rulebook. The other thing that I'm bad at doing is testing too often and then giving myself too many corrective doses. This means that my sugars constantly yo-yo from too high to too low and never really stabilise. Might this be happening to you? This is also something I associate with feeling rubbish pretty much all of the time as you describe. When you test between meals and you get a high reading, do you then correct with a QA dose? If so, this might be causing the low before your next meal. It might be worth just observing and seeing whether it would have dropped normally without your intervention. I'm not sure if this means that we should expect highs betwen meals or not as I guess we wouldn't normally be aware of them with DAFNE testing. Can any HCPs advise? If we shouldn't be seeing that and it's a problem then maybe a pump would be an option as that constantly monitors and corrects doesn't it? The other thing that JWo suggested to me is trying to be really good about not snacking between meals for a while. This isn't to say that you can never snack between meals obviously, it's just that this obviously makes your readings a bit less clear and it's easier to see what's going on if you restrict carbs to mealtimes for a few days just for the sake of clarity. With me, if my levels are constantly dropping throughout the day, this usually means too much BI so maybe keep looking at that as well. I also agree with what Novorapidboi says about when you take your QA. Although we are told that it doesn't make a difference when we take it, I'm convinced that it does. I quite often take it after a meal when I can be sure of the number of CPs I've eaten. However, I know that my control is much better when I take it before a meal. I guess you just need to experiment to see how it affects you. I also agree that you don't want to be doing that if your levels are low to begin with though so definitely try and solve that one first. Let me know what you think. Melissa xx

Apr 19, 2011 MelissaF 56 posts	Topic: Questions for HCPs / Information on menstrual cycle Hi guys, Sorry it's been a few days. Have had a 2 year old with chickenpox and don't really log on when I'm at home. Back at work now... I think that all women are really different when it comes to stuff like this so it's probably totally impossible to generalise with things like breast tenderness. Personally it's something that happens to me 2-3 days before my period is due but I don't really get PMT too badly so I'm guessing it's a lot worse for some. Also, I'm sure that some women do experience it during ovulation as well. Also, I know that my own syptoms vary massively from month to month. I guess if you chart your own cycle for a few months you may start picking up on stuff that's typical to you which you may not have noticed before. J - I think that a thermometer is just a thermometer so I guess it doesn't really matter where you get one from. I got a kit from Boots for about Â£20 but I think that you're probably just paying for the little book that you get with it rather than anything special about the thermometer itself. From what Caroline was saying, it would certainly seem that her cycle follows what I understand the pattern to be... in that it's the Follicular phase that it variable with diffferent cycles and the Luteal phase that seems to be a more set 14 days from Ovulation. As it's the Luteal phase that seems to determine your increased insulin requirements then this should be a bit easier to work out if you're aware of ovulation. Is Glucophage the same as Metformin? If so then yes it apparently can work well in regulating your cycle. If your increased insulin requirements are due to hormone levels then I guess that it may well even help with this as it can be used to lower insulin resistance (it can be used to treat Polycystic Ovary Syndrome where insulin resistance can be caused which, in turn I think can bring about Type 2 diabetes). We need feedback from an HCP on this though as I'm only guessing. Apparently it's pretty safe to use though and most docs will prescribe so definitely worth a go if you think it might help. My only tip would be that the standard Metformin can cause stomach upsets so best ask for the Metformin SR which is a bit gentler. M xx

Apr 18, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / menstrual cycle DAFNE Extra AHH......thanks, I understand now................that's a great idea to be honest, especially if they could figure out some kind of rules when it comes to the woman's menstrual behaviors.. I personally think lifestyle plays a large part on whether people stick at it............during the 5 days there the testing actually shows the principals working, so for those five days everything is exciting and new, and making sense...........but as we all know, things change every now and again, ratios, BI requirements..........it can be hard to get motivated when you just dont know whats happening.................online support like this and other diabetic forums should be mentioned much more I think....

Apr 18, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Hi All :) Hayliee-Louise said: How have you guys found diabetes & weight gain/weight loss? Before DAFNE my weight went up and down, I was on M3 too, but the 2 years run up to me pulling the finger out, I had lost a lot, didn't really notice it to be honest, but I was in a bad way. Ever since getting on top of things my weight has gradually went up, I am overweight but its a small price to pay for good, well, getting better, HbA1c results. My theory is/was that my body was starved of fuel for so long that it got used to using its own stores of fat and muscle for energy, and then pretty much overnight it was given real carbs and then insulin to process it, so in a panic it started to store energy (fat) in case it was forced to use its own stores again. It may be a wee fantasy I have came up with but I have convinced myself there may be some truth in it, however that was a few years back now, so whats my excuse now.................getting my thyroid checked this month, so maybe that may reveal some answers. You dont seem to be on a lot of insulin, do you eat much carbs.......? Most people lose weight after DAFNE as they fine tune there doses and actually end up on less than when they started.......

Apr 18, 2011 Hayliee-Louise 5 posts	Topic: General Discussion / Hi All :) Ps. Thanks for the link James, I'll deffo be having a go at that, just what I need whilst i wait for my new regime! Thanks a lot.

Apr 18, 2011 Hayliee-Louise 5 posts	Topic: General Discussion / Hi All :) I lost 5 stone in 6months once I was started on insulin. I was dress size 24, I am now a 10. Although I feel great as i never really understood why I was so big and jut couldn't shift the weight, I know it wasnt healthy. How have you guys found diabetes & weight gain/weight loss?

Apr 18, 2011 Hayliee-Louise 5 posts	Topic: General Discussion / Hi All :) Thanks for the replys guys, hearing other people's story's really does help you understand your own. Im going to hospital this week for a 24 hour heart tracker, doctors suspect Ectopic Beats, good or bad news it will put my mind at rest if I know once and for all. Im pushing for the course and awaiting my bolas regime, I'm currently on humalin M3 quickpen, taking 20mmol AM & 20mmol PM. I've explained to doctors I'm 21 with no real routine or structure to my life and can never really plan meal times, I have a busy job working for the NHS and it's a case of "grab lunch when you can". I love my job and the people I work with, doctors at my surgery are often giving me advice and keeping there watchful eye on me lol! At first checking my blood was a real pain so to be honest I didn't bother. I've just recently been given the Accu-check mobile tester which is making life a lot easier and now check my blood between 5/6 times a day. With stoping smoking, cutting out carbs and introducing exersize slowly until Im placed on DAFNE & Bolas, I'm hopping I can improve my sugar and maintain my weight as o l

Apr 18, 2011 Athena 52 posts	Topic: Questions for HCPs / menstrual cycle DAFNE Extra Hi Novorapid boi, Barriers to success are being investigated. These might be motivational , like patients feeling that DAFFNE is too much work so they give up, or they feel much iller on DAFNE sot hey give up, or, they might be physiological like there is some reasons to do with particular people's bodies that make it impossible for them to get control. By doing research with hundreds of graduates into all sorts of issues they hope to identify what the main problems are. Then they will design a course that will be part of a refresher and part new stuff with answers about how to overcome these problems. Us girls are hopig that our hormones and how they affect bg control will be covered in the course as so many of us are changing our BI all the time as our insulin requirements change over a month which is a nightmare. Hope this covers it but the course will not be delivered a s a pilot for a year or two and it will take longer for it to be rolled out nationwide.

Apr 18, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / menstrual cycle DAFNE Extra So what aspect is it that is being investigated exactly, sorry, I didn't quite follow............

Apr 18, 2011 Athena 52 posts	Topic: Questions for HCPs / menstrual cycle DAFNE Extra Hi All, Spoke as promised to people doing research into DAFNE with a view to designing an additioanl course for graduates. this will be called DAFNE Extra and will help people who ahve not managed to get control. They are currently investigating barriers to control. These could be psychological/ motivational for instance. They are also looking at physiological barriers which is where we come in. I explained our problems and they found this quite interesting. It was great talking to the researcher. In MAy, there will be another meeting and she will raise this issue with the people investigating the physiological barriers. I mentioned that it wasn't jsut me, there was plently of other people on the on- line discussion who were all experiencing the same problems. Unfortunatley, the underpinning research and then subsequent design of a course means that we won't see DAFNE Extra pilot courses in some of our centres for at least a couple of years! However, you may be interested to know that there is research going on with hundred of DAFNE graduates, some of which should be published soon. This looks at quality of life after DAFNE, and all sorts of issues about controland how people are getting on, not just HBA1c results. It will be really interesting to see if anything comes up.If I find anything, I will post the links here. In the meantime, I think we should keep the discussion going in order that there is recognition of what we all feel is a gap in the DAFNE education. take care everyone. Take

Apr 18, 2011 novorapidboi26 1,819 posts	Topic: Site Development / Online Diary......... Always a quick and efficient service.............thanks......

Apr 18, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Hi All :) Hi Hayliee-Louise, welcome to the site.......... You haven't been diagnosed very long so although your control has been bad for a while, you can turn it around and reverse some of the symptoms you may be having. The fact that you have acknowledged you should start to make an effort is really good, and a lot quicker than I realized, took me 10 years really. The quicker you get on DAFNE the better, the things your told about just make it seem so simple, its amazing, dont get me wrong, Diabetes is still a pain the ass and you can get blood glucose readings that just dont make sense, but for the majority of the time it does really work. An HbA1c of 10.2 is not too bad, I was 11.8 pre DAFNE, any higher and they were going to say NO..... ......and I was actually following the basic principal unofficially for over a year....... What insulin regime are you on now....?DAFNE will teach you to spot patterns with your blood sugars, establish how much background insulin you need over a 24 hour period and successfully change your own doses of both your background and meal time insulin. In the meantime you could visit the Bournemouth Online Carb Counting course, basically DAFNE but online........you can find it HERE.......might give you a head start and let you see some good blood sugars. If there are any general questions or information you would like, dont hesitate to ask, no question is silly..... Hope to hear from you soon..... James....

Apr 18, 2011 vic demain 87 posts	Topic: General Discussion / Hi All :) Hi Hayliee-Louise, welcome. First thing you are obviously very bright, that comes over in your post. Second, you have now accepted the fact that you have a problem and cannot continue to ignore it. So you are half way there. It is not easy and no one should tell you that it is. I have had Type 1 for 30 years and still my control is poor even though I have done DAFNE and worked bloody hard at it. But we both have choice, try and improve to hopefully enjoy a happy long life or ignore it and suffer the consequences. Badger your GP to get on a DAFNE education course, point them to this site, they will fight you but don't give in, show them that improved control will save the NHS money in the long term. You shouldn't have to live through the worries that you have, they are not necessary, with help and your commitment you can cope with diabetes. Good luck to you, you have a life to enjoy.

Apr 18, 2011 Hayliee-Louise 5 posts	Topic: General Discussion / Hi All :) Haha well now I feel a tool, bloody touch screen, anyway I'm 21 and I was diagnosed with type 1 diabetes on Xmas day 2010. If I'm honest the severity of the disease is only just starting to sink in recently. At first I stuck my head in the sand hoping it would all dissapear, sadly as you all know, that's not the case. It's 3:30am and i am currently led in bed scared to sleep due to palpitations and constant heart flutters that I have been experiencing recently. I found this forum just as I was mooching on the net about DAFNE as I'm hoping to be placed on a course in my area soon (Lancashire). My sugar control is terrible, I know little about the disease and how to control it and as a result I'm not, my blood sugar levels have been in the region of 18 - 30 for around 18 months now. Shocking I know, but I was stupid and really just couldn't get my head around this. I also suffer from Neuphrotic Syndrome I was diagnosed when I was 12 months old. When I was diagnosed with Diabetes I was having many personal & family problems which led to me having poor control, like I said I didn't understand the severity and to be Frank at that time I didn't care. 18 months on and a little wiser and after some research and interest on my wellbeing (I know that sentence sounds bizarre) I have come to realise the damage I am doing and have already done. I'm already suffering from numbness, tingled in my arms and legs, palpitations, blurred vision. I haven't slept at all really for the past week as my palpitations are getting out of hand, truth is in scared to sleep, scared I might not wake up. I've had 1 "hypo" since diagnosis and it was a scary thing. I'm hyperglycaemic so when my blood sugar does drop (lowest I've ever seen is 10) I feel like in having a hypo. I often have ketones and I was smoking also, thing of the past now though. Truth be told I'm so angry at myself for not realising how serious control is earlier on, and Im disgusted with myself. I'm finding it very hard to adapt. My last Hba1c was 10.6. I have taken it upon myself to research calorie counting as Im waiting to be placed on a define course and awaiting my bolas plan. The nurses at my hospital often find it hard to help me as they say I'm specialist. I really do hope things get better if I'm placed on a course, because at the moment I can't cope it's really effecting me day to day. I know what I need to do just dont really know how to get there. Please tell me with education it gets better! Hope I haven't bored you all death lol! Look forward to any replies guys x