Recent Posts - DAFNE Online

Apr 8, 2011

Athena 52 posts

Topic: General Discussion / Mesntrual Cycle

Dear All,

For those of you who are struggling to get control, and are seeing patterns linked to female hormones, there is a topic link about this in the questions for Healthcare professionals forum. You can follow advice etc. there.
If you are female and are struggling to get BI sorted, you may wish to consider that the problem might be related to your cycle and you may be able to chart the pattern which is a starting point for sorting it.However, you may also find that the step wise approach doesn't cope with this. For a lot of us, it seems to be too slow and lags behind the hormonal variations throughout the month.
It would be good to hear from females who have got this sorted and from females who got their BI and ratios worked out no problem i.e have found that the DAFNE step wise approach worked just fine and you use one BI throughout the month. If you do, can you also let us know if you are on the pill? This could be helpful for others who could try this.
Similarly, if you are struggling, it would be great if you could post too so that we can get an idea of the extent of the problem.

Thank you.

Apr 8, 2011

Athena 52 posts

Topic: Questions for HCPs / Information on menstrual cycle

Hi Jackie,

Thanks so much for getting back o n this one. An irregular cycle must have made it more difficult. I don't know how you coped!
I do think that they should mention it on the course. It took me about 6 months to realise that there was a pattern going on and then for the penny to drop. Why can't they just tell us? I wonder if it is because the step wise approach doesn't work for this. It is far too slow to keep up with the hormonal c hanges and, like you, I thought that it was me who was doing things incorrectly, but I couldn't work out where I was going wrong. However, I suppose if we work outside the step wise approach, it isn't DAFNE is it? But then there is no alternative or no DAFNE educatior is suggesting one. If I follow theDAFNE approach I spend one week a month hypo, both during the day and at night. I canonly take the night itme BI down by 1 per night and of course am not allowed to change the BI during the day at the same time so have to wait until the night time one is down low enough before starting on the day time one. No diabetic in their right mind would delibereatley spend a week hypo every month, but this si what the step -wise approach dictates. tTere seems to be no way out of it but to abandon DAFNE. thena s a patient you don't know what to do as you could be deemed non-compliant is you don't stick to the DAFNE rules.

If anyone else is finding difficulties and has not yet posted, please do so as this site is the only way to raise these issues on a nation-wide basis and maybe they will eventually change it.
Interestingly, on our course, there were 7 young women and 1 man. Only the man managed to get control, the rest of us still have not managed to work out our BI and it is well after the magical year. We have only succeeeded in making ourselves ill and our quality of life is much worse now, one girl having to give up work and me being on the brink of having to give up. we are all miserable and I just feel there is no point in being alive anymore, it is just horrible having to drag yourself through another exhausting day to collapse in bed and push yourself through it all again tommorrow. I was wonering about asking for hormone tablet to shut off female hormones or perhaps ovary removal. I am so desperate.If anyone has managed to get any of these interventions then please please let us know.

take care JAckie.

Igood luck with your pump JAckie. I am curious to know if this helps with tackling the hormone problem or not. It sounds as if it would be just as difficult on a pump as not on one. I think you will easily get the dawn phenomenon sorted on a pump as they will programme your insulin to automatically rise at the right time. itis just finding the right timing and the correct rise .
Please let us knwo how it goes with the hormone thing though as I would love a pump but do wonder if this would not work well because of the hormonal variations. If anyone else is on a pump and has this sorted via it,pleaselet us all know.

Apr 8, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / sick day rules

Ketones are processed by insulin just as glucose is so the more you have, the more insulin you need.....the thing with ketones is that is a bi product of a bodily function, so unlike eating, we have no control of them.

I can actually confess that I dont check for ketones unless I am unwell or have not eaten in some stupidly long time, which very very rarely occurs. I am only really high in the morning, and i will defo has a small amount then, and even if I have went really high, the insulin correction I take deals with the glucose, processes any ketones and dumps the surplus into the bog........... Laughing

Apr 8, 2011

Karl 83 posts

Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary)

I think its that it doesn't total up in the correction etc - if you do 8-1, the correction total is 0 and the tdd is 8 should they not be 1 and 7 ?

Apr 8, 2011

Simon 578 posts

Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary)

P.S. Hope you are enjoying the course! Smile

Apr 8, 2011

Simon 578 posts

Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary)

RobT, not sure what you're getting at here - the app lets you enter mealtime correctives in the format x+y, or even x-y if that's what you do. It then syncs them up to the site - what is the particular bug?

If I remember correctly on the DAFNE course they teach us to enter correctives with the mealtime dose in the above format, which has always been the guiding principle of how the app/site work.

Apr 8, 2011

daviebear 19 posts

Topic: General Discussion / sick day rules

I agree with novorapidboi there.Again I woke up with ++ ketones this morning with a high BG.I am aware that my high sugar is needing to be brought down by increasing my BI at night.I have been told by my DSN that my ketones are "starvation ketones",but not to worry too much about them.I do start the sick day rules regime(as advised to by my DSN),and find that after one or too extra doses of the TDD regime,that my ketones are gone and my BG is back down.I am aware though that ketones caused by other causes are not soo easy to get rid of.

Apr 8, 2011

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Postop patients using DAFNE

My understanding of the sliding scale is that it is basically like a pump except IV. With monitoring of BGs every hour or two..............so for me any patient on this, whether they are on a mixed insulin regime or MDI have to be treated the same way.

A DAFNE patient will probably be more suited to a sliding scale as they will know what there insulin/carb ratios are, which in my opinion is essential information when on the sliding scale. A pumper would be even more suited as this has many similarities in the fact there is a continuous supply of insulin and also the option to correct a BG at any time.

A mixed insulin patient would not be aware of any insulin/carb ratios so may find themselves going high after meals, but fortunately checks are made every hour or two, so quick action can be taken.

So to conclude in my non professional opinion, I hope it helps, is that any patient regardless of regime will be getting the same accuracy of monitoring and blood glucose correction but the pumpers and DAFNE patients will be able to provide you and your colleagues with better information regarding there insulin/carb ratios, dose times etc making your job much more successful in terms of their control.

I babbled on a bit their, I apologize if I went off topic.........

If the patient is not on an IV supply then I think treatment is limited to the regime..........if a mixed 2 a day regime, you could test their BGs as much as you want, but you wont be able to do much if they are spiking or going high, or will you...?

If a DAFNE patient, they should have the information to help you do the job effectively, and as you also have DAFNE training, it should be no problem, teaching the other nurses may be a pain right enough......

I hope I didn't talk nonsense there........

Apr 8, 2011

novorapidboi26 1,819 posts

Topic: Site Development / Glossary of Terms

JWo said:
Can't honestly remember but that's a pretty good example of what I saw! Maybe it is!

Is it true you can buy a book with all these slang diabetic words and phrases? Would you buy it? I probably wouldn't. ^_^;

Internet sources are free and more likely to be updated on a regular basis, so I probably wouldnt purchase it......unless the proceeds went to DUK.......

Apr 8, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / POST HYPO HIGHS

emma.nh said:
i have gastro-paresis so often i am stuffed with previous meals not properly digested and naturally find it difficult to eat occasionally.

Thats must be a real pain the ass.........establishing effective insulin/carb ratios must of been tricky........

I actually inject 30 minutes before I eat so as the insulin is starting to work by the time the digestion is under way. Kinda matching the insulin action curve with my foods digestion curve, it has proved really effective so far. For the last to weeks, Monday to Friday my BGs haven't been over 8, except the mornings. With your digestive condition, do you find that the food always takes much longer to digest or does it go both ways, sometimes normal, sometimes not. As there is a delay, injecting possible after you have eaten or splitting the dose may give you less hypos and actually help prevent spikes.

The liver is always secreting its glucose stores, this is what your background dose deals with but your muscles have their own store of fuel which can be used up first before the liver is asked to help out. So I would assume the liver isnt solely responsible for any highs directly, could be wrong though. I believe digestion may be the main problem in striking a good balance with the insulin and so can be tackled with your QA dose. I think dose times and possible splitting may be an avenue to explore.

Is there medication that helps empty the stomach...are you on it, and has it been reviewed recently.....?

Apr 8, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / sick day rules

My opinion is that ketones occur when there is no fuel for the body to use through lack of food, which can happen overnight when fasting or when to ill to eat anything.

So being ill in a sense is not the direct cause of them.................in my opinion.....

If you can compensate for the liver dumping extra fuel to fight infection or virus and keep eating then in theory you should keep ketone production under control........in the real world though getting this right quickly is often difficult........... Cool

Apr 7, 2011

RobT 7 posts

Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary)

What you say works, but in the app it takes account of corrective entries and gives you stats on them. If you do not use CORR as the entry type, by doing what you say, then that part of the stats are not correct or indeed available. The only time corrective entries are supposed to be given is at mealtimes (or bed time) and the entries are allocated for meals because they have CPs associated with them! This is a bug, until it is documented, whereupon it will become a feature. Eventually it may be fixed ... Laughing

Apr 7, 2011

Karl 83 posts

Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary)

Dont you just entry as per the written diary ie 8+4 ?

Apr 7, 2011

RobT 7 posts

Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary)

Just to say, first, love what you are doing. Great stuff!
Second :-
Trying to add two contemporaneous entries in the diary on the app (and also on the site, btw) as I want to separate CORRECTION entries from BOLUS(Food/CP) entries. E.G. at 17h30 I had dinner which has 8u for 8 CP but also I am adding +4 for CORR. It is useful to have two entries at the same time and date but marked differently as you do not offer a type that shows "FOOD+CORR". The same will be true for me at 07h30 when I have breakfast and my BI ... I have tried moving the time by 1 minute intervals and it accepts it when I am 15 mins ... this, of course, does not reflect reality! It is a workaround but not really satisfactory. Sad

Thirdly :-
I am on the last day (tomorrow) of my DAFNE course. Shocked

I am a professional analyst/programmer with nearly thirty years experience, only 15 years diabetic! My skills encompass, but not limited to, LAMP, MAMP, WIMP, Python, Perl, C (all variants), Java, Pascal, Unix/Linux command line, SQL command line, etc...
If you want advice and help just contact me Wink

Apr 7, 2011

Larissa 2 posts

Topic: Questions for HCPs / Postop patients using DAFNE

I am the Diabetes Link Nurse on my ward and was wondering whether there is any info with regards to managing a patient postoperatively???? Do we still manage them as we would patients who are on a 'twice daily' insulin regime postoperatively? What about DAFNE patients who have to be started on an insulin sliding scale post op, is the protocol the same when restarting them back on their regime??? I have looked every where and can't seem to find anything.

I am a diabetic myself using the DAFNE regime and have looked through the info that i was given but haven't found anything.

I am trying to put information together to help educate my collegues on the ward, some of which hadn't heard of the DAFNE course until a patient was admitted using this regime?

Any help and advice would be greatfully received Smile

Apr 7, 2011

JayBee 587 posts

Topic: General Discussion / sick day rules

I agree with novorapidboi26, if you're feeling better and can eat... with your BGs behaving much better, I would proceed with my normal insulin regime again. Smile

Ketones have been a strange one for me when I was last experiencing them a lot and my nurse explained that sometimes you won't need to be high to have some ketones. I was in a good range and getting ++ and the like. I never really fully established the exact cause for my ketones but apparently things like going too long with out food, exercise... can cause some ketones to appear.

With me being a diabetic for 20+ years, when this came to light, I was very alarmed. Ketones were very dangerous I was taught and it usually meant a hospital visit. This updated information from my nurse though has helped me though. When I changed over to the blood testing kit instead of the urine strips, it did take me a bit to realise what was a dangerous level of ketones - my blood seems to be obsessed with having a trace (0.1) but my nurse pointed out to me that this was nothing to worry about considering the levels to worry about are covered on the sickday rules page (stupid me didn't think to look!).

Check the main image out on the sick day rules page here.

Need to have much more than 0.1 to have to respond - so I've slowly come to terms with the fact my body will produce ketones sometimes even when I'm not ill. It is a natural process after all... you only need to worry when you're definitely sure you're ill (but don't hesitate to check your ketones when you're over 13 BG - best to check than not).

Apr 7, 2011

JayBee 587 posts

Topic: Site Development / Glossary of Terms

Can't honestly remember but that's a pretty good example of what I saw! Maybe it is!

Is it true you can buy a book with all these slang diabetic words and phrases? Would you buy it? I probably wouldn't. ^_^;

Apr 7, 2011

emmahope 17 posts

Topic: General Discussion / POST HYPO HIGHS

Ratios 1cp-2units humalog but just changed breakfast to 1.5u-1cp today.
BI -Lantus, was AM 8 units, PM 2UNITS...it was often making my bm too low during early hours or morning.
Tonight I am trying NO night time insulin after all changes were agreed with at post DAFNE review yesterday. Alongside this, it was suggested i raise AM lantus to 9,which i started this morning and at 2pm i had a hypo.i know small steps are the way to do it and maybe these are too many changes at once but i'll give it 2-4 days of the one jab of 9units AM lantus to get a proper measure of the change now i've done it. By the way i did mean calories affecting BM not carbs; thinking it may be because when ive not eaten enough, my liver starts pumping glycogen anyway.i have gastro-paresis so often i am stuffed with previous meals not properly digested and naturally find it difficult to eat occasionally. Once my BI is optimum for a while i'm hoping my body's reactivity may calm down.i will keep on keeping on and hope things become easier with more tweaking.
its always really helpful to read your posts on here Novorapidboi26 and will keep in mind and do appreciate what you say above.

Apr 7, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Norwich DAFNE Evening Meet!

hope it goes well..................defo get some pics........

Apr 7, 2011

Simon 578 posts

Topic: General Discussion / Norwich DAFNE Evening Meet!

Unfortunately I don't live near Norwich, but make sure you get some pics and we'll find a way to put them up on the site!


Apr 8, 2011 Athena 52 posts	Topic: General Discussion / Mesntrual Cycle Dear All, For those of you who are struggling to get control, and are seeing patterns linked to female hormones, there is a topic link about this in the questions for Healthcare professionals forum. You can follow advice etc. there. If you are female and are struggling to get BI sorted, you may wish to consider that the problem might be related to your cycle and you may be able to chart the pattern which is a starting point for sorting it.However, you may also find that the step wise approach doesn't cope with this. For a lot of us, it seems to be too slow and lags behind the hormonal variations throughout the month. It would be good to hear from females who have got this sorted and from females who got their BI and ratios worked out no problem i.e have found that the DAFNE step wise approach worked just fine and you use one BI throughout the month. If you do, can you also let us know if you are on the pill? This could be helpful for others who could try this. Similarly, if you are struggling, it would be great if you could post too so that we can get an idea of the extent of the problem. Thank you.

Apr 8, 2011 Athena 52 posts	Topic: Questions for HCPs / Information on menstrual cycle Hi Jackie, Thanks so much for getting back o n this one. An irregular cycle must have made it more difficult. I don't know how you coped! I do think that they should mention it on the course. It took me about 6 months to realise that there was a pattern going on and then for the penny to drop. Why can't they just tell us? I wonder if it is because the step wise approach doesn't work for this. It is far too slow to keep up with the hormonal c hanges and, like you, I thought that it was me who was doing things incorrectly, but I couldn't work out where I was going wrong. However, I suppose if we work outside the step wise approach, it isn't DAFNE is it? But then there is no alternative or no DAFNE educatior is suggesting one. If I follow theDAFNE approach I spend one week a month hypo, both during the day and at night. I canonly take the night itme BI down by 1 per night and of course am not allowed to change the BI during the day at the same time so have to wait until the night time one is down low enough before starting on the day time one. No diabetic in their right mind would delibereatley spend a week hypo every month, but this si what the step -wise approach dictates. tTere seems to be no way out of it but to abandon DAFNE. thena s a patient you don't know what to do as you could be deemed non-compliant is you don't stick to the DAFNE rules. If anyone else is finding difficulties and has not yet posted, please do so as this site is the only way to raise these issues on a nation-wide basis and maybe they will eventually change it. Interestingly, on our course, there were 7 young women and 1 man. Only the man managed to get control, the rest of us still have not managed to work out our BI and it is well after the magical year. We have only succeeeded in making ourselves ill and our quality of life is much worse now, one girl having to give up work and me being on the brink of having to give up. we are all miserable and I just feel there is no point in being alive anymore, it is just horrible having to drag yourself through another exhausting day to collapse in bed and push yourself through it all again tommorrow. I was wonering about asking for hormone tablet to shut off female hormones or perhaps ovary removal. I am so desperate.If anyone has managed to get any of these interventions then please please let us know. take care JAckie. Igood luck with your pump JAckie. I am curious to know if this helps with tackling the hormone problem or not. It sounds as if it would be just as difficult on a pump as not on one. I think you will easily get the dawn phenomenon sorted on a pump as they will programme your insulin to automatically rise at the right time. itis just finding the right timing and the correct rise . Please let us knwo how it goes with the hormone thing though as I would love a pump but do wonder if this would not work well because of the hormonal variations. If anyone else is on a pump and has this sorted via it,pleaselet us all know.

Apr 8, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / sick day rules Ketones are processed by insulin just as glucose is so the more you have, the more insulin you need.....the thing with ketones is that is a bi product of a bodily function, so unlike eating, we have no control of them. I can actually confess that I dont check for ketones unless I am unwell or have not eaten in some stupidly long time, which very very rarely occurs. I am only really high in the morning, and i will defo has a small amount then, and even if I have went really high, the insulin correction I take deals with the glucose, processes any ketones and dumps the surplus into the bog...........

Apr 8, 2011 Karl 83 posts	Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary) I think its that it doesn't total up in the correction etc - if you do 8-1, the correction total is 0 and the tdd is 8 should they not be 1 and 7 ?

Apr 8, 2011 Simon 578 posts	Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary) P.S. Hope you are enjoying the course!

Apr 8, 2011 Simon 578 posts	Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary) RobT, not sure what you're getting at here - the app lets you enter mealtime correctives in the format x+y, or even x-y if that's what you do. It then syncs them up to the site - what is the particular bug? If I remember correctly on the DAFNE course they teach us to enter correctives with the mealtime dose in the above format, which has always been the guiding principle of how the app/site work.

Apr 8, 2011 daviebear 19 posts	Topic: General Discussion / sick day rules I agree with novorapidboi there.Again I woke up with ++ ketones this morning with a high BG.I am aware that my high sugar is needing to be brought down by increasing my BI at night.I have been told by my DSN that my ketones are "starvation ketones",but not to worry too much about them.I do start the sick day rules regime(as advised to by my DSN),and find that after one or too extra doses of the TDD regime,that my ketones are gone and my BG is back down.I am aware though that ketones caused by other causes are not soo easy to get rid of.

Apr 8, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Postop patients using DAFNE My understanding of the sliding scale is that it is basically like a pump except IV. With monitoring of BGs every hour or two..............so for me any patient on this, whether they are on a mixed insulin regime or MDI have to be treated the same way. A DAFNE patient will probably be more suited to a sliding scale as they will know what there insulin/carb ratios are, which in my opinion is essential information when on the sliding scale. A pumper would be even more suited as this has many similarities in the fact there is a continuous supply of insulin and also the option to correct a BG at any time. A mixed insulin patient would not be aware of any insulin/carb ratios so may find themselves going high after meals, but fortunately checks are made every hour or two, so quick action can be taken. So to conclude in my non professional opinion, I hope it helps, is that any patient regardless of regime will be getting the same accuracy of monitoring and blood glucose correction but the pumpers and DAFNE patients will be able to provide you and your colleagues with better information regarding there insulin/carb ratios, dose times etc making your job much more successful in terms of their control. I babbled on a bit their, I apologize if I went off topic......... If the patient is not on an IV supply then I think treatment is limited to the regime..........if a mixed 2 a day regime, you could test their BGs as much as you want, but you wont be able to do much if they are spiking or going high, or will you...? If a DAFNE patient, they should have the information to help you do the job effectively, and as you also have DAFNE training, it should be no problem, teaching the other nurses may be a pain right enough...... I hope I didn't talk nonsense there........

Apr 8, 2011 novorapidboi26 1,819 posts	Topic: Site Development / Glossary of Terms JWo said: Can't honestly remember but that's a pretty good example of what I saw! Maybe it is! Is it true you can buy a book with all these slang diabetic words and phrases? Would you buy it? I probably wouldn't. ^_^; Internet sources are free and more likely to be updated on a regular basis, so I probably wouldnt purchase it......unless the proceeds went to DUK.......

Apr 8, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / POST HYPO HIGHS emma.nh said: i have gastro-paresis so often i am stuffed with previous meals not properly digested and naturally find it difficult to eat occasionally. Thats must be a real pain the ass.........establishing effective insulin/carb ratios must of been tricky........ I actually inject 30 minutes before I eat so as the insulin is starting to work by the time the digestion is under way. Kinda matching the insulin action curve with my foods digestion curve, it has proved really effective so far. For the last to weeks, Monday to Friday my BGs haven't been over 8, except the mornings. With your digestive condition, do you find that the food always takes much longer to digest or does it go both ways, sometimes normal, sometimes not. As there is a delay, injecting possible after you have eaten or splitting the dose may give you less hypos and actually help prevent spikes. The liver is always secreting its glucose stores, this is what your background dose deals with but your muscles have their own store of fuel which can be used up first before the liver is asked to help out. So I would assume the liver isnt solely responsible for any highs directly, could be wrong though. I believe digestion may be the main problem in striking a good balance with the insulin and so can be tackled with your QA dose. I think dose times and possible splitting may be an avenue to explore. Is there medication that helps empty the stomach...are you on it, and has it been reviewed recently.....?

Apr 8, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / sick day rules My opinion is that ketones occur when there is no fuel for the body to use through lack of food, which can happen overnight when fasting or when to ill to eat anything. So being ill in a sense is not the direct cause of them.................in my opinion..... If you can compensate for the liver dumping extra fuel to fight infection or virus and keep eating then in theory you should keep ketone production under control........in the real world though getting this right quickly is often difficult...........

Apr 7, 2011 RobT 7 posts	Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary) What you say works, but in the app it takes account of corrective entries and gives you stats on them. If you do not use CORR as the entry type, by doing what you say, then that part of the stats are not correct or indeed available. The only time corrective entries are supposed to be given is at mealtimes (or bed time) and the entries are allocated for meals because they have CPs associated with them! This is a bug, until it is documented, whereupon it will become a feature. Eventually it may be fixed ...

Apr 7, 2011 Karl 83 posts	Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary) Dont you just entry as per the written diary ie 8+4 ?

Apr 7, 2011 RobT 7 posts	Topic: DAFNE Online Mobile / Bug with iPhone app (& site diary) Just to say, first, love what you are doing. Great stuff! Second :- Trying to add two contemporaneous entries in the diary on the app (and also on the site, btw) as I want to separate CORRECTION entries from BOLUS(Food/CP) entries. E.G. at 17h30 I had dinner which has 8u for 8 CP but also I am adding +4 for CORR. It is useful to have two entries at the same time and date but marked differently as you do not offer a type that shows "FOOD+CORR". The same will be true for me at 07h30 when I have breakfast and my BI ... I have tried moving the time by 1 minute intervals and it accepts it when I am 15 mins ... this, of course, does not reflect reality! It is a workaround but not really satisfactory. Thirdly :- I am on the last day (tomorrow) of my DAFNE course. I am a professional analyst/programmer with nearly thirty years experience, only 15 years diabetic! My skills encompass, but not limited to, LAMP, MAMP, WIMP, Python, Perl, C (all variants), Java, Pascal, Unix/Linux command line, SQL command line, etc... If you want advice and help just contact me

Apr 7, 2011 Larissa 2 posts	Topic: Questions for HCPs / Postop patients using DAFNE I am the Diabetes Link Nurse on my ward and was wondering whether there is any info with regards to managing a patient postoperatively???? Do we still manage them as we would patients who are on a 'twice daily' insulin regime postoperatively? What about DAFNE patients who have to be started on an insulin sliding scale post op, is the protocol the same when restarting them back on their regime??? I have looked every where and can't seem to find anything. I am a diabetic myself using the DAFNE regime and have looked through the info that i was given but haven't found anything. I am trying to put information together to help educate my collegues on the ward, some of which hadn't heard of the DAFNE course until a patient was admitted using this regime? Any help and advice would be greatfully received

Apr 7, 2011 JayBee 587 posts	Topic: General Discussion / sick day rules I agree with novorapidboi26, if you're feeling better and can eat... with your BGs behaving much better, I would proceed with my normal insulin regime again. Ketones have been a strange one for me when I was last experiencing them a lot and my nurse explained that sometimes you won't need to be high to have some ketones. I was in a good range and getting ++ and the like. I never really fully established the exact cause for my ketones but apparently things like going too long with out food, exercise... can cause some ketones to appear. With me being a diabetic for 20+ years, when this came to light, I was very alarmed. Ketones were very dangerous I was taught and it usually meant a hospital visit. This updated information from my nurse though has helped me though. When I changed over to the blood testing kit instead of the urine strips, it did take me a bit to realise what was a dangerous level of ketones - my blood seems to be obsessed with having a trace (0.1) but my nurse pointed out to me that this was nothing to worry about considering the levels to worry about are covered on the sickday rules page (stupid me didn't think to look!). Check the main image out on the sick day rules page here. Need to have much more than 0.1 to have to respond - so I've slowly come to terms with the fact my body will produce ketones sometimes even when I'm not ill. It is a natural process after all... you only need to worry when you're definitely sure you're ill (but don't hesitate to check your ketones when you're over 13 BG - best to check than not).

Apr 7, 2011 JayBee 587 posts	Topic: Site Development / Glossary of Terms Can't honestly remember but that's a pretty good example of what I saw! Maybe it is! Is it true you can buy a book with all these slang diabetic words and phrases? Would you buy it? I probably wouldn't. ^_^;

Apr 7, 2011 emmahope 17 posts	Topic: General Discussion / POST HYPO HIGHS Ratios 1cp-2units humalog but just changed breakfast to 1.5u-1cp today. BI -Lantus, was AM 8 units, PM 2UNITS...it was often making my bm too low during early hours or morning. Tonight I am trying NO night time insulin after all changes were agreed with at post DAFNE review yesterday. Alongside this, it was suggested i raise AM lantus to 9,which i started this morning and at 2pm i had a hypo.i know small steps are the way to do it and maybe these are too many changes at once but i'll give it 2-4 days of the one jab of 9units AM lantus to get a proper measure of the change now i've done it. By the way i did mean calories affecting BM not carbs; thinking it may be because when ive not eaten enough, my liver starts pumping glycogen anyway.i have gastro-paresis so often i am stuffed with previous meals not properly digested and naturally find it difficult to eat occasionally. Once my BI is optimum for a while i'm hoping my body's reactivity may calm down.i will keep on keeping on and hope things become easier with more tweaking. its always really helpful to read your posts on here Novorapidboi26 and will keep in mind and do appreciate what you say above.

Apr 7, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Norwich DAFNE Evening Meet! hope it goes well..................defo get some pics........

Apr 7, 2011 Simon 578 posts	Topic: General Discussion / Norwich DAFNE Evening Meet! Unfortunately I don't live near Norwich, but make sure you get some pics and we'll find a way to put them up on the site!