Recent Posts - DAFNE Online

Apr 4, 2011

Alan 49 284 posts

Topic: Site Development / Glossary of Terms

So, no need for a Glossary of Terms, then?

Apr 4, 2011

Carolin 83 posts

Topic: Site Development / Glossary of Terms

Hi

The terms we use in DAFNE and throughout all the resources, workbook, diaries, etc are:

Quick Acting (QA) to refer to meal-related insulin, which covers CPs and 'corrects' high BGs
Background Insulin (BI) to refer to the long-acting insulin, taken once or more effectively twice each day

With multiple dose insulin (MDI) therapy these are 2 completely different insulins.

In continuous subcutaneous insulin infusion (CSII) pump therapy, there is only one type of insulin taken as it is all delivered from the pump as a continuous 'Basal' infusion (i.e. replacing BI), with additional 'Boluses' taken with CPs.

Is this any help?

Carolin

Apr 4, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / POST HYPO HIGHS

Have the hypos got any pattern, often hypos can breed more hypos................

Apr 3, 2011

emmahope 17 posts

Topic: General Discussion / POST HYPO HIGHS

It's rare for me that the day after a hypo I don't struggle to get my blood sugars at a reasonable level after they've shot up -well into the twenties sometimes.
I have at least two hypos per week and maybe 4. This happens even when I've had 1.5cp,fast acting to treat the hypo-ie not from over treating a hypo. Maybe the treatment I often use is problematic (not speedy enough?) I use 4 M&S jelly babies. I think my hormones are over reactive and my liver goes into overdrive... I get hypo unawareness sometimes so maybe I'm in hypo too long before I treat it??? My diabetes has always been brittle.
Any ideas or experiences out there that could be helpful? Thanks,Emma

Apr 3, 2011

JayBee 587 posts

Topic: General Discussion / Norwich DAFNE Evening Meet!

Hello all! (I will update this first post as and when changes to details occur! ;))

Emily2556 and I have been discussing the possibility of running a DAFNE meet and we've come to this conclusion so far:

Place: Norwich Riverside Wetherspoons: Queen of the Iceni - very close to parking and the train station!
Time: 7pm - 7.30pm; anyone is welcome to turn up earlier if want.
Date / Day: (Our individual options so far) Mon, Tues, Wednesday (both of us, possibly)... and Saturday or Sunday (just me). The date itself is undecided however we are looking at later on this month, 10th April at the earliest.

If you are interested in coming along, how well do these arrangements suit you? Partners can come along too - I'm sure they'll have much to discuss as well! Very Happy

Has anyone got a good suggestion on how to identify each other? Walk around with our DAFNE guidebooks out perhaps? ;)

Apr 3, 2011

daviebear 19 posts

Topic: General Discussion / What The Hell Happened Today.

I can understand that maria.But I haven't changed anything.I have remained ona 3:1 at breakfast and a 2:1 at all other times.My background also stayed the same.I should maybe not have taken the extra units though at breakfast because of the high breakfast BG and i can see that now.I was told by a nurse years and years ago that the lumps that you can get can sometimes contain insulin in with them that can then get released without warning.Has anyone else heard of this?I will just put friday down to a one off unless of course it happens again tomorrow when I'm at work,when I will really wonder what is going on.I love all the advice though as it makes me look at things from a different point of view.

Apr 3, 2011

nomis 6 posts

Topic: General Discussion / What The Hell Happened Today.

Good piece of advice Maria, I suppose too much adjusting of QA and BI on a high frequency basis i.e day to day will distort figures and lead you to the unknown.

It will give a stepped effect or semi-variable with QA & BI overlapping therefore it would lead you to say on that particular day to take 1 QA to raise BG by 3mmol and 1 CP to raise BG by the lowest factor. Therefore using the dafne targets to your advantage on all fronts while low BG'S are experienced.

Apr 3, 2011

maria51 22 posts

Topic: General Discussion / What The Hell Happened Today.

When you hypoed at 16:40 on thurs, I noticed you corrected at your next meal. I'm sure Dafne recommends to avoid giving corrections at the next meal following a hypo. Then at 9pm, another correction after your 6pm QA. I was taught that QA stays in your system between 4 to 5 hours & it seems to me that your QA is overlapping and a effecting BGL, keeping them low plus the hypo before that doesn't help either.

On Fri, 12:20, though not officially a hypo, you were getting close & corrected. Would this have been partially responsible for the hypos all day? Or maybe your're not giving yourself enough time to recover from the hypo the day before by maybe over correcting?

All the best & I'm sure you'll get a lot more comments coming your way & I too will be very interested to read what they say.

Apr 3, 2011

daviebear 19 posts

Topic: General Discussion / What The Hell Happened Today.

Hi guys ,big thanks for the replies.I take humulin I twice daily,not lantus,as lantus didn't do anything for me nomis.I may very well have to reduce the lunch ratio,but will continue to reduce the morning BI first.tweety my BG's were 3.4 in the afternoon and 2.7 the previous afternoon when on the 22 dose of BI.So I think I will reduce that again tomorrow and see where I stand.If no change then I will redcue the ratio at lunchtime.Thanks for all the help guys.really appreciate it.

Apr 2, 2011

tweety 13 posts

Topic: General Discussion / What The Hell Happened Today.

hi davie, what had your results been b4 you reduced your bi frm 22 to 20? if i had the results you've shared i would prob reduce the am bi again. i had a similar situation in work a few months back and had to stay for a couple of hours after work till my bg went up so i understand your frustration, but remember dont do loads of changes at once. hope this helps, good luck.

Apr 2, 2011

nomis 6 posts

Topic: General Discussion / What The Hell Happened Today.

Very interesting results I would say the 3.1 ratio is fine to get you right for mid day it would seem then a 1.1 but it makes me think from what I have picked up recently when going on the dafen regime should you start Lantus dose from scratch with one injection per day ?

Apr 2, 2011

daviebear 19 posts

Topic: General Discussion / What The Hell Happened Today.

Forgot to mention.I definately didn't use the wrong kind of insulin,as you can hopfully see by these charts.I use 2 different pens.I remember being told years ago,that I could be releasing insulin from the lumps I have required over the years.Has anyone else heard of this?The results here as as close as i could enter on the online form,but as you can see it was a lot of CP's with no gain in Blood Glucose.

Apr 2, 2011

daviebear 19 posts

Topic: General Discussion / What The Hell Happened Today.

Sorry about that .Here are those results now.

Apr 1, 2011

Edentherapies 8 posts

Topic: Site Development / Glossary of Terms

Aye,

When I was on my DAFNE course I had No idea what either were in reference to! Knew it was regarding the types of insuline but not sure which. Bit embarassed and didn't want to say! So it would be good to know exactly what they refer to as both were mentioned through out the course.

Apr 1, 2011

marke 686 posts

Topic: Site Development / Glossary of Terms

Its a good idea, but....
We need to find someone to do it, preferably a HCP rather an Simon or I. This is more to ensure accuracy and get good explinations, we are after all IT people, not a group known for their literary skills ( or their spelling skills Wink

)

Apr 1, 2011

marke 686 posts

Topic: General Discussion / Ideas

novorapidboi26 said:
Wow, the advice of not going above 4 for a correction is news to me, the curriculum of the course is always changing I suppose but I personally would say that is not the best advice, not going over 4 is fine if you blood sugar is not far off target ranges, but 26s are quite uncomfortably high.....

Don't worry you are not out of date Wink

, I am currently toiling over the conversion of the new handbook to the online version and it states:
'Until you have worked out your own sensitivity to your quick acting insulin , it is recommended that no more than a 4 unit correction is given at one time'

The figure 4 is therefore not a hard and fast maximum rather a guide when you are first working out your individual requirements. If you need more then you can give more. They are just urging caution initially.

Apr 1, 2011

marke 686 posts

Topic: General Discussion / Ideas

Until you have worked out your own sensitivity to your quick acting insulin , it is recommended that no more than a 4 unit correction is given at one time

Apr 1, 2011

marke 686 posts

Topic: General Discussion / What The Hell Happened Today.

Davie, as others have mentioned on other posts, its far easier if you put figures into the online diary and post a setion of that into the formum. Its very hard to give advice based on your free form description of CP's and insulin, especially with no context. I would say its very unlikely one hypo would cause this and given the amount of CP's you pumped into yourself it sounds like you potentailly used the wrong insulin. That could potentially cause what you describe and is one possible explination.

Apr 1, 2011

daviebear 19 posts

Topic: General Discussion / What The Hell Happened Today.

I was under the impression that hypo would be easier to treat under the dafne regime.So I am wondering what the hell happened today.1240pm BG 2.3,2Cp's taken along with 8.5 as lunch.16 units of QA taken so as to reduce insulin dose as well.Background dose was 20 at 10am(reduced from 22 yesterday).Blood glucose refused to go up,with a total of 2 380ml bottles of Lucozde and 500ml bottle of coke and 2 packets of crisps taken between 1250 and 1640.Doses of lucozade taken every 10 to 20 mins.Now at 1700 Bg now at 4.4.Is this maybe beacause I hypo'd yesterday and used up my glucagon store.Haven't had a day like this for while,but before I had the excuse of being on massive doses of insulin.Any ideas?

Apr 1, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Mentoring

Your words are kind, thanks........

I dont think I would walk away from the opportunity, would be scary though........ Twisted Evil

Mar 31, 2011

Edentherapies 8 posts

Topic: General Discussion / Mentoring

Novorapidboi, I think you ARE a fab mentor! You have been really helpfull and you seem very open and always have sound advise.

Bravo!

Real shame there isn't enough funding or trained people to offer more people the DAFNE courses. I really do feel privileged to have had a place!

Alan, dont take it personally. You never know what might be going on with the mentoree. Hope it hasn't put you off!

Laughing

Mar 31, 2011

nomis 6 posts

Topic: General Discussion / Ideas

Hi Neil

Its all a numbers game as I am sure you are aware. For instance look at your actual results and then say to yourself what if I had injected x instead of y to get me into dafne targets and in theory it should be that simple and I no it never is.

In summary dafne targets have to be hit and use your historic results as an aid and you rid yourself of peak highs by increasing QA all else being equal.

Eventually you will be fed up with stable BG's around the 5 mark and not looking like daily temperature readouts Laughing

not that mine are.

all the best

Mar 31, 2011

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Cant stop BG Levels going up

My understanding of resistance with regards to hormones, is that the main hormone responsible for this is the alpha cell secretion - Glucagon. This has the opposite effect against insulin and also contributes to the livers dump of glucose into the blood stream.

However when stressed glucagon may only be released in small amounts and with the help of other hormones released at this time, insulin effectiveness could be knocked out from normal behavior. Thats my basic understanding/theory of it anyway......... Smile

Mar 31, 2011

DFH_17 22 posts

Topic: Questions for HCPs / Cant stop BG Levels going up

Sorry - in 2nd paragraph meant to say I wasnt being treated very well by some colleagues.

Apr 4, 2011 Alan 49 284 posts	Topic: Site Development / Glossary of Terms So, no need for a Glossary of Terms, then?

Apr 4, 2011 Carolin 83 posts	Topic: Site Development / Glossary of Terms Hi The terms we use in DAFNE and throughout all the resources, workbook, diaries, etc are: Quick Acting (QA) to refer to meal-related insulin, which covers CPs and 'corrects' high BGs Background Insulin (BI) to refer to the long-acting insulin, taken once or more effectively twice each day With multiple dose insulin (MDI) therapy these are 2 completely different insulins. In continuous subcutaneous insulin infusion (CSII) pump therapy, there is only one type of insulin taken as it is all delivered from the pump as a continuous 'Basal' infusion (i.e. replacing BI), with additional 'Boluses' taken with CPs. Is this any help? Carolin

Apr 4, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / POST HYPO HIGHS Have the hypos got any pattern, often hypos can breed more hypos................

Apr 3, 2011 emmahope 17 posts	Topic: General Discussion / POST HYPO HIGHS It's rare for me that the day after a hypo I don't struggle to get my blood sugars at a reasonable level after they've shot up -well into the twenties sometimes. I have at least two hypos per week and maybe 4. This happens even when I've had 1.5cp,fast acting to treat the hypo-ie not from over treating a hypo. Maybe the treatment I often use is problematic (not speedy enough?) I use 4 M&S jelly babies. I think my hormones are over reactive and my liver goes into overdrive... I get hypo unawareness sometimes so maybe I'm in hypo too long before I treat it??? My diabetes has always been brittle. Any ideas or experiences out there that could be helpful? Thanks,Emma

Apr 3, 2011 JayBee 587 posts	Topic: General Discussion / Norwich DAFNE Evening Meet! Hello all! (I will update this first post as and when changes to details occur! ;)) Emily2556 and I have been discussing the possibility of running a DAFNE meet and we've come to this conclusion so far: Place: Norwich Riverside Wetherspoons: Queen of the Iceni - very close to parking and the train station! Time: 7pm - 7.30pm; anyone is welcome to turn up earlier if want. Date / Day: (Our individual options so far) Mon, Tues, Wednesday (both of us, possibly)... and Saturday or Sunday (just me). The date itself is undecided however we are looking at later on this month, 10th April at the earliest. If you are interested in coming along, how well do these arrangements suit you? Partners can come along too - I'm sure they'll have much to discuss as well! Has anyone got a good suggestion on how to identify each other? Walk around with our DAFNE guidebooks out perhaps? ;)

Apr 3, 2011 daviebear 19 posts	Topic: General Discussion / What The Hell Happened Today. I can understand that maria.But I haven't changed anything.I have remained ona 3:1 at breakfast and a 2:1 at all other times.My background also stayed the same.I should maybe not have taken the extra units though at breakfast because of the high breakfast BG and i can see that now.I was told by a nurse years and years ago that the lumps that you can get can sometimes contain insulin in with them that can then get released without warning.Has anyone else heard of this?I will just put friday down to a one off unless of course it happens again tomorrow when I'm at work,when I will really wonder what is going on.I love all the advice though as it makes me look at things from a different point of view.

Apr 3, 2011 nomis 6 posts	Topic: General Discussion / What The Hell Happened Today. Good piece of advice Maria, I suppose too much adjusting of QA and BI on a high frequency basis i.e day to day will distort figures and lead you to the unknown. It will give a stepped effect or semi-variable with QA & BI overlapping therefore it would lead you to say on that particular day to take 1 QA to raise BG by 3mmol and 1 CP to raise BG by the lowest factor. Therefore using the dafne targets to your advantage on all fronts while low BG'S are experienced.

Apr 3, 2011 maria51 22 posts	Topic: General Discussion / What The Hell Happened Today. When you hypoed at 16:40 on thurs, I noticed you corrected at your next meal. I'm sure Dafne recommends to avoid giving corrections at the next meal following a hypo. Then at 9pm, another correction after your 6pm QA. I was taught that QA stays in your system between 4 to 5 hours & it seems to me that your QA is overlapping and a effecting BGL, keeping them low plus the hypo before that doesn't help either. On Fri, 12:20, though not officially a hypo, you were getting close & corrected. Would this have been partially responsible for the hypos all day? Or maybe your're not giving yourself enough time to recover from the hypo the day before by maybe over correcting? All the best & I'm sure you'll get a lot more comments coming your way & I too will be very interested to read what they say.

Apr 3, 2011 daviebear 19 posts	Topic: General Discussion / What The Hell Happened Today. Hi guys ,big thanks for the replies.I take humulin I twice daily,not lantus,as lantus didn't do anything for me nomis.I may very well have to reduce the lunch ratio,but will continue to reduce the morning BI first.tweety my BG's were 3.4 in the afternoon and 2.7 the previous afternoon when on the 22 dose of BI.So I think I will reduce that again tomorrow and see where I stand.If no change then I will redcue the ratio at lunchtime.Thanks for all the help guys.really appreciate it.

Apr 2, 2011 tweety 13 posts	Topic: General Discussion / What The Hell Happened Today. hi davie, what had your results been b4 you reduced your bi frm 22 to 20? if i had the results you've shared i would prob reduce the am bi again. i had a similar situation in work a few months back and had to stay for a couple of hours after work till my bg went up so i understand your frustration, but remember dont do loads of changes at once. hope this helps, good luck.

Apr 2, 2011 nomis 6 posts	Topic: General Discussion / What The Hell Happened Today. Very interesting results I would say the 3.1 ratio is fine to get you right for mid day it would seem then a 1.1 but it makes me think from what I have picked up recently when going on the dafen regime should you start Lantus dose from scratch with one injection per day ?

Apr 2, 2011 daviebear 19 posts	Topic: General Discussion / What The Hell Happened Today. Forgot to mention.I definately didn't use the wrong kind of insulin,as you can hopfully see by these charts.I use 2 different pens.I remember being told years ago,that I could be releasing insulin from the lumps I have required over the years.Has anyone else heard of this?The results here as as close as i could enter on the online form,but as you can see it was a lot of CP's with no gain in Blood Glucose.

Apr 2, 2011 daviebear 19 posts	Topic: General Discussion / What The Hell Happened Today. Sorry about that .Here are those results now.

Apr 1, 2011 Edentherapies 8 posts	Topic: Site Development / Glossary of Terms Aye, When I was on my DAFNE course I had No idea what either were in reference to! Knew it was regarding the types of insuline but not sure which. Bit embarassed and didn't want to say! So it would be good to know exactly what they refer to as both were mentioned through out the course.

Apr 1, 2011 marke 686 posts	Topic: Site Development / Glossary of Terms Its a good idea, but.... We need to find someone to do it, preferably a HCP rather an Simon or I. This is more to ensure accuracy and get good explinations, we are after all IT people, not a group known for their literary skills ( or their spelling skills )

Apr 1, 2011 marke 686 posts	Topic: General Discussion / Ideas novorapidboi26 said: Wow, the advice of not going above 4 for a correction is news to me, the curriculum of the course is always changing I suppose but I personally would say that is not the best advice, not going over 4 is fine if you blood sugar is not far off target ranges, but 26s are quite uncomfortably high..... Don't worry you are not out of date , I am currently toiling over the conversion of the new handbook to the online version and it states: 'Until you have worked out your own sensitivity to your quick acting insulin , it is recommended that no more than a 4 unit correction is given at one time' The figure 4 is therefore not a hard and fast maximum rather a guide when you are first working out your individual requirements. If you need more then you can give more. They are just urging caution initially.

Apr 1, 2011 marke 686 posts	Topic: General Discussion / Ideas Until you have worked out your own sensitivity to your quick acting insulin , it is recommended that no more than a 4 unit correction is given at one time

Apr 1, 2011 marke 686 posts	Topic: General Discussion / What The Hell Happened Today. Davie, as others have mentioned on other posts, its far easier if you put figures into the online diary and post a setion of that into the formum. Its very hard to give advice based on your free form description of CP's and insulin, especially with no context. I would say its very unlikely one hypo would cause this and given the amount of CP's you pumped into yourself it sounds like you potentailly used the wrong insulin. That could potentially cause what you describe and is one possible explination.

Apr 1, 2011 daviebear 19 posts	Topic: General Discussion / What The Hell Happened Today. I was under the impression that hypo would be easier to treat under the dafne regime.So I am wondering what the hell happened today.1240pm BG 2.3,2Cp's taken along with 8.5 as lunch.16 units of QA taken so as to reduce insulin dose as well.Background dose was 20 at 10am(reduced from 22 yesterday).Blood glucose refused to go up,with a total of 2 380ml bottles of Lucozde and 500ml bottle of coke and 2 packets of crisps taken between 1250 and 1640.Doses of lucozade taken every 10 to 20 mins.Now at 1700 Bg now at 4.4.Is this maybe beacause I hypo'd yesterday and used up my glucagon store.Haven't had a day like this for while,but before I had the excuse of being on massive doses of insulin.Any ideas?

Apr 1, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Mentoring Your words are kind, thanks........ I dont think I would walk away from the opportunity, would be scary though........

Mar 31, 2011 Edentherapies 8 posts	Topic: General Discussion / Mentoring Novorapidboi, I think you ARE a fab mentor! You have been really helpfull and you seem very open and always have sound advise. Bravo! Real shame there isn't enough funding or trained people to offer more people the DAFNE courses. I really do feel privileged to have had a place! Alan, dont take it personally. You never know what might be going on with the mentoree. Hope it hasn't put you off!

Mar 31, 2011 nomis 6 posts	Topic: General Discussion / Ideas Hi Neil Its all a numbers game as I am sure you are aware. For instance look at your actual results and then say to yourself what if I had injected x instead of y to get me into dafne targets and in theory it should be that simple and I no it never is. In summary dafne targets have to be hit and use your historic results as an aid and you rid yourself of peak highs by increasing QA all else being equal. Eventually you will be fed up with stable BG's around the 5 mark and not looking like daily temperature readouts not that mine are. all the best

Mar 31, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Cant stop BG Levels going up My understanding of resistance with regards to hormones, is that the main hormone responsible for this is the alpha cell secretion - Glucagon. This has the opposite effect against insulin and also contributes to the livers dump of glucose into the blood stream. However when stressed glucagon may only be released in small amounts and with the help of other hormones released at this time, insulin effectiveness could be knocked out from normal behavior. Thats my basic understanding/theory of it anyway.........

Mar 31, 2011 DFH_17 22 posts	Topic: Questions for HCPs / Cant stop BG Levels going up Sorry - in 2nd paragraph meant to say I wasnt being treated very well by some colleagues.