Recent Posts - DAFNE Online

Mar 29, 2011

india 2 posts

Topic: General Discussion / DAFNE course manual

I did the DAFNE course about 8 years ago.....i am looking how to get hold of a DAFNE course manual to update......the centre i did mine at had a very basic version and i don't think it sounds like the same as the one i have been recommended. maybe i'm wrong.....but the centre that did my DAFNE course is not on the list either..

thanks for any help Smile

Mar 29, 2011

novorapidboi26 1,816 posts

Topic: Questions for HCPs / Ideas

Hey, not and HCP, but I responded over HERE

Mar 29, 2011

novorapidboi26 1,816 posts

Topic: Site Development / Time

Thanks boss........ Smile

Mar 29, 2011

novorapidboi26 1,816 posts

Topic: General Discussion / Ideas

There is a lot of information to take in there but the first thing I noticed, which really needs to be addressed, is the consistency of your correction doses, sometime you take 3 for a 14, sometime 2, and that pattern continues throughout.

If your not consistent with these then you will never be able to pin point the real causes for highs and lows as it may be your correction that is responsible as opposed to your carb/insulin ratio......

On Monday 21st at 23:50 you corrected a 26.9 with 6 units, assuming the normal correction rules apply at this time, which is 1 unit drops 2.5 mmol/l then you would have dropped to 11.9, so not enough really. The reality is that the higher you are the more you need, or in other words, the less effective 1 unit of insulin is. If I was 26.9 I would of taken 21 units to bring me on target. Everyone will respond differently to 1 unit of insulin the higher the blood glucose.

You should try and investigate this actually......................you may or may not be similar to me but these are the values I use.............

Blood Glucose: less than 10mmol/l - 1 unit drops 2.5mmol/l

Blood Glucose: between 10-13mmol/l - 1 unit drops 2mmol/l

Blood Glucose: between 13-17 - 1 unit drops 1.5mmol/l

Blood Glucose: above 17 - 1 unit drops 1mmol/l

My resistance may even go higher but thankfully I am seldomly much over 17. This is only what I have discovered and is not the opinion of any medical professional but I strongly believe this is the behavior of insulin as the blood glucose rises...

Sorry if I banged on a bit there........but I felt I couldn't comment confidently on your results knowing that the corrections were different from day to day and also my point regarding resistance.........

Hope this helped................... Very Happy

Mar 29, 2011

Neil Brown 28 posts

Topic: General Discussion / Ideas

Ratio is meant to be 2:1 in am 1.5:1 at lunch and 1:1 at dinner it's when I round up or down for insulin that j get funny ratio

Mar 29, 2011

novorapidboi26 1,816 posts

Topic: General Discussion / Mentoring

I would love to have a go at this, although I don't think I would be that confident in my teaching skills.

I think my first approach would be to let the mentoree ask questions, to allow us both to get to know one another then talk about what value the sessions could bring, nice and slow you know....... Wink

That is a shame that there is no DAFNE courses available to him or her, remember you can always offer the Bournemouth carb counting package HERE............

Is this something that will be getting rolled out or is it in testing stage....

Mar 29, 2011

Aneirin 15 posts

Topic: General Discussion / Ideas

I couldn't help but smirk at the ratios. You don't need to record 1.7:1 or 1.3:1, stick to 1:1 and try to stay as close as possible either ronding up if your high or down if your low. On thursday in particular, why did you give yourself a 1.7:1 ratio?

I would give the monring a few more days on 2:1 before upping it to 2.5:1. The odd way you have increased your morning ratios means it is difficult to see the affect raises have had (should be waiting for two days of patterns to emerge) I would be careful about the 2:1 at lunch as it seems to be taking you down by quite a bit (7 units) and it should keep you steady. Your 1.5:1 at lunch seemed to keep you a little ore steady with correction, but again things have changed to quick and you need to leave it a couple of days. You are also making multiple changes at once. It can be frustrating changing one thnig at a time but if you do change more it can lead to readings liek this which are quite hard to discern patterns from and plan accurate alterations to ratios.

Mar 28, 2011

Simon 574 posts

Topic: Site Development / Time

Done!

Mar 28, 2011

Neil Brown 28 posts

Topic: General Discussion / Ideas

Any ideas folks ?
Was thinking bout morning ratio

Mar 28, 2011

Neil Brown 28 posts

Topic: Questions for HCPs / Ideas

Hey any ideas welcome !

Mar 28, 2011

daviebear 19 posts

Topic: Questions for HCPs / New Graduate Ketonuria

Cheers Marke.Once again thanks for calming me down as it were.I now believe I do suffer from the Dawn Phenomenon,and am on a 3:1 ratio in the morning.Will increase my BI insulin again tonight as I am sure that will help.Am nearly their though as sugars have been roughly 10 all day so far so fingers crossed.Once again thanks.

Mar 28, 2011

Alan 49 280 posts

Topic: General Discussion / Mentoring

A couple of weeks ago there was a news item about diabetic mentoring, where an experienced Type 2 diabetic was mentoring a newly-diagnosed T2 person (or was it someone who was liable to become a T2?).

A couple of months ago the DSN at my GP surgery asked me if I would be willing to mentor a Type 1 diabetic who was having trouble with his control. Of course I agreed. The first session went well, I thought; the DSN and a GP were also there to monitor it. My first recommendation (predictably) was that he should get himself on a DAFNE course. This is proving to be a bit of a problem (an effect of the cut-backs already?) I made some more recommendations - relevant to his current control (or lack of it) and a follow-up meeting was arranged. Due to a mix up with appointments, he didn't show up and has not requested another session. Obviously, to be mentored, the 'mentoree' has to be a willing partner. Perhaps the first session didn't go as well as I thought it had.

Has anybody else had experience of mentoring?

Mar 28, 2011

novorapidboi26 1,816 posts

Topic: Site Development / Time

Have the clocks been put forward on site............ Question

Mar 28, 2011

JayBee 582 posts

Topic: General Discussion / local meetings

The more the merrier! Shall we pick a spot? Once we know what we're doing, can set up a thread on this forum and I'll promote it on the @DAFNEonline twitter feed if we like. Can promote others too when they come up! Smile

Mar 28, 2011

marke 643 posts

Topic: Questions for HCPs / New Graduate Ketonuria

Hi, don't panic about ketones. They are not going to do you any real harm short term unless they were pretty high which yours are not. As others have said the key is to get your BI correct and then fix the rest. If you
change more than one thing at once you have no way of knowing what has resolved the issue. One thing that has sort of been mentioned, most people find they need a higher ratio in the morning becasue of the waking up.
Sort of like the Dawn Phenomeon to a degree, most people to wake up in the morning fire off a load of hormones etc to get their body up and running. This tends to mean you need more insulin but as ever everyone is different.
Another thing to bear in mind, when you give yourself 11 QA at 12:30 and another 11+4 at 14:30 you will get an overlap in insulin since the normal time frame for QA is 'about' 5 hours. This can mean you get an effect you don't intend, its worth just bearing in mind.

Mar 28, 2011

JayBee 582 posts

Topic: General Discussion / To make you smile...

Golly... o_o;;

I always remove my pen needles now after the explanation about insulin crystallisation that happens, but usually put the used ones in my kit bag so I can dispose of it in a sharps bin later... I'm usually quite good for putting stuff away but I can't say I've always remembered.

I have had one of my nephews get hold of one covered pen needle before that I left on the side for a few moments... and he shove it up his nose! XD Thank gawd I usually put the over cover on straight away - his grin may not have been quite as cheeky otherwise!

Mar 28, 2011

marke 643 posts

Topic: General Discussion / Targets

you read the help Shocked

Diary Help

Mar 28, 2011

Neil Brown 28 posts

Topic: General Discussion / Targets

How do I change targets on this site

Mar 27, 2011

novorapidboi26 1,816 posts

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

hey.................I would recommend upping youe BI 2 units, see how that effects your BGs for a few days, you should see your corections coming down, and being more effective..............just keep pumping it up till you feel your going to low, then you can start on your QA.......

the more consecutive days you can get down the better, have a look at the online diary, you can post your results up an give other posters a better chance of interpreting your results........ Wink

Mar 27, 2011

daviebear 19 posts

Topic: Questions for HCPs / New Graduate Ketonuria

Cheers for all the advice.Stil had ketonuria today.Went carb free last night with quite a big rise this morning.Not keen to tocu my QA as of yet.Am waiting on my DSN getting back to me.All the advice has really helped though as it doen't make me feel like such a diddy.Still feel a bit shitty with the high BG's though which I know I will have to put up with until it's sorted.I know it's early days though so shouldn't expect perfection yet.

Mar 27, 2011

novorapidboi26 1,816 posts

Topic: Questions for HCPs / New Graduate Ketonuria

hey there...............

I would comment on your PM BI, it sees to be holding you overnight give or take which is good, you should investigate how much 1 unit of insulin drops you at different levels of BG, the higher you are the more you will need, this is briefly mentioned in the handbook, but is not widely known for some reason...

Before upping your QA, try a BI test during the day, a carb free breakfast, lunch or dinner can let you know what your dose of 20 is doing, best to do this before the QA adjustment...

you seem to be doing ok though, dont panic, all these results your writing down are helping you to understand whats going on, it doesnt change over night.....chin up..... Very Happy

Mar 27, 2011

DFH_17 22 posts

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

Have been reading this thread with great interest and really need some advice.

Did the DAFNE course back in mid January and my BG levels were on the money and I was doing really well. Have been a bit worried as last week my BG's have started to go haywire - has been v stressful at work lately. I should explain I inject my Lantus before bed and originally was injecting 44 before DAFNE and am now taking 34BI. Ratios are 1:1 at breakfast and lunch and then 1:5:1 at dinnertime. I use Novorapid for my QA.

Reading have been as follows:-
Saturday - 8.9(b/fast), 6 cp's, QA6 +1 correction
5.7 (lunch), 8.5 cp's, QA8
12.8 (dinner), 5 cp's, QA8 +2 correction
12.0 (bedtime), no cp's, 34BI and no QA correction
12.5 (random test at 1am),

Today - 10.3 (b/fast), 6 cp's, QA6 + 2 correction
11.7 (lunch), 10.5 cp's, QA11 +2 correction
10.7 (dinner), 9 cp's, QA14 +2 correction

Am really worried as the correction's I'm doing dont seem to be working - this has been happening since Tuesday. The only changes have been a more stressful time at work and I've changed what I've been eating at lunctime - eating a lot less such as a salad and roll (about 2.5 cp's) whereas before I was eating (about 6.5 cp's).

I'm not sure if its the ratios that need to be changed or the BI needs to be less??

Any help would be v much appreciated.

Mar 27, 2011

DFH_17 22 posts

Topic: Questions for HCPs / Painfull Hands

Have had the same issue Dave - had trigger finger in both hands - had to have an op on my left hand last Xmas which thankfully worked and have had cortisone injections in the right hand which also worked. Looked up 'trigger finger' on the internet as well and it said that diabetics especially women were prone to trigger finger :-(

Mar 29, 2011 india 2 posts	Topic: General Discussion / DAFNE course manual I did the DAFNE course about 8 years ago.....i am looking how to get hold of a DAFNE course manual to update......the centre i did mine at had a very basic version and i don't think it sounds like the same as the one i have been recommended. maybe i'm wrong.....but the centre that did my DAFNE course is not on the list either.. thanks for any help

Mar 29, 2011 novorapidboi26 1,816 posts	Topic: Questions for HCPs / Ideas Hey, not and HCP, but I responded over HERE

Mar 29, 2011 novorapidboi26 1,816 posts	Topic: Site Development / Time Thanks boss........

Mar 29, 2011 novorapidboi26 1,816 posts	Topic: General Discussion / Ideas There is a lot of information to take in there but the first thing I noticed, which really needs to be addressed, is the consistency of your correction doses, sometime you take 3 for a 14, sometime 2, and that pattern continues throughout. If your not consistent with these then you will never be able to pin point the real causes for highs and lows as it may be your correction that is responsible as opposed to your carb/insulin ratio...... On Monday 21st at 23:50 you corrected a 26.9 with 6 units, assuming the normal correction rules apply at this time, which is 1 unit drops 2.5 mmol/l then you would have dropped to 11.9, so not enough really. The reality is that the higher you are the more you need, or in other words, the less effective 1 unit of insulin is. If I was 26.9 I would of taken 21 units to bring me on target. Everyone will respond differently to 1 unit of insulin the higher the blood glucose. You should try and investigate this actually......................you may or may not be similar to me but these are the values I use............. Blood Glucose: less than 10mmol/l - 1 unit drops 2.5mmol/l Blood Glucose: between 10-13mmol/l - 1 unit drops 2mmol/l Blood Glucose: between 13-17 - 1 unit drops 1.5mmol/l Blood Glucose: above 17 - 1 unit drops 1mmol/l My resistance may even go higher but thankfully I am seldomly much over 17. This is only what I have discovered and is not the opinion of any medical professional but I strongly believe this is the behavior of insulin as the blood glucose rises... Sorry if I banged on a bit there........but I felt I couldn't comment confidently on your results knowing that the corrections were different from day to day and also my point regarding resistance......... Hope this helped...................

Mar 29, 2011 Neil Brown 28 posts	Topic: General Discussion / Ideas Ratio is meant to be 2:1 in am 1.5:1 at lunch and 1:1 at dinner it's when I round up or down for insulin that j get funny ratio

Mar 29, 2011 novorapidboi26 1,816 posts	Topic: General Discussion / Mentoring I would love to have a go at this, although I don't think I would be that confident in my teaching skills. I think my first approach would be to let the mentoree ask questions, to allow us both to get to know one another then talk about what value the sessions could bring, nice and slow you know....... That is a shame that there is no DAFNE courses available to him or her, remember you can always offer the Bournemouth carb counting package HERE............ Is this something that will be getting rolled out or is it in testing stage....

Mar 29, 2011 Aneirin 15 posts	Topic: General Discussion / Ideas I couldn't help but smirk at the ratios. You don't need to record 1.7:1 or 1.3:1, stick to 1:1 and try to stay as close as possible either ronding up if your high or down if your low. On thursday in particular, why did you give yourself a 1.7:1 ratio? I would give the monring a few more days on 2:1 before upping it to 2.5:1. The odd way you have increased your morning ratios means it is difficult to see the affect raises have had (should be waiting for two days of patterns to emerge) I would be careful about the 2:1 at lunch as it seems to be taking you down by quite a bit (7 units) and it should keep you steady. Your 1.5:1 at lunch seemed to keep you a little ore steady with correction, but again things have changed to quick and you need to leave it a couple of days. You are also making multiple changes at once. It can be frustrating changing one thnig at a time but if you do change more it can lead to readings liek this which are quite hard to discern patterns from and plan accurate alterations to ratios.

Mar 28, 2011 Simon 574 posts	Topic: Site Development / Time Done!

Mar 28, 2011 Neil Brown 28 posts	Topic: General Discussion / Ideas Any ideas folks ? Was thinking bout morning ratio

Mar 28, 2011 Neil Brown 28 posts	Topic: Questions for HCPs / Ideas Hey any ideas welcome !

Mar 28, 2011 daviebear 19 posts	Topic: Questions for HCPs / New Graduate Ketonuria Cheers Marke.Once again thanks for calming me down as it were.I now believe I do suffer from the Dawn Phenomenon,and am on a 3:1 ratio in the morning.Will increase my BI insulin again tonight as I am sure that will help.Am nearly their though as sugars have been roughly 10 all day so far so fingers crossed.Once again thanks.

Mar 28, 2011 Alan 49 280 posts	Topic: General Discussion / Mentoring A couple of weeks ago there was a news item about diabetic mentoring, where an experienced Type 2 diabetic was mentoring a newly-diagnosed T2 person (or was it someone who was liable to become a T2?). A couple of months ago the DSN at my GP surgery asked me if I would be willing to mentor a Type 1 diabetic who was having trouble with his control. Of course I agreed. The first session went well, I thought; the DSN and a GP were also there to monitor it. My first recommendation (predictably) was that he should get himself on a DAFNE course. This is proving to be a bit of a problem (an effect of the cut-backs already?) I made some more recommendations - relevant to his current control (or lack of it) and a follow-up meeting was arranged. Due to a mix up with appointments, he didn't show up and has not requested another session. Obviously, to be mentored, the 'mentoree' has to be a willing partner. Perhaps the first session didn't go as well as I thought it had. Has anybody else had experience of mentoring?

Mar 28, 2011 novorapidboi26 1,816 posts	Topic: Site Development / Time Have the clocks been put forward on site............

Mar 28, 2011 JayBee 582 posts	Topic: General Discussion / local meetings The more the merrier! Shall we pick a spot? Once we know what we're doing, can set up a thread on this forum and I'll promote it on the @DAFNEonline twitter feed if we like. Can promote others too when they come up!

Mar 28, 2011 marke 643 posts	Topic: Questions for HCPs / New Graduate Ketonuria Hi, don't panic about ketones. They are not going to do you any real harm short term unless they were pretty high which yours are not. As others have said the key is to get your BI correct and then fix the rest. If you change more than one thing at once you have no way of knowing what has resolved the issue. One thing that has sort of been mentioned, most people find they need a higher ratio in the morning becasue of the waking up. Sort of like the Dawn Phenomeon to a degree, most people to wake up in the morning fire off a load of hormones etc to get their body up and running. This tends to mean you need more insulin but as ever everyone is different. Another thing to bear in mind, when you give yourself 11 QA at 12:30 and another 11+4 at 14:30 you will get an overlap in insulin since the normal time frame for QA is 'about' 5 hours. This can mean you get an effect you don't intend, its worth just bearing in mind.

Mar 28, 2011 JayBee 582 posts	Topic: General Discussion / To make you smile... Golly... o_o;; I always remove my pen needles now after the explanation about insulin crystallisation that happens, but usually put the used ones in my kit bag so I can dispose of it in a sharps bin later... I'm usually quite good for putting stuff away but I can't say I've always remembered. I have had one of my nephews get hold of one covered pen needle before that I left on the side for a few moments... and he shove it up his nose! XD Thank gawd I usually put the over cover on straight away - his grin may not have been quite as cheeky otherwise!

Mar 28, 2011 marke 643 posts	Topic: General Discussion / Targets you read the help Diary Help

Mar 28, 2011 Neil Brown 28 posts	Topic: General Discussion / Targets How do I change targets on this site

Mar 27, 2011 novorapidboi26 1,816 posts	Topic: Questions for HCPs / Cant stop BG Levels going up hey.................I would recommend upping youe BI 2 units, see how that effects your BGs for a few days, you should see your corections coming down, and being more effective..............just keep pumping it up till you feel your going to low, then you can start on your QA....... the more consecutive days you can get down the better, have a look at the online diary, you can post your results up an give other posters a better chance of interpreting your results........

Mar 27, 2011 daviebear 19 posts	Topic: Questions for HCPs / New Graduate Ketonuria Cheers for all the advice.Stil had ketonuria today.Went carb free last night with quite a big rise this morning.Not keen to tocu my QA as of yet.Am waiting on my DSN getting back to me.All the advice has really helped though as it doen't make me feel like such a diddy.Still feel a bit shitty with the high BG's though which I know I will have to put up with until it's sorted.I know it's early days though so shouldn't expect perfection yet.

Mar 27, 2011 novorapidboi26 1,816 posts	Topic: Questions for HCPs / New Graduate Ketonuria hey there............... I would comment on your PM BI, it sees to be holding you overnight give or take which is good, you should investigate how much 1 unit of insulin drops you at different levels of BG, the higher you are the more you will need, this is briefly mentioned in the handbook, but is not widely known for some reason... Before upping your QA, try a BI test during the day, a carb free breakfast, lunch or dinner can let you know what your dose of 20 is doing, best to do this before the QA adjustment... you seem to be doing ok though, dont panic, all these results your writing down are helping you to understand whats going on, it doesnt change over night.....chin up.....

Mar 27, 2011 DFH_17 22 posts	Topic: Questions for HCPs / Cant stop BG Levels going up Have been reading this thread with great interest and really need some advice. Did the DAFNE course back in mid January and my BG levels were on the money and I was doing really well. Have been a bit worried as last week my BG's have started to go haywire - has been v stressful at work lately. I should explain I inject my Lantus before bed and originally was injecting 44 before DAFNE and am now taking 34BI. Ratios are 1:1 at breakfast and lunch and then 1:5:1 at dinnertime. I use Novorapid for my QA. Reading have been as follows:- Saturday - 8.9(b/fast), 6 cp's, QA6 +1 correction 5.7 (lunch), 8.5 cp's, QA8 12.8 (dinner), 5 cp's, QA8 +2 correction 12.0 (bedtime), no cp's, 34BI and no QA correction 12.5 (random test at 1am), Today - 10.3 (b/fast), 6 cp's, QA6 + 2 correction 11.7 (lunch), 10.5 cp's, QA11 +2 correction 10.7 (dinner), 9 cp's, QA14 +2 correction Am really worried as the correction's I'm doing dont seem to be working - this has been happening since Tuesday. The only changes have been a more stressful time at work and I've changed what I've been eating at lunctime - eating a lot less such as a salad and roll (about 2.5 cp's) whereas before I was eating (about 6.5 cp's). I'm not sure if its the ratios that need to be changed or the BI needs to be less?? Any help would be v much appreciated.

Mar 27, 2011 DFH_17 22 posts	Topic: Questions for HCPs / Painfull Hands Have had the same issue Dave - had trigger finger in both hands - had to have an op on my left hand last Xmas which thankfully worked and have had cortisone injections in the right hand which also worked. Looked up 'trigger finger' on the internet as well and it said that diabetics especially women were prone to trigger finger :-(