Recent Posts - DAFNE Online

Mar 30, 2011

Aneirin 15 posts

It seems to work for you, but when your blood sugars decrease, wouldn't your insulin resistance change? So giving 12 at 17, the first 7 or so unit will take you down to ten, at what point your insulin resistance will decrease and you now have a dose of insulin and the next 5 units (working at 1 unit taking down 2 blood sugars) may take you down to zero.

Wouldn't it be preferable if this high and working off these rules, to give yourself an initial dose at 1:1 to bring you to 10 and then a further dose once down to take you down the rest (on the assumption 1 takes you down 2 instead of one)

Mar 30, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Ratios etc

This is purely my own personal experiences............................

But my theory behind these corrections is that the higher your blood sugar the less effective 1 unit of insulin is, ie.....higher resistance...........

As a general principle:
1 unit of quick-acting insulin lowers blood glucose by 2-3mmol/l. For blood glucose levels above 11mmol/l this rule does not necessarily apply.

This statement can be found here........just realized you wont be able to access this link if your not signed up as a graduate, sorry........but its there believe me....... Wink

So I actually investigated how much 1 unit dropped me by at different levels and came up with 4 categories of blood glucose readings and a matching drop by 1 unit...........

Everyone is different in terms of their response to 1 unit, but for me at a level of 17 or above, 1 unit only drops me by 1mmol/l...............so to return to 5.5 from 17.2 I would need to drop 12mmol/l, hence the 12 units.......... Very Happy

Mar 30, 2011

india 2 posts

Topic: General Discussion / Ratios etc

hi..i am new to this site but am wondering about the 'if you were 17.5 then a dose of 12 would get you back to normal'?....i have been instructed always to take 1 unit to get me down 2 numbers......so if my blood weere 15 then to get to say 5....then 5 units of novorapid would in theory do the job.....i understand it doesn't always work like that.

but please tell me if i have got this wrong...but 12 units for a 17.5....wouldn't that throw you into severe hypo? as 12 would get you down a possible 24 numbers and therefore well past a blood of 5 - ish?

sorry if i have got this completely wrong....but i needed to ask....thanks

Mar 30, 2011

novorapidboi26 1,819 posts

Topic: Site Development / Glossary of Terms

Its a good idea I think............

Users on the site I believe should be familiar with the DAFNE abbreviations like, QA, BI, BG, etc............but it wouldn't hurt...........I think basal and bolus is a more general term and is used more in the pumping world to differentiate between two different dose purposes with one type of insulin. But there are a few pumpers in our midst so it would be a good idea I suppose.

Mar 30, 2011

Alan 49 284 posts

Topic: Site Development / Glossary of Terms

Would it be worth putting a Glossary of Terms on the website? Searching the Handbook for 'bolus' or 'basal' yields no results, so I'm still not sure which is quick-acting and which is background insulin. Abbreviations could also be there, so a newcomer to the site could find out what CP or BG mean or non-medical abbreviations, like 'lol' - which I only recently found out means 'laugh out loud'.

What do you think?

Mar 30, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / dafne app/carb calculator for Blackberry phones

I am on the android market and there are many apps for recording results, producing graphs etc.........not like the DAFNE app but useful none the less. I would expect there to be something similar on the BB market.

Are you looking for and app to count carbs, dont know if there are many out there to be honest. Are you looking for convenience or do you have a specific problem with counting carbs......?

There is a book called carbs and cals which has been recommended by many in the diabetic community, I do believe there is an iPhone app to accompany this also, you could try searching for this on the BB....

Good Luck............ Smile

Mar 30, 2011

JackieB 3 posts

Topic: Questions for HCPs / Information on menstrual cycle

Hi Athena,

Yes, variations in insulin requirements due to hormonal variation over my menstrual cycle have .... been the bain of my life. My cycle was very irregular which made it impossible to track. I only recognise this now after many years! I was on the first DAFNE course in Ireland and yes I learnt a huge amount but like you say the stepwise approach didn't work because of these variations. I used to think I was doing something wrong which didn't help motivation at all. I also have the dawn rises which I am still working on controlling with a pump.

I haven't got it sorted yet as I have a 5 week cycle with about 3 phases of insulin requirements over those 5 weeks.

However, I do believe that there should be more information available on this issue. Not knowing this has caused years of grief for me as I just wasn't getting it right(or near to it). I thought I was doing it all wrong but alot of the time it was my body. It should be mentioned in the DAFNE course even if there are no answers/research yet so that one can start to recognise this higher level pattern(over weeks/months). Maybe this was already obvious to people with regular cycles but for me I could have a 3 to 8 week cycle which meant I didn't see a pattern.

Sorry for the rant but I hope it may help others if they have the same issues.

Jackie

Mar 29, 2011

Edentherapies 8 posts

Topic: General Discussion / dafne app/carb calculator for Blackberry phones

Hi all,

I know that the Iphone has an app for DAFNE but does any one have any idea if there is one or something similar for the Blackberry? Been surfin the net for hours now and I'm getting nowhere! Rolling Eyes

Ta peeps,

Sam

Mar 29, 2011

DFH_17 22 posts

Topic: General Discussion / What made you smile today?

Getting the new Avil Lavigne album via play.com yesterday andlovin all the tracks :-)

Mar 29, 2011

DFH_17 22 posts

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

Hi,

Thanks for giving the advice. Started on the higher amount of 36BI from 34BI 2 nights ago - BG's are still a little bit high but are gradually calming down. will see how it goes tomorrow as well. Have gone a bit low this evening so more than likely will need to have a go at the QA tomorrow.

Thats what I hope to get - has been better today - had 1 high reading today at lunch - jumped from 6,7 at breakfast to 12,2 at lunch :-( But by dinner had calmed down to 7.9. I'll see how it goes before sharing my results with all - am hoping it will keep going the way it should do.

Mega thanks for your help - have been really worried.

Mar 29, 2011

Simon 578 posts

Topic: General Discussion / DAFNE course manual

Novorapidboi is right, if you are still in touch with your dafne educators then you can ask them for your 8 digit centre code. If not, drop us an email at [email protected] with your name and where you took the course and we can get you verified and grant access to the online handbook.

Mar 29, 2011

KennyB 2 posts

Topic: General Discussion / What made you smile today?

Finding the DAFNE app for the Iphone for recording carbs and insulin dosages.....saved myself a few Â£'s as the APP deos eveything I need and it is free Very Happy

Mar 29, 2011

Athena 52 posts

Topic: Questions for HCPs / Information on menstrual cycle

Hi All,

Looked into this a bit more and there should be a pattern of l:
lowest insulin requirements during menstruation
Rising requirements at end of menstruation
Highest requirements just prior to next menstruation

This is the most typical pattern, but it is not everybody's pattern. Yours may be different,it is just a question of noticing it.
I find the step wise approach useless as a result. When my period starts, I need to immediately go to my lowest dose and of course this takes ages via the step wise approach. A week of night iime and day time hypos occurs as you slowly turn the insulin down. Then the opposite occurs when I need the highest dose, I am high for over a week and feel really awful as the step wise approach is too slow in turning the dose up. We don't even ask about this with our HCP's as theres is no point if DAFNE doesn't recognise this. We discussed it ourselves and decided not to bother as ihaving read on DAFNE on - line that it is not an area for discussion then we thouoght that it would just put the educators in a position.
My course comprised young women who have not got ontrol. It seems to be the older ones and the men who manage better and I wonder if this is why. Does anyone know of any information on success rates of DAFNE. How many people actually manage to bget their BI and their ratios sorted out. I have searche dfor stuff but can't find any research on it. Was looking ofr demographic splits etc. e.g is there a difference in gender. Don't know how success is measured. how does anyone know if a patient has got control or not if this is never recorded anywhere?

Mar 29, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / DAFNE course manual

You will need to contact either marke or Simon and provide them with a graduate number relating to your center.......you may not have one as you done it a while back but if you explain this they should be able to give you access to it.......

It is open to graduates here on site through the DAFNE Tools tab at the top of the page........ Very Happy

Mar 29, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Ideas

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.....

Good news about the evening background, that gives you a good place to start if that is right......

So are you on 12 still for the evening BI dose.......?

The next logical step after your happy with that is your daytime BI dose, a few carb free meal should confirm its effectiveness....

Mar 29, 2011

Neil Brown 28 posts

Topic: General Discussion / DAFNE course manual

You can view manual online or on DAFNE mobile or try contacting the folk who supply the diaries

Mar 29, 2011

Neil Brown 28 posts

Topic: General Discussion / Ideas

Thanks everyone for advice I'm still getting my head round all this ! My corrections were aimed at getting level down obviously but was told we shouldn't go above a correction of 4 !
My BI seems better as for last two mornings BG has been the same as at bedtime so perhaps I'm getting there

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 1,819 posts

Topic: Questions for HCPs / Ideas

Hey, not and HCP, but I responded over HERE

Mar 29, 2011

novorapidboi26 1,819 posts

Topic: Site Development / Time

Thanks boss........ Smile

Mar 29, 2011

novorapidboi26 1,819 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 1,819 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 30, 2011 Aneirin 15 posts	Topic: General Discussion / Ratios etc It seems to work for you, but when your blood sugars decrease, wouldn't your insulin resistance change? So giving 12 at 17, the first 7 or so unit will take you down to ten, at what point your insulin resistance will decrease and you now have a dose of insulin and the next 5 units (working at 1 unit taking down 2 blood sugars) may take you down to zero. Wouldn't it be preferable if this high and working off these rules, to give yourself an initial dose at 1:1 to bring you to 10 and then a further dose once down to take you down the rest (on the assumption 1 takes you down 2 instead of one)

Mar 30, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Ratios etc This is purely my own personal experiences............................ But my theory behind these corrections is that the higher your blood sugar the less effective 1 unit of insulin is, ie.....higher resistance........... As a general principle: 1 unit of quick-acting insulin lowers blood glucose by 2-3mmol/l. For blood glucose levels above 11mmol/l this rule does not necessarily apply. This statement can be found here........just realized you wont be able to access this link if your not signed up as a graduate, sorry........but its there believe me....... So I actually investigated how much 1 unit dropped me by at different levels and came up with 4 categories of blood glucose readings and a matching drop by 1 unit........... Everyone is different in terms of their response to 1 unit, but for me at a level of 17 or above, 1 unit only drops me by 1mmol/l...............so to return to 5.5 from 17.2 I would need to drop 12mmol/l, hence the 12 units..........

Mar 30, 2011 india 2 posts	Topic: General Discussion / Ratios etc hi..i am new to this site but am wondering about the 'if you were 17.5 then a dose of 12 would get you back to normal'?....i have been instructed always to take 1 unit to get me down 2 numbers......so if my blood weere 15 then to get to say 5....then 5 units of novorapid would in theory do the job.....i understand it doesn't always work like that. but please tell me if i have got this wrong...but 12 units for a 17.5....wouldn't that throw you into severe hypo? as 12 would get you down a possible 24 numbers and therefore well past a blood of 5 - ish? sorry if i have got this completely wrong....but i needed to ask....thanks

Mar 30, 2011 novorapidboi26 1,819 posts	Topic: Site Development / Glossary of Terms Its a good idea I think............ Users on the site I believe should be familiar with the DAFNE abbreviations like, QA, BI, BG, etc............but it wouldn't hurt...........I think basal and bolus is a more general term and is used more in the pumping world to differentiate between two different dose purposes with one type of insulin. But there are a few pumpers in our midst so it would be a good idea I suppose.

Mar 30, 2011 Alan 49 284 posts	Topic: Site Development / Glossary of Terms Would it be worth putting a Glossary of Terms on the website? Searching the Handbook for 'bolus' or 'basal' yields no results, so I'm still not sure which is quick-acting and which is background insulin. Abbreviations could also be there, so a newcomer to the site could find out what CP or BG mean or non-medical abbreviations, like 'lol' - which I only recently found out means 'laugh out loud'. What do you think?

Mar 30, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / dafne app/carb calculator for Blackberry phones I am on the android market and there are many apps for recording results, producing graphs etc.........not like the DAFNE app but useful none the less. I would expect there to be something similar on the BB market. Are you looking for and app to count carbs, dont know if there are many out there to be honest. Are you looking for convenience or do you have a specific problem with counting carbs......? There is a book called carbs and cals which has been recommended by many in the diabetic community, I do believe there is an iPhone app to accompany this also, you could try searching for this on the BB.... Good Luck............

Mar 30, 2011 JackieB 3 posts	Topic: Questions for HCPs / Information on menstrual cycle Hi Athena, Yes, variations in insulin requirements due to hormonal variation over my menstrual cycle have .... been the bain of my life. My cycle was very irregular which made it impossible to track. I only recognise this now after many years! I was on the first DAFNE course in Ireland and yes I learnt a huge amount but like you say the stepwise approach didn't work because of these variations. I used to think I was doing something wrong which didn't help motivation at all. I also have the dawn rises which I am still working on controlling with a pump. I haven't got it sorted yet as I have a 5 week cycle with about 3 phases of insulin requirements over those 5 weeks. However, I do believe that there should be more information available on this issue. Not knowing this has caused years of grief for me as I just wasn't getting it right(or near to it). I thought I was doing it all wrong but alot of the time it was my body. It should be mentioned in the DAFNE course even if there are no answers/research yet so that one can start to recognise this higher level pattern(over weeks/months). Maybe this was already obvious to people with regular cycles but for me I could have a 3 to 8 week cycle which meant I didn't see a pattern. Sorry for the rant but I hope it may help others if they have the same issues. Jackie

Mar 29, 2011 Edentherapies 8 posts	Topic: General Discussion / dafne app/carb calculator for Blackberry phones Hi all, I know that the Iphone has an app for DAFNE but does any one have any idea if there is one or something similar for the Blackberry? Been surfin the net for hours now and I'm getting nowhere! Ta peeps, Sam

Mar 29, 2011 DFH_17 22 posts	Topic: General Discussion / What made you smile today? Getting the new Avil Lavigne album via play.com yesterday andlovin all the tracks :-)

Mar 29, 2011 DFH_17 22 posts	Topic: Questions for HCPs / Cant stop BG Levels going up Hi, Thanks for giving the advice. Started on the higher amount of 36BI from 34BI 2 nights ago - BG's are still a little bit high but are gradually calming down. will see how it goes tomorrow as well. Have gone a bit low this evening so more than likely will need to have a go at the QA tomorrow. Thats what I hope to get - has been better today - had 1 high reading today at lunch - jumped from 6,7 at breakfast to 12,2 at lunch :-( But by dinner had calmed down to 7.9. I'll see how it goes before sharing my results with all - am hoping it will keep going the way it should do. Mega thanks for your help - have been really worried.

Mar 29, 2011 Simon 578 posts	Topic: General Discussion / DAFNE course manual Novorapidboi is right, if you are still in touch with your dafne educators then you can ask them for your 8 digit centre code. If not, drop us an email at [email protected] with your name and where you took the course and we can get you verified and grant access to the online handbook.

Mar 29, 2011 KennyB 2 posts	Topic: General Discussion / What made you smile today? Finding the DAFNE app for the Iphone for recording carbs and insulin dosages.....saved myself a few Â£'s as the APP deos eveything I need and it is free

Mar 29, 2011 Athena 52 posts	Topic: Questions for HCPs / Information on menstrual cycle Hi All, Looked into this a bit more and there should be a pattern of l: lowest insulin requirements during menstruation Rising requirements at end of menstruation Highest requirements just prior to next menstruation This is the most typical pattern, but it is not everybody's pattern. Yours may be different,it is just a question of noticing it. I find the step wise approach useless as a result. When my period starts, I need to immediately go to my lowest dose and of course this takes ages via the step wise approach. A week of night iime and day time hypos occurs as you slowly turn the insulin down. Then the opposite occurs when I need the highest dose, I am high for over a week and feel really awful as the step wise approach is too slow in turning the dose up. We don't even ask about this with our HCP's as theres is no point if DAFNE doesn't recognise this. We discussed it ourselves and decided not to bother as ihaving read on DAFNE on - line that it is not an area for discussion then we thouoght that it would just put the educators in a position. My course comprised young women who have not got ontrol. It seems to be the older ones and the men who manage better and I wonder if this is why. Does anyone know of any information on success rates of DAFNE. How many people actually manage to bget their BI and their ratios sorted out. I have searche dfor stuff but can't find any research on it. Was looking ofr demographic splits etc. e.g is there a difference in gender. Don't know how success is measured. how does anyone know if a patient has got control or not if this is never recorded anywhere?

Mar 29, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / DAFNE course manual You will need to contact either marke or Simon and provide them with a graduate number relating to your center.......you may not have one as you done it a while back but if you explain this they should be able to give you access to it....... It is open to graduates here on site through the DAFNE Tools tab at the top of the page........

Mar 29, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Ideas 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..... Good news about the evening background, that gives you a good place to start if that is right...... So are you on 12 still for the evening BI dose.......? The next logical step after your happy with that is your daytime BI dose, a few carb free meal should confirm its effectiveness....

Mar 29, 2011 Neil Brown 28 posts	Topic: General Discussion / DAFNE course manual You can view manual online or on DAFNE mobile or try contacting the folk who supply the diaries

Mar 29, 2011 Neil Brown 28 posts	Topic: General Discussion / Ideas Thanks everyone for advice I'm still getting my head round all this ! My corrections were aimed at getting level down obviously but was told we shouldn't go above a correction of 4 ! My BI seems better as for last two mornings BG has been the same as at bedtime so perhaps I'm getting there

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 1,819 posts	Topic: Questions for HCPs / Ideas Hey, not and HCP, but I responded over HERE

Mar 29, 2011 novorapidboi26 1,819 posts	Topic: Site Development / Time Thanks boss........

Mar 29, 2011 novorapidboi26 1,819 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 1,819 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....