Recent Posts - DAFNE Online

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 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 578 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 49 284 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 1,819 posts

Topic: Site Development / Time

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

Mar 28, 2011

JayBee 587 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 686 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 587 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 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....

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 578 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 49 284 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 1,819 posts	Topic: Site Development / Time Have the clocks been put forward on site............

Mar 28, 2011 JayBee 587 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 686 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 587 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!