Recent Posts - DAFNE Online

Mar 17, 2011

Robby N. 7 posts

I have just graduated from my Dafne course, I find 3 jelly babies (1.5 CP) is better and much better tasting than Glucgel, also you can't spill jelly babies.

Mar 17, 2011

grandma carol 61 posts

Topic: General Discussion / Going below a 1:1 ratio

I have had to change my dinner time ratio from 1-1 down to 0.5-1 and it dose seem to be helping me. But in the mornings I am on 3-1.
I got a 0.5 unit pen and that has helped as going from 2-1 down to 1-1 things were just back and forth I was high and then low and still could not get it right and even with the 1-1 I was still going low and hypo before bed but things are better with the 0.5. I also changed my night time Lantus from having it at 20.45 to having it at 18.00.
Speek to your team and see if you can get a 0.5 pen
I was the same and did not have hypo awarenness but I have it back now so good look Aneirin.

Mar 17, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Going below a 1:1 ratio

You have the right ideas definitely, however some find that dropping their background to stop lows may send them high at some other point in the day, hence the need for a split............

But I would try going for the 0.5 ratio, if your comfortable, speak to your dsn if you need too.............. Smile

Mar 17, 2011

Aneirin 15 posts

Topic: General Discussion / Going below a 1:1 ratio

Thanks a lot. I did consider the bit about background insulin (that I may have to split it), however I take the background after dinner, and it wouldn't make sense if the background insluin was running out for the blood sugars to decrease. If it was rising before I take my background insulin I would, but as my blood sugars are going down before I take it I can only assume it is still working (well, may have to do a few more no carb lunches to check that out)

We have a review in 3 weeks so I can discuss it then. Will try fiddling around for the moment with the half ratio. Thanks a lot.

Mar 17, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Going below a 1:1 ratio

Hey there........

I wouldn't discount the background being off slightly, the dose may be right, but the distribution of the insulin may be out........a way to deal with that is to split your background dose, so a possible scenario for you may be 9 at 7:00am and 13 at 7:00pm, this strategy can compensate for the livers ever changing amounts of glucose secretion......

As you fear your weekends may differ from the week down to activity levels being less at the weekends, I would say that you should try a 0.5:1 ratio, I am aware of a good few people, one who was in my class on DAFNE who are on this ratio...........its undesirable purely because half units are a pain and could complicate things but ultimately you can do whatever is necessary........

Speak with your team, they can give you more professional advice on what to do, especially with your attempt to regain hypo awareness....................

Mar 17, 2011

Aneirin 15 posts

Topic: General Discussion / Going below a 1:1 ratio

By way of additional information, this did not occur during DAFNE traniing and only occurred when I went back to work. (curiously dinner hypo's don't appear to happen at weekends). My first thought was that my work counted as excercize (in which case a half ratio may be appropriateaccording to DAFNE rules) however, my work isn't exactly intensive, being office based, interviewing people, and it does not explain why I raise from morning to lunch, then decrease from lunch to dinner (as I do not do more work in the morning than I do in the afternoon)

Mar 17, 2011

Aneirin 15 posts

Topic: General Discussion / Going below a 1:1 ratio

Hello there. Just did DAFNE a few eeks ago and am now off on my own. During DAFNE everything was going well, keeping stable on a 1:1 ratio cross the board. Reduced my background insulin from 36 to 24 during the week. Was sufeirng hypo's in the morning but not anymore which is great.

However, I am now suffering hypo's before dinner. I can wind up around 10 before lunch and then 2.5 before dinner. I have lowered my background more since then (to 22) but nothing seems to be happening, and my bloodsugars from night to morning seem to be steady so I dno't beleive it is the background. I know that a 1/2 to 1 ratio isn't something that should be done, so I thought I would get other opinions on it first.

I am trying to run my sugars at higher range of DAFNE targets to regain hypo awareness at the moment. I usually go from 7 to 10 between breakfast and lunch, and I am happy with that at the moment, once I get awareness back, I may change the breakfast ratio.

Mar 16, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Loss of Hypo warning signs

For DAFNE to be effective you really need to test.....more than 4 times a day in my opinion......then you can identify at least when the highest chance of hypo is.........

Mar 16, 2011

Kathryn76 2 posts

Topic: General Discussion / Loss of Hypo warning signs

I have done the dafne course back in November and I have gained a lot from doing this, however the diabetic consultant has suggested to run my blood sugars high between 8 and 13 which I have been doing for about 4 months now and my hba1c came up to 8, which I was shocked about. However the last 6 weeks or so I have brought them down a touch well to single figures where possible but I have still done blood test on occasion and they have been between 2 and 3 and not felt low at all. The only symptom I say I may get is the feeling of being hungry!
I am still communicating with community diabetic nurses when I have needed to but I see my consultant soon so I will be having another hba1c done so I sill just see what that's like.

To be honest I am not doing as many tests as I should be which was 4 a day, it was running my life and it became a bit OCD! Just feeling proper p***ed off with it all and it's getting me down so I just do them when I think it's needed.

Mar 16, 2011

DFH_17 22 posts

Topic: General Discussion / Not impressed x 2

Dont know if this will help - re: stomach issue - I do my daytime injections in my stomach and my BI in my thighs but split the dose so use both thighs to inject in.

Mar 16, 2011

DFH_17 22 posts

Topic: General Discussion / weather and hypos

I find when its warmer I tend to go hypo. And am really releived to see reference to hypos around when having a period. Have found that I need less insulin when I'm on the actual week of my period otherwise if I dont adjust my bg's go mad.

Mar 16, 2011

DFH_17 22 posts

Topic: General Discussion / Loss of Hypo warning signs

I've found since doing the DAFNE course in January I'm beginning to recognise the warning signs - tend to feel v tired n achey n can't concentrate. I completely lost all warning signs last September so has been a bit frightening. However I can also say that I have done random tests and the test has been a below 3.5.

Mar 16, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / Loss of Hypo warning signs

I take it running your blood sugar higher has not helped...............in situations like this there could be other underlying problems that will be contributing to you lack of awareness and struggle to regain the symptoms.............

What has your care team suggested.........

Do you have lots of hypos, or just seldomly.........

Mar 15, 2011

Kathryn76 2 posts

Topic: General Discussion / Loss of Hypo warning signs

I have lost all my awareness of hypos and I have been like this for about 6 months now. I am still unable to work as I have a job in a warehouse and it was unsafe for me to continue working being up and down ladders etc.. I have also had to surrender my driving licence and I have no idea when I will get it back, especially with the way things are going and I still have no awareness back I want to know will I ever get any awareness back as I do really want to get my licence back.

I have had diabetes for 25 years and always been well controlled but just had a very bad 12 months which has resulted in these problems.

To be honest I am very very worried about what is happening and I really thought that it be resolved after a couple of months, I just perhaps need some advice from someone that may have been through this

Thanks

Mar 15, 2011

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / calories affecting insulin required?

I don't personally account for anything other than countable carbohydrates but I have heard of people counting their proteins, like meat and eggs......................more commonly people on pumps, this is because the insulin they are using is just one type, novorapid, so there is no slow acting insulin dealing with slow and negligible glucose production from these foods, even though there is what they call a basal dose being delivered constantly through the day...........

But everyone is different and can be sensitive in terms of digestion........

God Luck with DAFNE and I look forward to seeing you on here as a fully fledged graduate...............

Mar 15, 2011

kymmbo46 2 posts

Topic: Carbohydrate Counting / calories affecting insulin required?

Hi Emma and helen,
I have just completed the DAFNE course and have found the information invaluable. It really does clarify issues and let you focus on gaining control of your life and you have support to look at problems when they arize and most of all you'll find you are not alone....

Mar 15, 2011

novorapidboi26 1,819 posts

Topic: Site Development / Smilie Icons....

Alot of forums nowadays have this facility which can assist in expressing the tone of the post...........

Just another suggestion to the long list.........lol........ Smile

Mar 14, 2011

HelenP 218 posts

Topic: General Discussion / Insulin Pumps

The hardest part was getting the appointment with the Credentialled Diabetic Educator...literally took 5 months! The Endo was fine with it (a bit surprised I went with an Animas pump but OK with my choice). He wrote a letter to the Health Fund (Queensland Teachers), (mentioning varying HbA1c's and hypos) and apparently teachers do well on pumps! (control freaks/obsessive compulsives?) they paid for it all ($(AUD)7,500). The day in hospital was fraught! There is a lot to learn in the 2-3 hours the educator is there. And off course you cannot really practice on your pump as it is attached. The educator established the settings and basically left me to it. Lunch arrived and I got out the cheat sheet and could not get past the first two steps,,,hence no bolus for lunch so used my trusty pen! Spoke to the RN who rang the CDE who simply said do the usual (use the pen!). I was unimpressed...what am I doing sitting in a hospital bed supposed learning how to "pump" and using a pen for more than 24 of the 28 hours I am in hospital (the basal was functioning). I then decided I could fix it...out with the manual and after some thought and manual reading I "enabled" a function. Did not realize I could test the "theory" by simply disconnecting from the pump so told the RN that I thought I had fixed it. She had kittens on the spot! Rang the Endo who blasted the CDE and the situation was wait until tea and do it with the CDE on the phone...reading each screen. I had fixed it! To the CDE's credit I think she had the basal rate fairly right (although it is the same over 24 hours and that does not seem logical) but she is way down on the I:C ratio and I have been asked not to touch it (I had, so reversed it) but to keep taking corrections through the pump! So I am still counting carbs inputing that data letting the pump calculate how much insulin I need...documenting that and then adding in what I think (and documenting that). The BGs are OK (not good) on this but it seems a bit pointless not to increase the I:C ratio based on what I needed for carbs pre pump. I will give her two weeks then I will decide what to change. My Endo is OK with that but has warned me not to be too adventurous! I leave to go to Korea (the land of rice and honey) in 11 days. Saw my GP for a flu vac yesterday...I think he is impressed!

I have decided not to insure it as it is attached to me, It seems that if I do insure it I have to insure it under house/contents insurance, like jewellery, and whilst I like the look of the pump it is hardly bling! This type of insurance is expensive. Will discuss travel insurance with the travel agent later today but probably will not insure it as it will never leave my side. The Animas "lady" has offered me a loan pump as a spare to take with me. Much more kit to take than when on MDI's

Helen

Mar 17, 2011 Robby N. 7 posts	Topic: Carbohydrate Counting / glucogel I have just graduated from my Dafne course, I find 3 jelly babies (1.5 CP) is better and much better tasting than Glucgel, also you can't spill jelly babies.

Mar 17, 2011 grandma carol 61 posts	Topic: General Discussion / Going below a 1:1 ratio I have had to change my dinner time ratio from 1-1 down to 0.5-1 and it dose seem to be helping me. But in the mornings I am on 3-1. I got a 0.5 unit pen and that has helped as going from 2-1 down to 1-1 things were just back and forth I was high and then low and still could not get it right and even with the 1-1 I was still going low and hypo before bed but things are better with the 0.5. I also changed my night time Lantus from having it at 20.45 to having it at 18.00. Speek to your team and see if you can get a 0.5 pen I was the same and did not have hypo awarenness but I have it back now so good look Aneirin.

Mar 17, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Going below a 1:1 ratio You have the right ideas definitely, however some find that dropping their background to stop lows may send them high at some other point in the day, hence the need for a split............ But I would try going for the 0.5 ratio, if your comfortable, speak to your dsn if you need too..............

Mar 17, 2011 Aneirin 15 posts	Topic: General Discussion / Going below a 1:1 ratio Thanks a lot. I did consider the bit about background insulin (that I may have to split it), however I take the background after dinner, and it wouldn't make sense if the background insluin was running out for the blood sugars to decrease. If it was rising before I take my background insulin I would, but as my blood sugars are going down before I take it I can only assume it is still working (well, may have to do a few more no carb lunches to check that out) We have a review in 3 weeks so I can discuss it then. Will try fiddling around for the moment with the half ratio. Thanks a lot.

Mar 17, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Going below a 1:1 ratio Hey there........ I wouldn't discount the background being off slightly, the dose may be right, but the distribution of the insulin may be out........a way to deal with that is to split your background dose, so a possible scenario for you may be 9 at 7:00am and 13 at 7:00pm, this strategy can compensate for the livers ever changing amounts of glucose secretion...... As you fear your weekends may differ from the week down to activity levels being less at the weekends, I would say that you should try a 0.5:1 ratio, I am aware of a good few people, one who was in my class on DAFNE who are on this ratio...........its undesirable purely because half units are a pain and could complicate things but ultimately you can do whatever is necessary........ Speak with your team, they can give you more professional advice on what to do, especially with your attempt to regain hypo awareness....................

Mar 17, 2011 Aneirin 15 posts	Topic: General Discussion / Going below a 1:1 ratio By way of additional information, this did not occur during DAFNE traniing and only occurred when I went back to work. (curiously dinner hypo's don't appear to happen at weekends). My first thought was that my work counted as excercize (in which case a half ratio may be appropriateaccording to DAFNE rules) however, my work isn't exactly intensive, being office based, interviewing people, and it does not explain why I raise from morning to lunch, then decrease from lunch to dinner (as I do not do more work in the morning than I do in the afternoon)

Mar 17, 2011 Aneirin 15 posts	Topic: General Discussion / Going below a 1:1 ratio Hello there. Just did DAFNE a few eeks ago and am now off on my own. During DAFNE everything was going well, keeping stable on a 1:1 ratio cross the board. Reduced my background insulin from 36 to 24 during the week. Was sufeirng hypo's in the morning but not anymore which is great. However, I am now suffering hypo's before dinner. I can wind up around 10 before lunch and then 2.5 before dinner. I have lowered my background more since then (to 22) but nothing seems to be happening, and my bloodsugars from night to morning seem to be steady so I dno't beleive it is the background. I know that a 1/2 to 1 ratio isn't something that should be done, so I thought I would get other opinions on it first. I am trying to run my sugars at higher range of DAFNE targets to regain hypo awareness at the moment. I usually go from 7 to 10 between breakfast and lunch, and I am happy with that at the moment, once I get awareness back, I may change the breakfast ratio.

Mar 16, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Loss of Hypo warning signs For DAFNE to be effective you really need to test.....more than 4 times a day in my opinion......then you can identify at least when the highest chance of hypo is.........

Mar 16, 2011 Kathryn76 2 posts	Topic: General Discussion / Loss of Hypo warning signs I have done the dafne course back in November and I have gained a lot from doing this, however the diabetic consultant has suggested to run my blood sugars high between 8 and 13 which I have been doing for about 4 months now and my hba1c came up to 8, which I was shocked about. However the last 6 weeks or so I have brought them down a touch well to single figures where possible but I have still done blood test on occasion and they have been between 2 and 3 and not felt low at all. The only symptom I say I may get is the feeling of being hungry! I am still communicating with community diabetic nurses when I have needed to but I see my consultant soon so I will be having another hba1c done so I sill just see what that's like. To be honest I am not doing as many tests as I should be which was 4 a day, it was running my life and it became a bit OCD! Just feeling proper p***ed off with it all and it's getting me down so I just do them when I think it's needed.

Mar 16, 2011 DFH_17 22 posts	Topic: General Discussion / Not impressed x 2 Dont know if this will help - re: stomach issue - I do my daytime injections in my stomach and my BI in my thighs but split the dose so use both thighs to inject in.

Mar 16, 2011 DFH_17 22 posts	Topic: General Discussion / weather and hypos I find when its warmer I tend to go hypo. And am really releived to see reference to hypos around when having a period. Have found that I need less insulin when I'm on the actual week of my period otherwise if I dont adjust my bg's go mad.

Mar 16, 2011 DFH_17 22 posts	Topic: General Discussion / Loss of Hypo warning signs I've found since doing the DAFNE course in January I'm beginning to recognise the warning signs - tend to feel v tired n achey n can't concentrate. I completely lost all warning signs last September so has been a bit frightening. However I can also say that I have done random tests and the test has been a below 3.5.

Mar 16, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / Loss of Hypo warning signs I take it running your blood sugar higher has not helped...............in situations like this there could be other underlying problems that will be contributing to you lack of awareness and struggle to regain the symptoms............. What has your care team suggested......... Do you have lots of hypos, or just seldomly.........

Mar 15, 2011 Kathryn76 2 posts	Topic: General Discussion / Loss of Hypo warning signs I have lost all my awareness of hypos and I have been like this for about 6 months now. I am still unable to work as I have a job in a warehouse and it was unsafe for me to continue working being up and down ladders etc.. I have also had to surrender my driving licence and I have no idea when I will get it back, especially with the way things are going and I still have no awareness back I want to know will I ever get any awareness back as I do really want to get my licence back. I have had diabetes for 25 years and always been well controlled but just had a very bad 12 months which has resulted in these problems. To be honest I am very very worried about what is happening and I really thought that it be resolved after a couple of months, I just perhaps need some advice from someone that may have been through this Thanks

Mar 15, 2011 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / calories affecting insulin required? I don't personally account for anything other than countable carbohydrates but I have heard of people counting their proteins, like meat and eggs......................more commonly people on pumps, this is because the insulin they are using is just one type, novorapid, so there is no slow acting insulin dealing with slow and negligible glucose production from these foods, even though there is what they call a basal dose being delivered constantly through the day........... But everyone is different and can be sensitive in terms of digestion........ God Luck with DAFNE and I look forward to seeing you on here as a fully fledged graduate...............

Mar 15, 2011 kymmbo46 2 posts	Topic: Carbohydrate Counting / calories affecting insulin required? Hi Emma and helen, I have just completed the DAFNE course and have found the information invaluable. It really does clarify issues and let you focus on gaining control of your life and you have support to look at problems when they arize and most of all you'll find you are not alone....

Mar 15, 2011 novorapidboi26 1,819 posts	Topic: Site Development / Smilie Icons.... Alot of forums nowadays have this facility which can assist in expressing the tone of the post........... Just another suggestion to the long list.........lol........

Mar 14, 2011 HelenP 218 posts	Topic: General Discussion / Insulin Pumps The hardest part was getting the appointment with the Credentialled Diabetic Educator...literally took 5 months! The Endo was fine with it (a bit surprised I went with an Animas pump but OK with my choice). He wrote a letter to the Health Fund (Queensland Teachers), (mentioning varying HbA1c's and hypos) and apparently teachers do well on pumps! (control freaks/obsessive compulsives?) they paid for it all ($(AUD)7,500). The day in hospital was fraught! There is a lot to learn in the 2-3 hours the educator is there. And off course you cannot really practice on your pump as it is attached. The educator established the settings and basically left me to it. Lunch arrived and I got out the cheat sheet and could not get past the first two steps,,,hence no bolus for lunch so used my trusty pen! Spoke to the RN who rang the CDE who simply said do the usual (use the pen!). I was unimpressed...what am I doing sitting in a hospital bed supposed learning how to "pump" and using a pen for more than 24 of the 28 hours I am in hospital (the basal was functioning). I then decided I could fix it...out with the manual and after some thought and manual reading I "enabled" a function. Did not realize I could test the "theory" by simply disconnecting from the pump so told the RN that I thought I had fixed it. She had kittens on the spot! Rang the Endo who blasted the CDE and the situation was wait until tea and do it with the CDE on the phone...reading each screen. I had fixed it! To the CDE's credit I think she had the basal rate fairly right (although it is the same over 24 hours and that does not seem logical) but she is way down on the I:C ratio and I have been asked not to touch it (I had, so reversed it) but to keep taking corrections through the pump! So I am still counting carbs inputing that data letting the pump calculate how much insulin I need...documenting that and then adding in what I think (and documenting that). The BGs are OK (not good) on this but it seems a bit pointless not to increase the I:C ratio based on what I needed for carbs pre pump. I will give her two weeks then I will decide what to change. My Endo is OK with that but has warned me not to be too adventurous! I leave to go to Korea (the land of rice and honey) in 11 days. Saw my GP for a flu vac yesterday...I think he is impressed! I have decided not to insure it as it is attached to me, It seems that if I do insure it I have to insure it under house/contents insurance, like jewellery, and whilst I like the look of the pump it is hardly bling! This type of insurance is expensive. Will discuss travel insurance with the travel agent later today but probably will not insure it as it will never leave my side. The Animas "lady" has offered me a loan pump as a spare to take with me. Much more kit to take than when on MDI's Helen