Search the DAFNE Online Forums
15,847 posts found
|
Jan 25, 2018
HelenP
218 posts
|
Topic: General Discussion / Pump users / Glucose Control over duration of the vial volume Hi Andy, I live in Brisbane, Australia and our day temperatures are regularly over 30 degrees, especially currently(10:00am and it is already 31 degrees!). Been a diabetic for 40+ years and on pump therapy for over 8 years. This is my second pump. My first pump had a cartridge with only 200 units and I would regularly run out half way through the third day. My problem was at the change over...after I had changed the infusion set I would have 8-12 hours where the new set was embedding (often needing top ups with an injection)! It would then run smoothly. The second pump has a 300u cartridge and lasts me 3+ days on average. I find the point of insertion tends to break down at 4 days and I change it at 3.5 days rather than continue. I can get lucky but I think it is a product of 30 years of injections and damage to the underlying fat layer (scarring?). I have not noticed any deterioration of the insulin over waves of 30+ days. We recently had a run of over 35 degrees and I found I drank more water and my insulin demand went up slightly (always does in the heat) but the insulin seemed fine.All the best with your research. Helen |
|
Jan 24, 2018
Alan 49
284 posts
|
Topic: General Discussion / Libre to be available on the NHS..... The website address for this petition ishttps://petition.parliament.uk/petitions/204550 You'll have to copy and paste this to get to it |
|
Jan 23, 2018
Colin McC
15 posts
|
Topic: General Discussion / Libre to be available on the NHS..... Just found out there is a government petition relating to the freestyle libre. It's got @ 7300+ so far so if you want to sign up then go to Petitions - UK Government and Parliament then Open Partitions then type in diabetic & it will show Provide free flash glucose monitoring systems to type 1 diabetics on the NHS. Then just follow the instructions. I think tis worth a go & tis only takes a few minutes out of your life to register |
|
Jan 21, 2018
AMcD
38 posts
|
Topic: General Discussion / Pump users / Glucose Control over duration of the vial volume I am currently starting an MSc in Biomedical Science Project. I have had type 1 for nearly 30 years and started pump therapy in summer 2015. I have found that my BG control is excellent over the first 3 days but thereafter BG levels begin to rise until a new vial of insulin is filled when doing a set change. I am examining the effect that the temperature of the insulin within the pump may have on the efficiency of the insulin. There is some detail in the litterateur about storage and room temperature and the insulin producers say that insulin should be kept below 30 degrees. I would be delighted to receive any feedback from other pump users to see if they find loss in control towards the end of the pump vial - say after day 3? Thanks in advance. Andy |
|
Jan 17, 2018
Peter
109 posts
|
Topic: General Discussion / Wanted: DAFNE Graduate user representatives to join DAFNE Executive Board The DAFNE Executive Board has decided to increase the graduate membership from 2 to 7 to give equality with the number of doctors and of nurses/dieticians. This will allow the Executive Board to access both a broader perspective from the DAFNE graduate community and a wider range of skills and backgrounds thereby achieving both increased participation and partnership.As a result, an election is now being planned to select 5 additional DAFNE graduates to supplement the 2 graduate representatives who are already members of the Board. At this stage, we are looking for expressions of interest in the roles. Further details of the role plus the application and election processes will be issued in February. The overall responsibilities of the DAFNE Executive Board are: • to have delegated responsibility for the setting and the achievement of the strategic and operational objectives of the Central DAFNE Team (CDT) [see note1]. • the approval of the annual budget for the CDT and agreeing how any surplus will be used for the development of the DAFNE programme for the benefit of the Members. • ensuring the quality of the DAFNE programme healthcare professional and patient training resources and materials and that these reflect current best practice. • ensuring the competencies of DAFNE Educators, doctors and advisors at the point of DAFNE certification and registration. Nominations for the additional graduate representative roles are open to DAFNE graduates who are DAFNE Graduate Group (DGG) members [see note 2]. Board membership requires attendance at 4 Board meetings per year, and involvement in delegated activities between meetings which will typically use e-mail correspondence. Two of the Board meetings each year are usually held in January and May by teleconference, each typically lasting half a day. There is an annual 2-day face-to-face meeting (usually held in October near Newcastle-upon-Tyne) which covers strategic and business matters. Board members are also invited to attend the 1-day annual DAFNE Collaborative meeting (typically in Manchester in June) which is for DAFNE healthcare professional development. The graduate members will be expected to participate in all aspects of the work of the Board, alongside the clinical members e.g. reviewing proposed changes to the DAFNE programme. Those involved in delegated activities between meetings will be chosen according to individual availability plus experience and/or interest in the subject area. In this way graduate members will be able to choose where they have a greater level of participation. Expertise in social media, business and marketing skills would be particularly welcome. In total it is anticipated that the role will require 4-11 days activity per year, most of which can be undertaken at evenings and/or weekends. The roles are voluntary and unpaid, although costs for travel, hotel and reasonable expenses will be provided in line with the NHS rules on reimbursement. It is expected that the election process will commence in mid-February. On completion of the election, the successful representatives will be invited to an introductory meeting during June with representatives of the Board, including both existing graduate members, before joining the 2-day full Executive meeting on 16th & 17th October. Full details of these roles and an application pack will be sent to all DGG members in mid-February. If you are a DAFNE Graduate and are interested in receiving more details, but are not currently a member of the DGG [see note 3], please send an e-mail to ][email protected] and the information will be sent when available. Alternatively, the information will be downloadable from the DAFNE website (http://www.dafne.uk.com/) from mid-February. [Note 1] The CDT is a dedicated centralised resource responsible for the delivery of the programme core operational objectives and provides support to the Trusts providing DAFNE. The CDT also initiates, implements and manages a common development strategy for DAFNE. [Note 2] If you need to join the DGG please firstly create a dafneonline account at https://www.dafneonline.co.uk/signup?to=%252F. You will then need to contact your DAFNE course Educator to request a DAFNE Centre code. This should be added to your dafneonline account along with selecting the “Subscribe to DGG email list” option on the Signup page. This will both complete your membership of the DGG and allow you to access the latest DAFNE Handbook through the dafneonline site. [Note 3]Membership of the DGG will be required prior to making an application. See footnote #2. |
|
Jan 16, 2018
Colin McC
15 posts
|
Topic: General Discussion / BD pen 4mm/32g needles For many years now I have used BD Micro-Fine Ultra pen needles 4mm/32g with no problems. Today I discovered my GP has replaced these needles for the BD Viva 4mm/32g version. Apparently the GP has been directed, by whom I do not know, to now prescribe these. I can only imagine it is due to NHS costs, £20 approx for the Micro-fine against £7 approx. for the Viva. So I ask has this happened to anyone else & does anyone use the Viva? Be pleased to know if the Viva are any good as I bruise easily. |
|
Jan 15, 2018
ytyynycefn
9 posts
|
Topic: Questions for HCPs / freestyle libra
My management is better because I’m actually checking my blood sugars lol. I’ve been in burnout for a few years and had adopted the “if I don’t know what it is, I don’t need to worry about it” approach - pretty much since doing the DAFNE course in the first place. Like not opening the brown envelopes that come through the door telling you you’re in financial trouble! It wasn’t that I couldn’t handle the calculations, I’m very good at maths. It was the constant finger pricking required - to do it properly I found my fingers getting shredded. My hands get very dirty with my work, and I was getting infections; I also need precision with my work (I’m a jewellery silversmith) and sore fingers meant I was fumbling my creations and ruining them - and that gets very expensive when you’re working with precious metal! So I stopped testing regularly, just took my BI and the occasional QA when I was having loads of carbs. I also have Asperger’s, which means that I have poor “executive function” - basically doing the things I need to do to take care of myself become massively difficult. However, the Libre has changed all that, I’m scanning all the time and have a very detailed picture of what is happening. In the four days I’ve had this sensor in, the wild fluctuations have decreased drastically and I’ve actually been in my target range for the last 20 hours, except for a small 8.1 spike after lunch, which I took 1 unit of insulin for. It seems to be all about small corrections. If you message me your email address, I will happily send you some photos of the graphs on my meter to back up your case - I’ve (hopefully) included my diary in this reply. |
|
Jan 15, 2018
novorapidboi26
1,819 posts
|
Topic: Questions for HCPs / freestyle libra
Is your management better because you can now get ahead of any highs or lows before they manifest properly.....? what has the Libre brought that the DAFNE principles couldn't get right for you... My health board are still thrashing out a few details before its readily available but there will be criteria to get one obviously.... I have clinic on Wednesday and will be asking about it then....... |
|
Jan 13, 2018
ytyynycefn
9 posts
|
Topic: Questions for HCPs / freestyle libra Hi, I’ve just been issued it on prescription on a three month trial basis in South Wales. If I can bring my terrible (~10) HbA1c down by 2.5 I’ll be able to have it long term. So it’s available, but limited to cases like mine and people who fingerprick test eight or more times a day. So far!It’s brilliant. My management is already so much better. |
|
Jan 8, 2018
ruthhutchinson
39 posts
|
Topic: General Discussion / Split Levemir dose Thanks for this advice. Unfortunately I have taken a really bad cold so everything is on hold until I battle through. When you say to eat something do you mean before bed or when I notice my BG starting to rise. And do you suggest carbs or something else at that time. Sorry for all the questions but I would like to get this sorted. |
|
Jan 8, 2018
novorapidboi26
1,819 posts
|
Topic: General Discussion / Split Levemir dose as you have now split the dose you can evaluate evening and morning doses separately and adjust them separately too......so do some basal testing overnight with the 10pm dose and adjust it until you are holding steady [until 5am at least]..... you cant really stop the dawn phenomenon and its hard to deal with on injections but what will help is eating something as its the absence of food and the recent fast that is spurring the liver on to dump some glucose.....so get something in the stomach.... as for the morning levemir dose, the same riles apply, do the tests and adjust accordingly.... |
|
Jan 5, 2018
ruthhutchinson
39 posts
|
Topic: General Discussion / Split Levemir dose Thanks. I will give that a go this evening. |
|
Jan 5, 2018
Alan 49
284 posts
|
Topic: General Discussion / Split Levemir dose Yes, Ruth - that's what I would do - increase the 10pm Levmir by 1 unit and see what effect that has. You may have to increase it again, if you're still high in the morning. I would leave the morning dose unchanged. |
|
Jan 4, 2018
ruthhutchinson
39 posts
|
Topic: General Discussion / Split Levemir dose My BG rises dramatically between 5am and 7am (obviously dawn phenomenon) but even if I give myself a couple of units of Novorapid when I notice at 5 it does not come down until lunch time. I have just changed to a split dose of Levemir (11 units at 7 am and 11 units at 10 pm). Should I increase my 10pm dose? And if I do this should I decrease my morning dose? |
|
Dec 22, 2017
NicoleClark1992
2 posts
|
Topic: General Discussion / Weight Loss Thanks for the advice guys, I'm feeling a bit better about it now. I've stopped eating so much bread which seems to have helped. I also think that while I was on the course I wasn't very active, I'm training to be a primary school teacher, so am constantly on the go and I think this tends to keep the weight down a bit too. I'm closer to the weight I am normally now, I just panicked because it was a lot to put on in 2 weeks! |
|
Dec 19, 2017
torana
53 posts
|
Topic: General Discussion / Weight Loss Hi Nicole,A dietitian is a great idea however it is critical that you have a plan of attack already before you go as there a variety of dieticians with differing backgrounds and understanding of diabetes as well as endos who believe that an excellent result with your HBA1C is a satisfactory achievement in itself. For example, there are now specialist doctors aligned to Dietician’s that deal with specifically low carb ketogenic diets if that is what you are seeking. On the other hand, some established diabetic clinics find this in the too hard basket. It is very difficult to find a dietitian that relates to your needs. Maybe on this forum members may be able to direct you a dietitian that will cater for weight loss and diabetes in your area that they have found a success. |
|
Dec 18, 2017
Warwick
423 posts
|
Topic: General Discussion / Weight Loss To answer your question Nicole, assuming that diet is the same as previously but your HbA1c and blood sugars are lower since doing the DAFNE course, then yes, I would expect you to have put on weight.Why? Well previously, you weren't taking enough insulin, so not all of the blood sugar could be stored in your cells but would be expelled in your urine. Now that you are taking an appropriate level of insulin to keep your BGLs in the correct range, your body is storing more of the blood sugar, and anything it doesn't use for glycogen or in daily activity will be stored as fat. What can you do about it? I'd recommend seeing a dietitian. As Torana says, the whole insulin/diet relationship is complex and a dietitian is well trained in helping to manage that. They can look at things such as your daily activity levels, metabolic rates, daily food intake and make recommendations based on that. |
|
Dec 18, 2017
Warwick
423 posts
|
Topic: General Discussion / Weight Loss I highly recommend this web site and if you are interested in following a low-carb program then theirs is very helpful. There is a lot of good support here too in the forums - http://www.diabetes.co.uk/ |
|
Dec 18, 2017
torana
53 posts
|
Topic: General Discussion / Weight Loss Hi NicolaThe relationship between insulin and food intake is extremely complex as denoted by the huge library of books on the topic and medicos who work in the area. So you are not alone in trying to overcome this dilemma of weight gain. In fact insulin is the hormone that allows sugar into the cells. I tend to agree with Warwick to cut down on your carbs throughout the day which we all know is hard when having to top up after a low or the socialisation problem of constant celebrations in the workplace and home whether it be Christmas, birthdays, a food after exercise etc etc. I have cut down my carbs to 30grams per day and hence less insulin. I was finding that with lows there would be a greater intake of carbs anyway so during the week there may be many more carbs eaten. I eat low carb bread for breakfast 2 pieces=.05 of a gram, the same for lunch with tomatoes and cheese and for dinner 20grams. I usually fit in a piece of fruit somewhere in the day after a walk etc. I also always weigh my foods and use the calorie king app to see what the product comprises of in terms of carbs. My usual premise is that if it tastes really good check out the carb content. So I have stuck to a regime over many years that includes the amount of carbs in a week, the timing of my needles and the checking of BGs throughout the day to create some degree of consistency and understanding of the diabetes dilemma. Of course always have a chat to your endo about what your plans are and changes to the insulin regime. |
|
Dec 18, 2017
NicoleClark1992
2 posts
|
Topic: General Discussion / Weight Loss Is it normal to gain weight when HbA1c drops? I did DAFNE a couple of weeks ago and have gained a lot of weight, I developed a double chin over night, it's really upset me as I'm used to being around 8st but now feel very heavy on my feet and out of breath at the slightest thing because of the extra weight, any advice? |
|
Dec 14, 2017
torana
53 posts
|
Topic: Carbohydrate Counting / Never carb counted Hi Kelly3392It will be a tremendous advantage to be able to carb count and give appropriate dosage of insulin by doing a DAFNE course. I can highly recommend that you give it a try after so many years. Over 17 years there have been improvements in insulin that make them measurable and thus adjustable. Therefore this makes the intake of carbs able to be varied and and changed to individual requirements. I have used all the insulins over the years and had to suffer with lack of control and be uneducated in new invaluable research of how to tame this wild medicinal horse and at least have the reins to steer. Truly, taking insulin without a DAFNE course is like driving a car without a steering wheel. I can’t recommend the DAFNE course highly enough in able to be able to take some control over your diabetes. |
|
Dec 14, 2017
novorapidboi26
1,819 posts
|
Topic: Carbohydrate Counting / Never carb counted BERTIE Online |
|
Dec 14, 2017
torana
53 posts
|
Topic: Questions for HCPs / freestyle libra Hi Rafa, You’ve done a fantastic job getting the HBA1C down to the low 7’s. I find to get it even lower on a consistent basis requires a huge effort and extreme care not to have too many hypos yet I tend to agree with Warwick that by cutting back on carbs throughout the day and hence lowering insulin levels to correspond is worth a try. I know this sounds a contradiction but in the morning my bg’s are high even after a low carb meal of approx .5 of a gram so I have been increasing the insulin to bring down the BG levels. It appears it’s horses for courses and trial and error but whatever works is the best solution for me. I have also been on the freestyle libre for some months and it’s invaluable to wear it a few weeks before a consultation to get a window into what exactly is happening in a 24 hour period and hence over a fortnight. |
|
Dec 13, 2017
Warwick
423 posts
|
Topic: Questions for HCPs / freestyle libra I haven't used the Libre, but use another brand's CGM and it has been incredibly helpful in seeing patterns. I used to have cereal for breakfast and assumed that my insulin was handling that well as my pre-breakfast and pre-lunch levels were similar, but I was shocked to see on CGM that my BGLs were hitting 17 for a couple of hours after breakfast before returning to normal levels. I cut out the cereal and changed to eggs and now I have a flat line after breakfast.Also really helpful for seeing trends during exercise - flat lines on my cycle to work but downward trends on my cycle home from work. It has been really helpful so that I can make educated changes to my insulin regime and diet. |
|
Dec 13, 2017
Rafa
99 posts
|
Topic: Questions for HCPs / freestyle libra I just ordered one myself over here in Ireland. HbA1c is in the low 7's so praying this will help get it down. Had my regular eye check and have been referred to the eye hospital as they need to take a look. They mentioned I may need treatment so need to take a look. |