Recent Posts

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

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

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

Thanks. I will give that a go this evening.

Jan 5, 2018

Alan 49 284 posts

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

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

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

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 425 posts

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 425 posts

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

Hi Nicola
The 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

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

Hi Kelly3392
It 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

BERTIE Online

Dec 14, 2017

torana 53 posts

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 425 posts

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

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.

Dec 12, 2017

Warwick 425 posts

Hi Kelly,

To learn the DAFNE principles, you need to do the course, but carb-counting itself can be learned outside of the course. DAFNE isn't available online but teaches you how to use carb counting to calculate the appropriate basal and bolus doses. If you are able to attend a course, then I highly recommend it. It is extremely helpful even for those who have had T1D for decades.

Dec 10, 2017

kelly3392 1 post