Recent Posts - DAFNE Online

Jan 25, 2011

Carolin 83 posts

Topic: General Discussion / Conflicting Advice

Hi Jen,
The '4 is the floor' is quite out-dated now.
In DAFNE we recommend you should keep your BG above 4.5mmol/l at any time of the day; remember your DAFNE pre-meal target BG:
Breakfast: 5.5 - 7.5mmol/l
Lunch/Tea: 4.5 - 7.5mmol/l
Bed: 6.5 - 8.0mmol/l
In terms of hypos, we still define a hypo as a BG below 3.5mmol/l and you should always treat these immediately with your 1.5 - 2 CPs of rapid acting carbohydrate.
If you have a BG between 3.5 and 4.5mmol/l (so not hypo but below target) you should have carbohydrate to get your BG back into a safe target range: you may only need 1 CP to raise your BG by 2-3mmol/l.
If you do have difficulties recognising your hypos, we recommend you aim to keep your pre-meal BG towards the upper end of the DAFNE target range, e.g. 6.0 - 8.0mmol/l for a couple of months, so during this time be very cautious with corrective QA doses and try to avoid going hypo at all costs.
I hope this clarifies and helps you.
Good luck,
Carolin

Jan 25, 2011

tsavage1990 11 posts

Topic: Carbohydrate Counting / glucogel

i take glucogel when my hypos more severe or when i dont trust myself not to just spill lucozade everywhere. thanks

Jan 24, 2011

Trudi 8 posts

Topic: General Discussion / TYPE 1 PREGNANCY

Hi Vickyrees,
I waited a LONG time to have children because I was so concerned about bringing a child into the world who may get diabetes and before I could make the decision to go ahead, I needed to rationalise that even healthy women had babies that were not. I needed to take diabetes out of the mix as much as I could. This is where my control became so important â€“ if I could ensure that my levels were as good as I could get them, that my HbA1C was below 6.5 and stayed there, that I took all the appropriate pills/meds etc, worked with my team and was open and honest about everything (even if I wasnâ€™t sure if it was important), then I was minimising the impact that diabetes could play. Of course I knew that problems could still arise but I needed to go into this feeling that I wouldnâ€™t look back and feel guilty about not doing enough if something did go wrong.
My retinopathy played up during both pregnancies but fortunately for me, after giving birth both times has settled down. I knew this might occur but I decided that having the babies was really important to us as a family and went into it knowing that my eyes may not be as good on the other side.
I loved being pregnant and had two reasonably easy pregnancies - one at age 38, the other at 39 and the babies were born 7ib 2oz and 5lb 9oz so weren't the diabetic 'big babies' that everyone told me I'd have.
Best wishes with your choice - weigh up what the experts have told you and your own desires for your family - good luck with it all.
Trudi

Jan 24, 2011

Simon 574 posts

Topic: DAFNE Online Mobile / Pump Users

Hi Chris,

Yes - as a non pump user I need a definitive list of what fields you want to store, as well as the units these are measured in.

Simon

Jan 24, 2011

SimonR 3 posts

Topic: Site Development / Entry type

Would it be possible to have a Type called 'During Exercise'? I do a lot of long distance running/cycling events, whilst I dont tend to enter my CP's etc... whilst exercising, although you could if you wanted, I think it would be useful to retrospectively log CP's taken specifically during an exercise session. Kind Regards

Jan 23, 2011

JayBee 582 posts

Topic: Questions for HCPs / Difference in BG from different fingers!

Hear, hear! Smile

Even if we have the 20%, I don't know about you guys, but I've yet to find it that big of an issue while seeking great control. Smile

Having some rough indication is better than no indication at all after all! Very Happy

Jan 23, 2011

JayBee 582 posts

Topic: Questions for HCPs / Information on menstrual cycle

Golly, I don't think it's worth quitting DAFNE over this. Sad

If anything, DAFNE is the first step to working it all out!

If it's of any help towards figuring it out, it's taken me more than one hormonal time to work it out before even if I put my BI up two units at a time, I needed more than a week to find out my final dose (all because life gets in the way - and I'm still not sure I'm 100% there yet but my sugar levels have been much better since doing the experiment to find out). Make sure you compare each time!

I'm finding at the moment that I go from 11 - 9 (split dose on Levermir, morning - night) to 11 - 18 and this is for the whole week before my period properly starts. Once this week finishes I put it back down to 11 - 9 to prevent any hypos.

I recall the pre-menstrual time is the week before so I think it's happening because of that (thankfully I don't get PMS! XD). With me taking the pill, it seems to happen on the thursday night, about 4 nights before I finish the pills - this has been consistent each month thankfully (possibly due to the pill?).

On another related note, I found that before my this time last month, I was 11 - 9, but when I came off, I seemed to need 11 - 11 because my BG was still fairly raised which hints that it can change. I have been stressed out a bit lately which may be a factor to consider.

I shall continue working on finding my doses (and please don't use me as a generalisation because we know we're not all the same)!
Good luck everyone!

Jan 23, 2011

Stew B 123 posts

Topic: Site Development / Targets for exercise

Ooooohhhh! Brill, thanks Simon!

Stew

Jan 23, 2011

ChrisE 2 posts

Topic: DAFNE Online Mobile / Pump Users

Before recently starting on a pump I was using the App on a Ipod and it was extremely useful. Is there any way it could be modified slightly for use by pump users?

Jan 23, 2011

Sam 64 posts

Topic: General Discussion / Driving Licence Renewal

I also received my renewal a few weeks ago and like you the photo form wasn't there so I called them and they told me it was a mistake and to ignore it, also if you send you're licence away and you're unfortunate to be stopped by the police you quote under section 88 of road traffic etc let's them know it's with dvla

Jan 21, 2011

marke 646 posts

Topic: Questions for HCPs / Difference in BG from different fingers!

I think you are missing the point a bit here. They have never claimed the meters are 100% accurate and indeed I think it is almost impossible
for them to be 100% accurate. I think people trust too much in medical advances and think anything can be done nowadays. There is also the fact that your BG reading in your hand doesn't necessarily reflect that in the rest of your body.
It is an estimate, nothing more, intended to aid your control. I suspect it will never be 100% accurate but compare it to urine strips which many of the people I know remember and you realise how lucky we are ;-)

Jan 21, 2011

HelenP 218 posts

Topic: Questions for HCPs / Information on menstrual cycle

Check insulin pumping books because they certainly acknowledge the need for a different regime for some women. I have the Walsh book: "Pumping Insulin" by John Walsh and Ruth Roberts. Quote: "Each woman needs to figure out her own pattern and be prepared to make these (dosing) adjustments to stay in good control". They acknowledge that some women need LARGE (my emphasis) adjustments in both basal and bolus rates. There must be papers out there. Helen

Jan 21, 2011

HelenP 218 posts

Topic: General Discussion / Weight

Ketones suppress appetite.
People on Very Low Carb diets (Shakes) are intentionally put into and maintained in mild ketoacidosis to help suppress appetite.
Helen

Jan 21, 2011

SimonC 78 posts

Topic: Questions for HCPs / Difference in BG from different fingers!

The figure of 20% is from the operator who spoke to me when I rang Abbott - the makers, given that they make machines that are inaccurate - the information they give out could equally be 20% out, where that leave's us I have no idea.

I was surprised when she told me that they were allowed - with no penalty, to be so inaccurate, but there we have it - it is only an indication not a set in stone absolute.

Jan 21, 2011

Simon 574 posts

Topic: Site Development / DAFNE Online iPhone application - help with content/design needed

Hi John/All,

This has flagged up a few problems with the existing implementation. I haven't looked much at the Australian carbs lit so didn't know how different it was. As a first stage I'll add that info into the app (I can't have 2 versions in different app stores) and add the ability to switch between the two. Perhaps even some clever country detection mechanism, but that might be pushing it a bit.

Regarding the portion sizes, I take your point that there isn't any one consistent mechanism, however broadly speaking there are two types of carb entries - those with portion information, and those with CP info for a specific weight/volume. So as there's only 2 types of carb entries, I'm sure I could come up with a way to add an entry to a plate by either number of portions or weight/volume depending on the type.

Looking at let you guys add your own carb info, this would be fine in the app - the only problem is if you wanted to sync to the site - it would potentially create a lot of duplication of entries, which at some point have to be verified by the DAFNE Dieticians, and as they have limited time it may not get done.

These are my brief thoughts on the matter - happy to take feedback / ideas on how to overcome the issues described, and I'll be tacking them in the order I've written them down, so that the Oz DAFNE Graduates can get their CP list in the app as soon as possible.

Simon

Jan 21, 2011

Simon 574 posts

Topic: DAFNE Online Mobile / Rationale - Please read

Hi Simon,

Thanks for your positive comments - I'll let Apple know that we deserve some commission on iPhone sales ;)

Anyway, regarding your problem, if you check the settings page you'll see a Normal Bedtime entry. This allows you to specify a cut off time for the diary to put entries in the same day. It's useful because if you normally go to bed after midnight for example, your bedtime entry won't appear in the correct day If you set this to 0200, it will (provided you go to bed before 2am!)

Hope this fixes things for you - regarding the Carbs List I think people are just asking for updates to the existing functionality.

Simon

Jan 21, 2011

Jenny Spollen 13 posts

Topic: Questions for HCPs / Bad hypos even when following all dafne rules!

Hi Claire,

I don't know if you are already splitting your Lantus dose but if not it might be worth a shot. Your post is all too familiar sounding. I used to have a very similar experience taking it all in one dose. Have since switched to twice daily injections and things are a whole lot better. Night time and early morning hypos are now a rarity and well worth an extra dose. Though am def convinced that for me there is no lasting in Lantus in a once daily shot and no where near the 24hour coverage

As to pens, I'm using an Autopen 24 that comes in single unit doses but it isn't a disposable pen if that is where your preference lies.

Hope things work out for you Very Happy

Jan 25, 2011 Carolin 83 posts	Topic: General Discussion / Conflicting Advice Hi Jen, The '4 is the floor' is quite out-dated now. In DAFNE we recommend you should keep your BG above 4.5mmol/l at any time of the day; remember your DAFNE pre-meal target BG: Breakfast: 5.5 - 7.5mmol/l Lunch/Tea: 4.5 - 7.5mmol/l Bed: 6.5 - 8.0mmol/l In terms of hypos, we still define a hypo as a BG below 3.5mmol/l and you should always treat these immediately with your 1.5 - 2 CPs of rapid acting carbohydrate. If you have a BG between 3.5 and 4.5mmol/l (so not hypo but below target) you should have carbohydrate to get your BG back into a safe target range: you may only need 1 CP to raise your BG by 2-3mmol/l. If you do have difficulties recognising your hypos, we recommend you aim to keep your pre-meal BG towards the upper end of the DAFNE target range, e.g. 6.0 - 8.0mmol/l for a couple of months, so during this time be very cautious with corrective QA doses and try to avoid going hypo at all costs. I hope this clarifies and helps you. Good luck, Carolin

Jan 25, 2011 tsavage1990 11 posts	Topic: Carbohydrate Counting / glucogel i take glucogel when my hypos more severe or when i dont trust myself not to just spill lucozade everywhere. thanks

Jan 24, 2011 Trudi 8 posts	Topic: General Discussion / TYPE 1 PREGNANCY Hi Vickyrees, I waited a LONG time to have children because I was so concerned about bringing a child into the world who may get diabetes and before I could make the decision to go ahead, I needed to rationalise that even healthy women had babies that were not. I needed to take diabetes out of the mix as much as I could. This is where my control became so important â€“ if I could ensure that my levels were as good as I could get them, that my HbA1C was below 6.5 and stayed there, that I took all the appropriate pills/meds etc, worked with my team and was open and honest about everything (even if I wasnâ€™t sure if it was important), then I was minimising the impact that diabetes could play. Of course I knew that problems could still arise but I needed to go into this feeling that I wouldnâ€™t look back and feel guilty about not doing enough if something did go wrong. My retinopathy played up during both pregnancies but fortunately for me, after giving birth both times has settled down. I knew this might occur but I decided that having the babies was really important to us as a family and went into it knowing that my eyes may not be as good on the other side. I loved being pregnant and had two reasonably easy pregnancies - one at age 38, the other at 39 and the babies were born 7ib 2oz and 5lb 9oz so weren't the diabetic 'big babies' that everyone told me I'd have. Best wishes with your choice - weigh up what the experts have told you and your own desires for your family - good luck with it all. Trudi

Jan 24, 2011 Simon 574 posts	Topic: DAFNE Online Mobile / Pump Users Hi Chris, Yes - as a non pump user I need a definitive list of what fields you want to store, as well as the units these are measured in. Simon

Jan 24, 2011 SimonR 3 posts	Topic: Site Development / Entry type Would it be possible to have a Type called 'During Exercise'? I do a lot of long distance running/cycling events, whilst I dont tend to enter my CP's etc... whilst exercising, although you could if you wanted, I think it would be useful to retrospectively log CP's taken specifically during an exercise session. Kind Regards

Jan 23, 2011 JayBee 582 posts	Topic: Questions for HCPs / Difference in BG from different fingers! Hear, hear! Even if we have the 20%, I don't know about you guys, but I've yet to find it that big of an issue while seeking great control. Having some rough indication is better than no indication at all after all!

Jan 23, 2011 JayBee 582 posts	Topic: Questions for HCPs / Information on menstrual cycle Golly, I don't think it's worth quitting DAFNE over this. If anything, DAFNE is the first step to working it all out! If it's of any help towards figuring it out, it's taken me more than one hormonal time to work it out before even if I put my BI up two units at a time, I needed more than a week to find out my final dose (all because life gets in the way - and I'm still not sure I'm 100% there yet but my sugar levels have been much better since doing the experiment to find out). Make sure you compare each time! I'm finding at the moment that I go from 11 - 9 (split dose on Levermir, morning - night) to 11 - 18 and this is for the whole week before my period properly starts. Once this week finishes I put it back down to 11 - 9 to prevent any hypos. I recall the pre-menstrual time is the week before so I think it's happening because of that (thankfully I don't get PMS! XD). With me taking the pill, it seems to happen on the thursday night, about 4 nights before I finish the pills - this has been consistent each month thankfully (possibly due to the pill?). On another related note, I found that before my this time last month, I was 11 - 9, but when I came off, I seemed to need 11 - 11 because my BG was still fairly raised which hints that it can change. I have been stressed out a bit lately which may be a factor to consider. I shall continue working on finding my doses (and please don't use me as a generalisation because we know we're not all the same)! Good luck everyone!

Jan 23, 2011 Stew B 123 posts	Topic: Site Development / Targets for exercise Ooooohhhh! Brill, thanks Simon! Stew

Jan 23, 2011 ChrisE 2 posts	Topic: DAFNE Online Mobile / Pump Users Before recently starting on a pump I was using the App on a Ipod and it was extremely useful. Is there any way it could be modified slightly for use by pump users?

Jan 23, 2011 Sam 64 posts	Topic: General Discussion / Driving Licence Renewal I also received my renewal a few weeks ago and like you the photo form wasn't there so I called them and they told me it was a mistake and to ignore it, also if you send you're licence away and you're unfortunate to be stopped by the police you quote under section 88 of road traffic etc let's them know it's with dvla

Jan 21, 2011 marke 646 posts	Topic: Questions for HCPs / Difference in BG from different fingers! I think you are missing the point a bit here. They have never claimed the meters are 100% accurate and indeed I think it is almost impossible for them to be 100% accurate. I think people trust too much in medical advances and think anything can be done nowadays. There is also the fact that your BG reading in your hand doesn't necessarily reflect that in the rest of your body. It is an estimate, nothing more, intended to aid your control. I suspect it will never be 100% accurate but compare it to urine strips which many of the people I know remember and you realise how lucky we are ;-)

Jan 21, 2011 HelenP 218 posts	Topic: Questions for HCPs / Information on menstrual cycle Check insulin pumping books because they certainly acknowledge the need for a different regime for some women. I have the Walsh book: "Pumping Insulin" by John Walsh and Ruth Roberts. Quote: "Each woman needs to figure out her own pattern and be prepared to make these (dosing) adjustments to stay in good control". They acknowledge that some women need LARGE (my emphasis) adjustments in both basal and bolus rates. There must be papers out there. Helen

Jan 21, 2011 HelenP 218 posts	Topic: General Discussion / Weight Ketones suppress appetite. People on Very Low Carb diets (Shakes) are intentionally put into and maintained in mild ketoacidosis to help suppress appetite. Helen

Jan 21, 2011 SimonC 78 posts	Topic: Questions for HCPs / Difference in BG from different fingers! The figure of 20% is from the operator who spoke to me when I rang Abbott - the makers, given that they make machines that are inaccurate - the information they give out could equally be 20% out, where that leave's us I have no idea. I was surprised when she told me that they were allowed - with no penalty, to be so inaccurate, but there we have it - it is only an indication not a set in stone absolute.

Jan 21, 2011 Simon 574 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi John/All, This has flagged up a few problems with the existing implementation. I haven't looked much at the Australian carbs lit so didn't know how different it was. As a first stage I'll add that info into the app (I can't have 2 versions in different app stores) and add the ability to switch between the two. Perhaps even some clever country detection mechanism, but that might be pushing it a bit. Regarding the portion sizes, I take your point that there isn't any one consistent mechanism, however broadly speaking there are two types of carb entries - those with portion information, and those with CP info for a specific weight/volume. So as there's only 2 types of carb entries, I'm sure I could come up with a way to add an entry to a plate by either number of portions or weight/volume depending on the type. Looking at let you guys add your own carb info, this would be fine in the app - the only problem is if you wanted to sync to the site - it would potentially create a lot of duplication of entries, which at some point have to be verified by the DAFNE Dieticians, and as they have limited time it may not get done. These are my brief thoughts on the matter - happy to take feedback / ideas on how to overcome the issues described, and I'll be tacking them in the order I've written them down, so that the Oz DAFNE Graduates can get their CP list in the app as soon as possible. Simon

Jan 21, 2011 Simon 574 posts	Topic: DAFNE Online Mobile / Rationale - Please read Hi Simon, Thanks for your positive comments - I'll let Apple know that we deserve some commission on iPhone sales ;) Anyway, regarding your problem, if you check the settings page you'll see a Normal Bedtime entry. This allows you to specify a cut off time for the diary to put entries in the same day. It's useful because if you normally go to bed after midnight for example, your bedtime entry won't appear in the correct day If you set this to 0200, it will (provided you go to bed before 2am!) Hope this fixes things for you - regarding the Carbs List I think people are just asking for updates to the existing functionality. Simon

Jan 21, 2011 Jenny Spollen 13 posts	Topic: Questions for HCPs / Bad hypos even when following all dafne rules! Hi Claire, I don't know if you are already splitting your Lantus dose but if not it might be worth a shot. Your post is all too familiar sounding. I used to have a very similar experience taking it all in one dose. Have since switched to twice daily injections and things are a whole lot better. Night time and early morning hypos are now a rarity and well worth an extra dose. Though am def convinced that for me there is no lasting in Lantus in a once daily shot and no where near the 24hour coverage As to pens, I'm using an Autopen 24 that comes in single unit doses but it isn't a disposable pen if that is where your preference lies. Hope things work out for you