Recent Posts - DAFNE Online

Jan 19, 2011

Garry 328 posts

Topic: Questions ? / Difference in BG from different fingers!

Following SimonC's post where he mentions Optium Exceed meter test solutions, as far as I remember!! the acceptable meter result range using the high solution is around 13 to 21 so that gives us a good idea of the error bound...which reminds me that I have not checked my meter for some time!
You are right....Don't worry about it

Jan 19, 2011

marke 655 posts

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

John,
The verified carb values on the website and thus in the app, are supplied by the DAFNE Programme's themselves so we cannot 'standardise' or change them in any way. On the site itself it shows you the AU carb
values and UK members the UK values. I'm not sure what the app does without Simons input. Although 'internationalisation' is possible I'm not sure how practical and desirable it is for most people. We would need to expand
the carb data substantially and that would rely on users to input it. Given that we have been running 2 years and there have not been a huge number of entries, thankls to those that have added entries though !, I'm not sure the idea would work. We how have 5 countires involved with DAFNEOnline which is again not a large base to draw carb info from.
While we appreciate the suggestions I'm not sure many will actually get implemented because of the issues above. Thats not to say we won't do them just I'm not sure how we can at this stage. There is no reason on the site that I cannot add a country field to the carb entry 'add' form since the database already has a country field. I would need to decide how to filter the output though. From the site perspective I will have a think about it, with regard to the iPhone App I will let Simon repsond on that.

Jan 19, 2011

novorapidboi26 1,818 posts

Topic: Questions ? / Difference in BG from different fingers!

The meters are never spot on, but they dont need to be I suppose............

Jan 18, 2011

Paul Lyons 8 posts

Topic: Questions ? / Difference in BG from different fingers!

Thanks for your replies - it is true that the fault is with the machine accuracy and possibly down to normal circulation that results in the blood being 10 minutes or so out - which can be a big difference if the test is immediately after a hypo and there is a 1/3 rd of a bottle of lucozade inside me!

I have 2 new meters now so am going to see how the % difference on readings from these are - I wont think about it too much though!

Jan 18, 2011

SimonC 78 posts

Topic: Questions ? / Difference in BG from different fingers!

Just to echo JWo's post - I have 3 Optium Exceed machines (one a Boots branded one), they will all produce different results from the same drop of blood - up to 20% difference.

When I called the manufactures to query the results I was told that this was normal and within the permitted limits - they sent me test drops for low, and high sugar readings and they all still produced different results - I had to do the test over the phone with an operator - they decided the results were all acceptable and within the tolerances's set. I repeated the test later and got different results again, ie 1 machine wasn't always higher, they varied.

As long as I use the same machine, then the results will all be reliable - for that machine, and give me an indication of what my blood sugar levels are - they are only an indication, it is not an absolute.

My personnel view is that not only will the machine give different results for the same drop of blood - if you were able to test that, but your body and how it behaves is still a mystery and we are only getting an indication - not an absolute, when we do the test. The doctors and nurses know very little - obviously more than me, but they are not gods and have to make educated guesses based on indications. Some of the more enlightened will admit this, those that tell you they know and make absolute statements should be treated with some scepticism - I do.

Jan 18, 2011

John Stevens 9 posts

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

Hi Simon,
I too would like to request a BI option and a During Exercise option.
On the Carb Counter/Plate idea, I like it, but I see some issues with it. Particularly as the Carb Counter info is a little non standard, and fixed.
Non-Standard:
Because the Carb Counter is not standardised to gCarbs/100g/ml for every entry, using a calculator can be fraught with issues. Personally I don't mind using a calculator, and always go by the packaging of a product in preference to the Carb Counter. The Carb Counter is a fallback for me, for various reasons.

Fixed:
Well, basically the Carb Counter uses the UK info. That is reasonably good, but differs a lot from other areas. For instance in .au, bread is more often than not 2 CP per slice, rather than 1.5. Also, there are "local" variations in products as well.

My suggestion would be to make the DAFNE Carb Counter in the App more variable, and tailorable to country/locality. It would need the backend database at DAFNE online to be able to accept info from the app, and the app would need to be able to download the country/locality data for the area you are in. This would be a great benefit in two ways:
1) Everyone could input food data from their area, and keep any personal recipes in their local app database (backed up through iTunes). DAFNE online would then become a live and up to date source of info for all foods, including international foods, and would quickly grow to be a fantastic resource for all diabetics regardless of nationality, and the app becomes truly international.
2) When travelling, you could update your country in the app, and get all the local foods data downloaded to you, courtesy of the locals.

The Carb counter would then be a truly up to date and fantastic tool for all of us world wide.

I understand that this is a pretty big step. The App needs to have some serious work done, and the Carb Counter database needs to become very flexible, as well as we would have to standardise on how the data is stored.

I would suggest gCarbs per 100g as the basis of every entry. Each entry can then also have a standard portion size (cup, spoon, pieces,etc) that can be used in a Plate calculation, or the actual weight can be entered, and the CP calculated automatically. We may also have to have an option for different units, like oz for countries that prefer imperial measurements, but that can easily be calculated on the fly. A setting in the app can apply the calculations, so even when travelling to a country with different units, you can choose to stick with your own.

If you need any help with the back end, I have copious years experience in IT development and databases. Don't have the facilities (yet) to help with the App. I would love to be involved in improving this whole aspect of DAFNE Online.

I must also add, you have done a fantastic job with this app, it is a small wonder how you have been able to keep up with our suggestions/requests. Well done.
Cheers

BTW, the app crashing I experience appears to be linked to the iPhone multi-tasking. If it gets "pushed off" the 4 app stack (rare), it tries to start from the "last point", but then crashes. This App isn't the only one I have seen this with. My GPS Navigation App (not TomTom) does the same, as do some others.

Jan 18, 2011

Simon 574 posts

Topic: General Discussion / What are you reading?

Just finished the 'The Girl' Series (With the Dragon Tattoo/Who Played With Fire/Who Kicked The Hornets nest). I'm not normally a reader but these has me engrossed!

Jan 18, 2011

JayBee 582 posts

Topic: Questions ? / Difference in BG from different fingers!

I think we're over-thinking this way too much. I mean, there's other factors to consider when you do each blood test - such as hand washing (I mean, using a cleaning wipe is generally not recommended), as well as others such as the blood testing machine's tendency to not be 100% correct.

I find it fascinating that thread responders seem more interesting in finding excuses about their "body being strange" (in their machine's defence), rather than considering the possibility that your machine may be in need of a check up - especially if you find it happens regularly. How can you trust the machine with this going on?
If you're not aware, you can request testing solution from your machine's company so you can test that it's working properly.

Oh well. Good luck with this study.

Jan 18, 2011

JayBee 582 posts

Topic: General Discussion / What are you reading?

My boyfriend got a book for me called "In the Miso Soup" for Christmas and I just finished it the other day. I did enjoy reading it, however I found the open end of the story a bit disappointing. Despite this, I do recommend this book to anyone looking for a rather short, dark and thrilling read. I agree with the quote on the front - it does read like a script for "American Psycho - Holiday Abroad". Smile

Jan 18, 2011

JayBee 582 posts

Topic: General Discussion / What made you smile today?

Got my first ever mp3 player today... very happy with it! ^___^

Jan 18, 2011

HelenP 218 posts

Topic: Questions ? / Difference in BG from different fingers!

I raised this issue with a "researcher" on a medical trial that I am on and her suggestion was that it could have something to do with the circulation system and the "distance' and the route that some blood flows...she suggested that someone try the right and left foot (well, toes on the right and left foot) and we may find that we get 4 different readings. I'll stick to my left hand, thanks! Helen

Jan 17, 2011

ytyynycefn 9 posts

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

Hi Simon, could I just add to Tony's request and ask for a "background insulin" option too? For example I take a split dose at 8am and 8pm, but that doesn't necessarily coincide with meals. When it does, the next meal of that type automatically adds it in. And as I'm sure I'm not alone in finding that weekday and weekend breakfasts often happen at very different times.... You see what I mean? I'm currently using the "other" option but a specific BI choice would be brilliant.

Thanks so much for a great app, couldn't be without it now!

Mel

Jan 17, 2011

Tony 3 posts

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

Hi Simon, excellent app, thank you so much. One thing I would like is, during exercise and during night added to the "type" dropdown box

Regards Tony

Jan 17, 2011

Simon 574 posts

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

Hi all, need your help/advice again.

After a brief iPhone development break whilst we upgraded the DAFNE Online servers, I'm working on the next update again. The first new bit of functionality I'm putting in is the creation of a meal - adding carbs to a 'plate' to count total CPs. First question - whilst you're looking at Carb information in the app, how do you want to add that info to the meal? Buttons with predefined amounts? Or a text box? Any other ideas?

Simon

Jan 17, 2011

marke 655 posts

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

Claire with regard to registering as a graduate, I'm not sure what you mean by 'hospital code'. If you email us using the link at the bottom of every page, with your name, what hospital you did your DAFNE Course at and roughly when (exact dates are not necessary) we can get you verified via DAFNE Central and your account changed to graduate. You will then be able to access the online handbook.
You can also send us your 'hospital code' however I suspect it is more likely to be a DAFNE Centre number, a number of centres seem to confuse this with the DAFNEOnline code which is generated by them on the site itself. There are codes per centre NOT per patient.

Jan 17, 2011

SiobhanOsborne 1 post

Topic: Carbohydrate Counting / Iphone Apps

Love the DAFNE ap - so much more convenient than pulling out a diary and carb list...

One thing though - is it possible to put in your correction dose seperate from the QA ratio dose?

Jan 17, 2011

JayBee 582 posts

Topic: Questions ? / sport and high bloods

What CPs are you putting on board to compensate for the exercise?

If you don't have anything at all, your body will naturally start releasing glucose to provide the energy needed - especially for strenuous exercise - and because of this, your sugar levels can rise quite a bit (I usually hit around 20 if I don't provide CPs for strenuous exercise). Due to the fact your body uses insulin more effectively after exercise as well (it's a bit like the effect in the 24 hours after a hypo), this can put you more at risk of hypo if you correct after exercise as well (which may explain the hypos during the night/in the morning).

If you're regularly exercising so much you can plan ahead and you're interested in losing weight, look at taking the CPs from your last meal instead of eating a snack pre-exercise.

All this is covered in the exercise section of the DAFNE guidebook.

Jan 17, 2011

MikeH 8 posts

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

i use the Lantus Solostar pen it has 1 unit doses on it, also i found i was haveing problems with my Lantus lasting for 24 hours so with the help from my HCP's i split the dose and now inject the Lantus twice a day this has worked very well for me.

Jan 16, 2011

ClaireMccann 2 posts

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

thank you, i do find the site useful to record my sugars and I've tried to register as a graduate but my hospital code won't work!
is that a generic code for each hospital or should i have a specific one for me as a patient?

the problem with the background is that if i drop it any lower than it is (i take 12 of lantus each night) I start to run v high the next day, almost as if the lantus runs out. What would you recommend as a pre-bed sugar, if my last insulin was more than 4 hours ago? I use the pen, and the disposable lantus pen has a minimum dose of 2 units (ie either 12 or 14 but not 13)

On Friday I had a pint with my dinner, but only one so I'm not sure if that would have caused it? i'm very conscious if i've been drinking to have a carb snack before bed, even if it does induce a higher morning sugar (as I've had the post alcohol hypos and they are not fun)

My general problem is that my hba1c is too low - its thankfuly gone up in recent months (from 5.4 to 6.3) but i feel that some of that may be due to hypo kickbacks but when i reduce insulins, even by a unit im suddenly up over 10 all the time so im on a permanent sugars see-saw.

Jan 16, 2011

Broady 13 posts

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

If you had 3cps and didn't take any insulin and still had a hypo during the night, I would say that your background insulin needs to be altered. Can i ask if you are injecting or using a pump

Jan 16, 2011

marke 655 posts

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

Hi, I'm not sure why you would need to take 3 CP's to 'keep your BG up' overnight. This would suggest your background insulin is too high.
You should be able to have 'stable'-ish BG's if you don't eat anything with just background insulin. If you are having to eat without injecting that doesn't sound right. Having accurate estimates of CP's should only affect your Quick acting insulin. You don't say when these hypo's
occurred and under what circumstances. Are you doing more exercise, have other things changed in your day to day life. You need to look
at the big picture, which is what your Blood Glucose Diary will hopefully tell you. Look for patterns, especially round the hypos and try to
spot causes. You can also post your BG's on here if you want too, to get advice from others, although I appreciate many people (including me) find it difficult to share their BG's.

P.S You should get yuorself registered as a graduate on the site, having done a DAFNE course.

Jan 16, 2011

marke 655 posts

Topic: Carbohydrate Counting / Conflicting Adivce

Hi, You don't say if your new nurse is DAFNE trained I presume not. The DAFNE Handbook says 3.5 is the 'floor' and with DAFNE you are managing your BG much more tightly so thats why there is a lower figure. With regard to correcting a Hypo, I have never been told a 'range'
to correct too and I can't see anything in the handbook. The aim is not to overtreat a hypo by eating too much, so just increasing your BG higher than the floor is the aim. This invariably leads to your BG being higher than that, but you just don't want it to be +10.
With regard to diet, I would guess their 'take time' advice is due to your DKA. If you try to lose weight too quickly or don't give enough
insulin this is the path to DKA, so slowly and reliably is the way. Easier said than done I guess.
Finally if you contact your original DAFNE Centre or us, we can verify you as a graduate and change your account to reflect this. This will mean
you can check stuff like the above in the online handbook.

Jan 15, 2011

ClaireMccann 2 posts

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

Hi,

I have suffered from some bad hypos in recent months so started to follow my DAFNE rules more strictly (complete weighing of foods etc) - i completed the course a few years ago. Last night, 4 hours after my dinner and appropriate dinner insulin my BG was 5 going to bed so i approx 3 CP to keep it up overnight, which i have found has worked well before but this morning i had an extremely bad hypo. I couldn't test my sugar as my limbs were super jerky so it took all my focus to get the lucozade down me!

is there any explanation why this might have happened? I usually wake up if I am low but this morning and am able to resolve the situation normally, but this morning this didn't happen either.

thanks
Claire

Jan 15, 2011

Jen1984 2 posts

Topic: General Discussion / Conflicting Advice

I recently moved to Scotland and have been on the DAFNE course. Had a few problems with hypos but when I spoke to my new nurse they contradicted some of DAFNE saying 4 is the floor for hypo not 3.5 and only correct back to 8, instead of 4.5 to 7.5! I am confused what to do, my hbalc before dafne was 14 and got down to 10 in two months. Also concerned with weight as got 2.5 stone to loose but they keep telling me not to be hard on myself and things take time but after being in hospital 6 times last year with DKA I am anxious.

Can anyone help/ any weight loss tips?!

Jen

Jan 15, 2011

Jen1984 2 posts

Topic: Carbohydrate Counting / Conflicting Adivce

I recently moved to Scotland and have been on the DAFNE course. Had a few problems with hypos but when I spoke to my new nurse they contradicted some of DAFNE saying 4 is the floor for hypo not 3.5 and only correct back to 8, instead of 4.5 to 7.5! I am confused what to do, my hbalc before dafne was 14 and got down to 10 in two months. Also concerned with weight as got 2.5 stone to loose but they keep telling me not to be hard on myself and things take time but after being in hospital 6 times last year with DKA I am anxious.

Can anyone help/ any weight loss tips?!

Jen

Jan 19, 2011 Garry 328 posts	Topic: Questions ? / Difference in BG from different fingers! Following SimonC's post where he mentions Optium Exceed meter test solutions, as far as I remember!! the acceptable meter result range using the high solution is around 13 to 21 so that gives us a good idea of the error bound...which reminds me that I have not checked my meter for some time! You are right....Don't worry about it

Jan 19, 2011 marke 655 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed John, The verified carb values on the website and thus in the app, are supplied by the DAFNE Programme's themselves so we cannot 'standardise' or change them in any way. On the site itself it shows you the AU carb values and UK members the UK values. I'm not sure what the app does without Simons input. Although 'internationalisation' is possible I'm not sure how practical and desirable it is for most people. We would need to expand the carb data substantially and that would rely on users to input it. Given that we have been running 2 years and there have not been a huge number of entries, thankls to those that have added entries though !, I'm not sure the idea would work. We how have 5 countires involved with DAFNEOnline which is again not a large base to draw carb info from. While we appreciate the suggestions I'm not sure many will actually get implemented because of the issues above. Thats not to say we won't do them just I'm not sure how we can at this stage. There is no reason on the site that I cannot add a country field to the carb entry 'add' form since the database already has a country field. I would need to decide how to filter the output though. From the site perspective I will have a think about it, with regard to the iPhone App I will let Simon repsond on that.

Jan 19, 2011 novorapidboi26 1,818 posts	Topic: Questions ? / Difference in BG from different fingers! The meters are never spot on, but they dont need to be I suppose............

Jan 18, 2011 Paul Lyons 8 posts	Topic: Questions ? / Difference in BG from different fingers! Thanks for your replies - it is true that the fault is with the machine accuracy and possibly down to normal circulation that results in the blood being 10 minutes or so out - which can be a big difference if the test is immediately after a hypo and there is a 1/3 rd of a bottle of lucozade inside me! I have 2 new meters now so am going to see how the % difference on readings from these are - I wont think about it too much though!

Jan 18, 2011 SimonC 78 posts	Topic: Questions ? / Difference in BG from different fingers! Just to echo JWo's post - I have 3 Optium Exceed machines (one a Boots branded one), they will all produce different results from the same drop of blood - up to 20% difference. When I called the manufactures to query the results I was told that this was normal and within the permitted limits - they sent me test drops for low, and high sugar readings and they all still produced different results - I had to do the test over the phone with an operator - they decided the results were all acceptable and within the tolerances's set. I repeated the test later and got different results again, ie 1 machine wasn't always higher, they varied. As long as I use the same machine, then the results will all be reliable - for that machine, and give me an indication of what my blood sugar levels are - they are only an indication, it is not an absolute. My personnel view is that not only will the machine give different results for the same drop of blood - if you were able to test that, but your body and how it behaves is still a mystery and we are only getting an indication - not an absolute, when we do the test. The doctors and nurses know very little - obviously more than me, but they are not gods and have to make educated guesses based on indications. Some of the more enlightened will admit this, those that tell you they know and make absolute statements should be treated with some scepticism - I do.

Jan 18, 2011 John Stevens 9 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi Simon, I too would like to request a BI option and a During Exercise option. On the Carb Counter/Plate idea, I like it, but I see some issues with it. Particularly as the Carb Counter info is a little non standard, and fixed. Non-Standard: Because the Carb Counter is not standardised to gCarbs/100g/ml for every entry, using a calculator can be fraught with issues. Personally I don't mind using a calculator, and always go by the packaging of a product in preference to the Carb Counter. The Carb Counter is a fallback for me, for various reasons. Fixed: Well, basically the Carb Counter uses the UK info. That is reasonably good, but differs a lot from other areas. For instance in .au, bread is more often than not 2 CP per slice, rather than 1.5. Also, there are "local" variations in products as well. My suggestion would be to make the DAFNE Carb Counter in the App more variable, and tailorable to country/locality. It would need the backend database at DAFNE online to be able to accept info from the app, and the app would need to be able to download the country/locality data for the area you are in. This would be a great benefit in two ways: 1) Everyone could input food data from their area, and keep any personal recipes in their local app database (backed up through iTunes). DAFNE online would then become a live and up to date source of info for all foods, including international foods, and would quickly grow to be a fantastic resource for all diabetics regardless of nationality, and the app becomes truly international. 2) When travelling, you could update your country in the app, and get all the local foods data downloaded to you, courtesy of the locals. The Carb counter would then be a truly up to date and fantastic tool for all of us world wide. I understand that this is a pretty big step. The App needs to have some serious work done, and the Carb Counter database needs to become very flexible, as well as we would have to standardise on how the data is stored. I would suggest gCarbs per 100g as the basis of every entry. Each entry can then also have a standard portion size (cup, spoon, pieces,etc) that can be used in a Plate calculation, or the actual weight can be entered, and the CP calculated automatically. We may also have to have an option for different units, like oz for countries that prefer imperial measurements, but that can easily be calculated on the fly. A setting in the app can apply the calculations, so even when travelling to a country with different units, you can choose to stick with your own. If you need any help with the back end, I have copious years experience in IT development and databases. Don't have the facilities (yet) to help with the App. I would love to be involved in improving this whole aspect of DAFNE Online. I must also add, you have done a fantastic job with this app, it is a small wonder how you have been able to keep up with our suggestions/requests. Well done. Cheers BTW, the app crashing I experience appears to be linked to the iPhone multi-tasking. If it gets "pushed off" the 4 app stack (rare), it tries to start from the "last point", but then crashes. This App isn't the only one I have seen this with. My GPS Navigation App (not TomTom) does the same, as do some others.

Jan 18, 2011 Simon 574 posts	Topic: General Discussion / What are you reading? Just finished the 'The Girl' Series (With the Dragon Tattoo/Who Played With Fire/Who Kicked The Hornets nest). I'm not normally a reader but these has me engrossed!

Jan 18, 2011 JayBee 582 posts	Topic: Questions ? / Difference in BG from different fingers! I think we're over-thinking this way too much. I mean, there's other factors to consider when you do each blood test - such as hand washing (I mean, using a cleaning wipe is generally not recommended), as well as others such as the blood testing machine's tendency to not be 100% correct. I find it fascinating that thread responders seem more interesting in finding excuses about their "body being strange" (in their machine's defence), rather than considering the possibility that your machine may be in need of a check up - especially if you find it happens regularly. How can you trust the machine with this going on? If you're not aware, you can request testing solution from your machine's company so you can test that it's working properly. Oh well. Good luck with this study.

Jan 18, 2011 JayBee 582 posts	Topic: General Discussion / What are you reading? My boyfriend got a book for me called "In the Miso Soup" for Christmas and I just finished it the other day. I did enjoy reading it, however I found the open end of the story a bit disappointing. Despite this, I do recommend this book to anyone looking for a rather short, dark and thrilling read. I agree with the quote on the front - it does read like a script for "American Psycho - Holiday Abroad".

Jan 18, 2011 JayBee 582 posts	Topic: General Discussion / What made you smile today? Got my first ever mp3 player today... very happy with it! ^___^

Jan 18, 2011 HelenP 218 posts	Topic: Questions ? / Difference in BG from different fingers! I raised this issue with a "researcher" on a medical trial that I am on and her suggestion was that it could have something to do with the circulation system and the "distance' and the route that some blood flows...she suggested that someone try the right and left foot (well, toes on the right and left foot) and we may find that we get 4 different readings. I'll stick to my left hand, thanks! Helen

Jan 17, 2011 ytyynycefn 9 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi Simon, could I just add to Tony's request and ask for a "background insulin" option too? For example I take a split dose at 8am and 8pm, but that doesn't necessarily coincide with meals. When it does, the next meal of that type automatically adds it in. And as I'm sure I'm not alone in finding that weekday and weekend breakfasts often happen at very different times.... You see what I mean? I'm currently using the "other" option but a specific BI choice would be brilliant. Thanks so much for a great app, couldn't be without it now! Mel

Jan 17, 2011 Tony 3 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi Simon, excellent app, thank you so much. One thing I would like is, during exercise and during night added to the "type" dropdown box Regards Tony

Jan 17, 2011 Simon 574 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi all, need your help/advice again. After a brief iPhone development break whilst we upgraded the DAFNE Online servers, I'm working on the next update again. The first new bit of functionality I'm putting in is the creation of a meal - adding carbs to a 'plate' to count total CPs. First question - whilst you're looking at Carb information in the app, how do you want to add that info to the meal? Buttons with predefined amounts? Or a text box? Any other ideas? Simon

Jan 17, 2011 marke 655 posts	Topic: Questions ? / Bad hypos even when following all dafne rules! Claire with regard to registering as a graduate, I'm not sure what you mean by 'hospital code'. If you email us using the link at the bottom of every page, with your name, what hospital you did your DAFNE Course at and roughly when (exact dates are not necessary) we can get you verified via DAFNE Central and your account changed to graduate. You will then be able to access the online handbook. You can also send us your 'hospital code' however I suspect it is more likely to be a DAFNE Centre number, a number of centres seem to confuse this with the DAFNEOnline code which is generated by them on the site itself. There are codes per centre NOT per patient.

Jan 17, 2011 SiobhanOsborne 1 post	Topic: Carbohydrate Counting / Iphone Apps Love the DAFNE ap - so much more convenient than pulling out a diary and carb list... One thing though - is it possible to put in your correction dose seperate from the QA ratio dose?

Jan 17, 2011 JayBee 582 posts	Topic: Questions ? / sport and high bloods What CPs are you putting on board to compensate for the exercise? If you don't have anything at all, your body will naturally start releasing glucose to provide the energy needed - especially for strenuous exercise - and because of this, your sugar levels can rise quite a bit (I usually hit around 20 if I don't provide CPs for strenuous exercise). Due to the fact your body uses insulin more effectively after exercise as well (it's a bit like the effect in the 24 hours after a hypo), this can put you more at risk of hypo if you correct after exercise as well (which may explain the hypos during the night/in the morning). If you're regularly exercising so much you can plan ahead and you're interested in losing weight, look at taking the CPs from your last meal instead of eating a snack pre-exercise. All this is covered in the exercise section of the DAFNE guidebook.

Jan 17, 2011 MikeH 8 posts	Topic: Questions ? / Bad hypos even when following all dafne rules! i use the Lantus Solostar pen it has 1 unit doses on it, also i found i was haveing problems with my Lantus lasting for 24 hours so with the help from my HCP's i split the dose and now inject the Lantus twice a day this has worked very well for me.

Jan 16, 2011 ClaireMccann 2 posts	Topic: Questions ? / Bad hypos even when following all dafne rules! thank you, i do find the site useful to record my sugars and I've tried to register as a graduate but my hospital code won't work! is that a generic code for each hospital or should i have a specific one for me as a patient? the problem with the background is that if i drop it any lower than it is (i take 12 of lantus each night) I start to run v high the next day, almost as if the lantus runs out. What would you recommend as a pre-bed sugar, if my last insulin was more than 4 hours ago? I use the pen, and the disposable lantus pen has a minimum dose of 2 units (ie either 12 or 14 but not 13) On Friday I had a pint with my dinner, but only one so I'm not sure if that would have caused it? i'm very conscious if i've been drinking to have a carb snack before bed, even if it does induce a higher morning sugar (as I've had the post alcohol hypos and they are not fun) My general problem is that my hba1c is too low - its thankfuly gone up in recent months (from 5.4 to 6.3) but i feel that some of that may be due to hypo kickbacks but when i reduce insulins, even by a unit im suddenly up over 10 all the time so im on a permanent sugars see-saw.

Jan 16, 2011 Broady 13 posts	Topic: Questions ? / Bad hypos even when following all dafne rules! If you had 3cps and didn't take any insulin and still had a hypo during the night, I would say that your background insulin needs to be altered. Can i ask if you are injecting or using a pump

Jan 16, 2011 marke 655 posts	Topic: Questions ? / Bad hypos even when following all dafne rules! Hi, I'm not sure why you would need to take 3 CP's to 'keep your BG up' overnight. This would suggest your background insulin is too high. You should be able to have 'stable'-ish BG's if you don't eat anything with just background insulin. If you are having to eat without injecting that doesn't sound right. Having accurate estimates of CP's should only affect your Quick acting insulin. You don't say when these hypo's occurred and under what circumstances. Are you doing more exercise, have other things changed in your day to day life. You need to look at the big picture, which is what your Blood Glucose Diary will hopefully tell you. Look for patterns, especially round the hypos and try to spot causes. You can also post your BG's on here if you want too, to get advice from others, although I appreciate many people (including me) find it difficult to share their BG's. P.S You should get yuorself registered as a graduate on the site, having done a DAFNE course.

Jan 16, 2011 marke 655 posts	Topic: Carbohydrate Counting / Conflicting Adivce Hi, You don't say if your new nurse is DAFNE trained I presume not. The DAFNE Handbook says 3.5 is the 'floor' and with DAFNE you are managing your BG much more tightly so thats why there is a lower figure. With regard to correcting a Hypo, I have never been told a 'range' to correct too and I can't see anything in the handbook. The aim is not to overtreat a hypo by eating too much, so just increasing your BG higher than the floor is the aim. This invariably leads to your BG being higher than that, but you just don't want it to be +10. With regard to diet, I would guess their 'take time' advice is due to your DKA. If you try to lose weight too quickly or don't give enough insulin this is the path to DKA, so slowly and reliably is the way. Easier said than done I guess. Finally if you contact your original DAFNE Centre or us, we can verify you as a graduate and change your account to reflect this. This will mean you can check stuff like the above in the online handbook.

Jan 15, 2011 ClaireMccann 2 posts	Topic: Questions ? / Bad hypos even when following all dafne rules! Hi, I have suffered from some bad hypos in recent months so started to follow my DAFNE rules more strictly (complete weighing of foods etc) - i completed the course a few years ago. Last night, 4 hours after my dinner and appropriate dinner insulin my BG was 5 going to bed so i approx 3 CP to keep it up overnight, which i have found has worked well before but this morning i had an extremely bad hypo. I couldn't test my sugar as my limbs were super jerky so it took all my focus to get the lucozade down me! is there any explanation why this might have happened? I usually wake up if I am low but this morning and am able to resolve the situation normally, but this morning this didn't happen either. thanks Claire

Jan 15, 2011 Jen1984 2 posts	Topic: General Discussion / Conflicting Advice I recently moved to Scotland and have been on the DAFNE course. Had a few problems with hypos but when I spoke to my new nurse they contradicted some of DAFNE saying 4 is the floor for hypo not 3.5 and only correct back to 8, instead of 4.5 to 7.5! I am confused what to do, my hbalc before dafne was 14 and got down to 10 in two months. Also concerned with weight as got 2.5 stone to loose but they keep telling me not to be hard on myself and things take time but after being in hospital 6 times last year with DKA I am anxious. Can anyone help/ any weight loss tips?! Jen

Jan 15, 2011 Jen1984 2 posts	Topic: Carbohydrate Counting / Conflicting Adivce I recently moved to Scotland and have been on the DAFNE course. Had a few problems with hypos but when I spoke to my new nurse they contradicted some of DAFNE saying 4 is the floor for hypo not 3.5 and only correct back to 8, instead of 4.5 to 7.5! I am confused what to do, my hbalc before dafne was 14 and got down to 10 in two months. Also concerned with weight as got 2.5 stone to loose but they keep telling me not to be hard on myself and things take time but after being in hospital 6 times last year with DKA I am anxious. Can anyone help/ any weight loss tips?! Jen