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Wow, that's quite a contrast of results for not washing your hands, but it does make sense! :/ I'm quite religious with my hand washing before meals so this potential problem shouldn't be an issue for me (hopefully).

On a similar note - do you avoid the 99.9% hand cleaning stuff? I hate it, personally, so I usually do. I'm often worried it'll make my results in correct - along very similar lines to being as bad as not washing your hands.

There is also those cleaning wipes as well - I used to grab the clean wipes that you get at places like KFC but my nurse told me that they had chemicals that would throw my blood results off so I avoid those too now.

Would be great to have a simple wipe that doesn't require water... would be a great addition to our medical kits! ^_^

Nov 18, 2010

novorapidboi26 1,819 posts

I agree you should drop it, if there were no other factors influencing the reading.....

Are you not approaching the dose they had you on when attending the course?

Nov 18, 2010

grandma carol 61 posts

yes thank you but she the DAFNE nurse told me to drop it if I had hypo at night and I have agen last night so thats why I thought that I should drop it agen tonight Asked her on the phone about doing a split of BI and she said just to leave it I have to go back on 3rd Dec for the blood moniter but it will be a different nurse the one I spoke to is on holiday. It just to get this moniter fitted.

Nov 18, 2010

novorapidboi26 1,819 posts

As your on Lantus changing your dose on a daily basis is madness.........you need to look for patterns.......

If you hold steady for 2-3 nights in a row and thats without food or quick acting working then the dose is right.....

You can then start work on the ratios etc........

Another problem with one a day is that you may hold steady overnight but then become more resistant to insulin during the day, which means you may need more during the day.....but you cant as you are only on one dose...

It will be a pain, but try and get 2-3 days holding overnight with no food or quick acting....

Nov 18, 2010

grandma carol 61 posts

well I dident get an appointment she just phoned back and said to drop BI to 14. Well did and still had another hypo at 2.30 going to drop it agen to night I have been low all day yesterday and so far today as well .Thank you

Nov 18, 2010

Garry 328 posts

Mellissa
May I ask - Do you always wash your hands before blood testing?
Most BG kits now use such a small blood sample that any contamination error has a really dramatic effect.
BG 16 to 5.6 in 45 minutes is very unusual.

I say this from experience with an Medisense Abbott Optium Xceed meter which on 5 second Optium Plus test strips uses a tiny blood sample - 0.6 Î¼L.
They did a 3 second strip for a time which used an even smaller blood sample. But not sure whether they are available now.
Anyway I proved contamination error to myself by repeated trials of unwashed hands v washed hands - washed immediately after - and saw errors of up to 8 BG.

My conclusion was that I had to always accept the need for lack of contamination and to stick with washed hands at testing time.

Regards Garry

Nov 18, 2010

JayBee 587 posts

Ooooo sounds lovely! I hope you get the results you're hoping for! ^0^

Nov 18, 2010

Sam 64 posts

Well Guys

I had sausage, bacon and eggs from the delightful NHS canteen! As much as I enjoy a cooked breakfast I enjoy it more at the weekend, I felt as though I forced myself to eat it and washed it down with diet irn bru lol! Just hope it fills me up until lunchtime. Thanks for all the replies I guess when you're so used to eating a carb breakfast you forget what you can eat carb free!

Sam

Nov 18, 2010

JayBee 587 posts

Sausages will have carbs? I've never had any problems with sausages!

Are we talking about meat sausages right? Or a special kind? :/ Usually it's the meat proteins that stop the carbs in the meat from affecting your sugar levels - this applies to all meats - and fish I suppose...

Nov 18, 2010

novorapidboi26 1,819 posts

Appointments are had to get I know, but if your online you can keep in touch be email too, thats what I do.........

However if you need help quick if things are not working then they shoull make time sharpish.....

Nov 18, 2010

meltow 78 posts

Karaway, don't get carried away!
The sausage, no matter how premium, will have carbs. The filler in sausages is usually iderived from bread or breadcrumbs.
I can smell the bacon cooking, from here! ; )

Nov 18, 2010

vic demain 87 posts

Topic: General Discussion / oz

Lucky you linsey, just in time for the Ashes.

Nov 18, 2010

karaway 7 posts

I'm with the bacon and eggs but I would add mushrooms, half a tomato, onions and sausage!!!! Yum

Nov 18, 2010

HelenP 218 posts

Topic: General Discussion / flu jab

See the Oz thread! Helen

Nov 18, 2010

HelenP 218 posts

Topic: General Discussion / oz

Depends on your GP.
Depends on your GP and YES you really need it!

I have one every year and because I am an insulin dependent diabetic I get it for free.
I believe some GPs charge for the visit but you actually get the jab for free. Consultation plus jab for the price of the consultation (usually about $AUD60). You may be eligible for a rebate from Medicare of a bit over $30. You can ask before you see the Dr and you can search for a bulk billing Dr but they are fairly hard to find.
My winters have been much healthier since adopting the annual flu regime. Usually get mine about Easter.
Helen

Nov 18, 2010

linsey ramage 6 posts

Topic: General Discussion / oz

will i be offered a flu jab just emigrated dont no the procedure?
how much will it cost?
do i really need it?

Nov 18, 2010

linsey ramage 6 posts

Topic: General Discussion / flu jab

hey peeps,just emigrated to oz 5 weeks ago any ideas if i will be offered flu jab here?will i pay for it?whats the cost? do i really need it?

Nov 17, 2010

JayBee 587 posts

My last HbA1c was 8.5%, or under the new system, IFCC 69mmol/mol. I'm still mainly familiar with HbA1c so the new results system confuses me still - but whatever way I look at it, this was an improvement on my last HbA1c which was above 9%. I went on Levemir towards the end of this result.

Try very hard to not over correct - or snack - if you can. Trust me, the results will be worth while in the long run! Once everything is clarified, your freedoms will come back. Don't panic - remember, short term highs won't do you any long term harm. One day of highs can help for more days of good levels.

You can do it! ^_^

Also, for a suggestion, how about for each hypo you have, if it's not right before a meal, you only eat 2 fast CPs (tablets, jelly babies, etc) and 2 slow CPs... this is so you don't have to inject more insulin (for example, 13 Nov - you had a hypo over 3 hours before your next meal. To make sure you got what you needed, it would have been better to leave off 2 units off the 5 slow CPs - this is to make sure you recover during the time before your next meal). See the hypos section of the DAFNE booklet (bottom of page 37 to be exact) to see what I'm talking about. Smile

Don't worry if you don't know things - or even forget things about DAFNE - it'll happen (especially when you're having a hypo - logic goes out the window usually for me!)

I think if that's the case with the educator, perhaps it's not worth worrying about too much now. If you feel that you weren't being very good with your DAFNE towards the end of using Lantus, how can you be sure that going back is worth it really?

I do get you with agreeing with changes very easily though. If only diabetic control was something you could quick fix! ^_^ I'm sure they meant well.

It's funny you mention about pumps - I was told that if you're offered a pump at my hospital it's usually because you're not one for controling your sugar levels well. I never want to go on a pump generally and in a way, this statement from my hospital makes me even more determined to get my levels under control!

You'll be surprised how much exercise just playing with your little boy will provide! Picking him up for example... that's lifting a weight! Smile

That's perfectly fine about trying out the 12 hour markers for the BI doses. I hope it provides some results! Very Happy

The between meal stuff for things like driving is understandable - I test every time before I drive as well (every diabetic should do).

However, its the snacking and insulin taking that's the main problem because you're taking on extra QA. If you start to feel funny, see if you are low rather than just eat something - doing so will help with pattern finding - especially if you find you hypo after lunch or dinner as well (like I did for the 8th November in my first set of copied and pasted results back on page 3 of this thread - I put my morning BI down for this because it affected me during the day).

When I was still on Lantus I used to have to snack around 11am but that was because I was taking the incorrect amount of insulin. Unfortunately, I didn't realise that until quite some time after doing DAFNE - the breakfasts I used to eat to compensate were a lot of CPs! I hope something similar is not happening with you... (signs are showing on 14 and 15 Nov results I think).

Let's see how we get on... leave it for a few days and post our results together if you like. Very Happy

We can do this, M!

Nov 17, 2010

andy2209 3 posts

Topic: General Discussion / Abusive posting will not be tolerated

Could not agree more

Nov 17, 2010

MelissaF 56 posts

Hi J,

Going to be a fairly quick reply I'm afraid as I'm still at work but thank you so much again for all the info. I'm just going to try and answer a few of your main questions...

You're right, I definitely do over-correct. I just panic with the levels too high but I'm really going to try not to.

My educator didn't really give me a reason for trying Levemir. She just thought that it "might help". My control was bad at the time but that was because I wasn't being a very good girl with my DAFNE. The harder I try with it, the more results I see obviously. I've been asking her for clearer reasons why she thinks it's the better option but the "flexibility" one is all that I have at the moment. I agreed to the change because you will agree to anything that might make your diabetes more managable don't you? (except maybe a pump!) I mailed her again today actually with more questions based on all this info but I haven't heard back yet.

Exercise doesn't really apply to me I'm afraid. My little boy is hard work but it's not really strenous exercise and I don't do anything else (yes, I know I should).

I genuinely didn't realise about the 12 hour gap with the Levemir. Novorapidboi told me about it so I've been doing it for the last 2 days. No result yet but we shall see.

Sometimes I do blood tests between meals because (a) I'm driving or (b) I feel odd. I understand that it's not going to give me a good picture of my patterns but for something like driving I really have to. I should probably just test before meals and ignore the other results. A few days ago I tested at 16 before I left work and tested again a little while later before eating with a friend and it had dropped to 5.6 in 45 minutes!

When you're pregnant you have to test before meals and then within an hour after eating (it should have dropped to below 8 within that hour - hah!). I think, because I've got pregnancy on my mind at the moment I think about that quite a lot as well even though I don't need to be testing like that at the moment.
The extras I eat in between meals are sometimes snacks and sometimes just thinks like a latte (2 units!). I guess I should do without them for the sake of the exercise really - you're right.

Looking back at your points I think that one of the main points you make is that I'm a bit jumbled with my eating and treatments and not very consistant with anything. I think that you're absolutely right. I think that part of it is panic at feeling like I've got a limited time to get it sorted. I think I just need to take some deep breaths and re-evaluate.

What was your HbA1c the last time you had it tested if you don't mind my asking?

M

Nov 17, 2010

JayBee 587 posts

Look! Consistantly around 10! Finally a pattern - and all it took was me doing no corrections and having nothing between meals lol! ^_^

Considering the slight raise over night, I will make my first change putting one more unit on my Evening BI and leaving it for two days (unless I hypo).

Melissa - do you notice how I'm high between the 10s? My QA insulin is still working during those times. Even when I do my evening blood test, I know my QA from dinner won't run out until at least 11.30pm. I will be doing a test around 3am to see how I get on over night tonight.

*giggles* Oh noes! It's Mr Pendantic! Razz

I'm not sure I agree with you Marke about exercise because my DAFNE nurse (JJPAG on here) made a point of it to me when I was trying to determine why I had a high so long after the exercise. She said that the high would not have been a result of the exercise (we're talking 4+ hours here) because it stops effecting your body after about 2 hours.

Why would we be told different things? :/ Maybe it's more down to how well your body responds to exercise.. I mean, someone who doesn't exercise as much won't respond to their insulin in the same way as someone who does exercise a lot.

Does that make sense? I think we covered this in my last DAFNE group meet back in August too.

On another thought - perhaps what kind of exercise you do is also a factor? eg, How strenuous...

Nov 17, 2010

marke 686 posts

Sorry to be Mr Pendantic, but exercise can affect your BG for upto 24 hours not 2 hours ! If for example you do exercise in the evening it can still affect your insulin needs the following morning. I know this is true because it used to happen to me a lot when I went to the Gym in
the evenings.... I agree with the rest of the post though :-)

Nov 17, 2010

JayBee 587 posts

Hiya M, ^_^

I've had quite an interesting day with my sugar levels today! Once I've replied, I will get them typed up and I'll post you them!

Considering it's also taken into consideration as a BI in the DAFNE book, I'm sure Levemir is a well established insulin. Smile

I wouldn't be surprised if it's been around for longer than Lantus!

I put up for Lantus for years before changing, so I don't exactly share the same view when it comes to something like 5 months being a deadline for a decision. It can be difficult to work out a new insulin's doses, especially when old habits are involved - so it can take a long time to adjust.

It will be unpredictable because it's a different insulin - don't forget that. You need to work out the puzzle of Levemir.

I'm trying to think of some more suggetions here to help you get back on track.... I know... I'll quote a few things you've said...

My DAFNE educator told me that it gave me more flexibility which I guess it does as you have two different doses to play with but I just find that makes things more complicated.

These I can understand. It gets complicated when there's an over lap and there is times when I wonder if I should have put up both doses at the same time, but often my DAFNE team remind me that I need to do one change at a time. Once you understand where your over lap is - if you have one - you'll be able to work out what dose you need to adjust.

For example - if I was sitting on a high almost every day in the afternoon - it would either be my morning BI or possibly time for me to look at my lunch time ratio.

Once you've applied a change, unless you hypo, you should leave it a few days because you need to give your body time to adjust to the new dose.

I also need to clarify something (another quote):

I've been a DAFNE graduate for the last 3.5 years. I've found it really helpful and it definitely helped my HbA1cs initially. However, I now have a 2 year old and, since having him, I've found that my control has worsened a lot - I think simply because life is much more hectic than it used to be and I spend less time looking after myself.

I've been trying to get things back on track again and my DAFNE educator suggested that I switch from Lantus to Levemir for my BI.

What was the exact reason your educator gave you the original suggestion to go to Levemir? Why did you agree with this change at the time?

I was put on to Levemir because it an insulin that has been designed to be an split dose and I understand the benefits to a certain extend because (as I mentioned already) I feel it works at a different "strength" to Lantus. This does allow for more flexibility I think, but this is just my opinion based on my experiences with both insulins. I feel Levemir noticably gives me more freedom when it comes to adjusting my doses (yep, despite the annoying highs and lows!)

Also - How much strenuous exercise do you get now with your lil' boy? Do you plan for this exercise?

If you are running around like a loon with them, take into consideration that my may need to eat extra or if it's planned, look at taking off a unit or two (depending on your blood sugar levels - please see the DAFNE guidebook for what I mean) before you get going. Simply doing this can help stop hypos and keep your body stable.

You mention about weight gain - effective exercise planning and taking a few units off at a meal can help you exercise it off because not only do you work your muscles, but you don't have to eat extra CPs for the exercise! Smile

I found this hard to understand at first but when you exercise, your insulin is used much better and as a result, if you don't compensate for it, it results in hypos or even highs. So if you eat something, like 2 CPs because your bloods are around 5 or 6, before exercise, don't worry about the insulin - based on the DAFNE exercise rules, you should be a-okay afterwards!

Also, don't forget that exercise can affect your body for up to two hours afterwards - this was something else I didn't understand for some time as well - and I love exercise! Sad

I often find that if I shoot up high after some exercise, my body responds quite quickly to insulin so it's best not to inject it until the exercise period is over... if you see karaway's post on this thread it roughly explains what happens and why you can potentially hypo if you inject after exercising! Smile

It's a shame I haven't a clue about having children and the affect it has. I understand your concern with getting things on track but remember you're not pregnant yet... I mean, you're not right? Look at one thing at a time... don't stress yourself out with worry with future possibilities, okay? I had similar worries with me learning how to drive currently - everything will be fine, just concentrate on the present for now. You can do this. Very Happy

Okay - Looking at your results that you posted on page 1 of this thread, let's try and break this down...
(I'm going to have to base it on my DAFNE stuff okay? Let's see how this looks!)

You tend to inject your evening BI between 10pm and 11pm. This is fair enough - an hour is a reasonable time frame in my books - I exercise this myself. (Based on my 16 hours) this may run out around 2pm - 3pm the next day.

You inject your morning BI between 7am and 9am - if possible, try to shrink this gap down because consistanty will help you. (Based on my 16 hours) this may run out anywhere between 11pm and 1am.

Looking that the BI stuff, as long as Levemir works between 13 - 18 hours, you're pretty much covered!

If you are worried that you might be at 12 hours, I would speak to your DAFNE team on how you can go about finding this out. I found out the hard way with Lantus (with it clearly letting me down in the afternoon after 2pm)... I'm still not 100% sure if Levemir does, but I've yet to see any major gaps to have any doubts.

Hmmm, I've just realised that you've made two consecutive changes to your BI and not given it a few days to see the full picture. Try not to do this if you make any more changes, mmkay?

Right, so meal ratios.... all are 1:1...

Hmmmm.... Why do you eat so long after you blood test? (The 11am and then eating with no blood test at 13.45)
Your sugar levels can potentially change in that time frame. This is why it's better to test before the meal.

I also see that on some of those days, you've been eating extra in the morning between break fast and lunch - how are you feeling when you do this? Feeling spells of hypo potential or just a genuine snack?

If it's snack - look at possibly going with out them for a week or two considering it means there is insulin still on board when it comes to your lunchtime - in other words, insulin that is distorting the patterns.

I'll leave it at this for now... how are you feeling about this feedback? Keep your chin up, M. Smile

Nov 17, 2010

JayBee 587 posts

We should do a charity morning featuring carb free breakfasts at this rate lol. XD

Nov 17, 2010

Sbee1980 7 posts