Recent Posts - DAFNE Online

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Levemir issues

There must of been a reason for you to go on Levemir, like the Lantus not lasting the full 24 hours....

The change over from these 2 insulins can be hard as the dose is now split and are weighed out differently, like they are now, more in the morning, less at night...

Its basically like starting from the beginnig, the BI dose needs to be established before anything else fits into place......

For me when I changed I started at the overnight readings, no food or QA, just BI, if its holds steady you have the right dose, if not adjust until its right..........then you can move onto the morning dose....miss breakfast and see what your blood does......if it goes up, fire on a unit, then you could maybe miss lunch the next day, or carb free, and see what happpens, just keep adjusting till it holds...........

While this BI investigation is going on your bound to have dodgy readings, you just have to try and compensate with th QA until your confident the doses are right........

You mentioned waking up high every morning even with putting up your PM BI dose, probably dawn phenomonon, I have suffered from this since starting DAFNE, theres not much that can be done apart from pump therapy.......speak to your team about dawn phenomonon, they might have better advice....

good luck

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / BG RESULTS

I would agree with previous posts regarding BI timings, my control go tmuch better when I made sure I was getting the 12 hour split...

There could be other factors involved, but for now, try and take your doses say at 6:30am and pm give or take an hour....and see what happens then....

Nov 15, 2010

Garry 328 posts

Topic: General Discussion / BG RESULTS

Think you have hit the nail on the head with your last post.

With the limited information given I reckon that you need balance up the timings of your BI to 12 and 12 hours.
We see that Friday morning BI to night BI was 14Â½ hours and Friday night BI to Saturday morning was only 7 hours. Hence during Saturday day time you likely had two separate doses of BI active at the same time.
Saturday morning BI to night BI was 16 hours and Saturday night BI to Sunday morning was 10 hours...quite a difference.

Personally speaking, I take my morning Lantus BI at breakfast and evening BI at dinner and find that this often ends up as a good 12 hour split... rarely more than an hour out.

You may find that when things steady out that some additional BI changes are needed. But wait and see the impact of one change at a time of course.
I think most of us find that a BI split at 50:50 is also beneficial.
Would discuss any changes with your HCP to have their support and give you the confidence to make any changes needed.

Good luck. Keep us posted with your progress.

Regards Garry

Nov 15, 2010

MelissaF 56 posts

Topic: Questions for HCPs / Levemir issues

Hi,

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. I've been using it for about 5 months now and I still can't get the hang of it. It's difficult to explain but I feel that my results on it are much less predictable than on the Lantus and I seem to be getting many more extreme highs than I feel that I used to on the Lantus with less justification. It feels like I get a more extreme reaction with highs and lows and obviously what I'm striving for is a more constant level. Just as I think that I've got the right BI levels and it seems to be working, I need to alter them again for seemingly no reason. There seems to be no consistancy.

In particular I'm having a real problem with my BG results first thing in the morning. I'm waking each morning with readings of 15 and above and increasing my evening BI doesn't seem to be having an effect.

I also find it hard having 2 injections of BI a day as I find it less easy to judge doses.

I'm wondering if there is anything related to Levemir that might be causing this and any reason why things on Lantus seemed to be more predictable? I know that Levemir is generally seen as a "better" insulin but could there be any reason why I'm better suited to the Lantus. My DAFNE educator is keen for me to keep trying with it but my results seem to be getting worse and worse and it's really disheartening. I also find it hard to apply the DAFNE principles as the results seem to be totally unpredictable.

I'm currently taking 9 units of Levemir at night and 3 in the morning.

Any help or advice would be really appreciated. It's really getting me down.

Many thanks,

Melissa

Nov 15, 2010

karaway 7 posts

Topic: Questions for HCPs / BGL's prior to menstration

I am a 31 year old female and I have only graduated from DAFNE in the last few days. I am due for my period in a week or so and over the last two days I have found that my lunch and dinner time ratio seems to be wrong. I am getting in the 14's and it doesn't seem to be coming down when I test four hours later. I am so mad at myself for not asking about this during my course. What should I do?

Nov 15, 2010

HelenP 218 posts

Topic: Questions for HCPs / wound healing

Well, have I had an interesting day!

Had an ultrasound and sinogram and the radiologist (who also happened to be a surgeon doing a sub speciality) could only get a "yellow" cannula into the "hole". He found a sinus that was "6mL" and running just under the skin to the left of the "hole". Compared to a 10mL syringe that's not very big. He strongly advised me to return to my GP (he has sent a copy of his report to: the plastic surgeon (referring doctor), the original surgeon and the GP) before I discuss the results with the plastic surgeon next Friday as I may well get a different opinion. He described it as line ball and that I had to consider what I would achieve having the surgery.

I got the distinct impression that he would not touch it. The "hole" is almost closed over and once it does the body deals with the sinus differently. If there is "infection" there and as I have not had any antibiotics in over two months I seem to be dealing with it OK. He knew I was an insulin dependent diabetic but was not concerned about the possibility of the infection getting a hold if my BGs were OK.
They are and my TDD is back around what it was pre original surgery. Could be opening another can of worms!

Not sure what the GP will say but I believe he is very conservative. Helen

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / McD's

The majority of carbs there is the actual potatoe,, should be the same every visit, thats how I know mcdonalds so well..........6 for large chips, 4 for the quarter pounder bun, 3 for any bun smaller than that.

Nov 15, 2010

JayBee 587 posts

Topic: General Discussion / Job Hunting

I've always been told that it makes you more likely to get an interview if you do declare you're a diabetic, so I've never held it back whenever I've applied for a job. I think it's very irresponsible not to tell them - I mean, what if you hypo'd in the middle of the interview? XD

Not had any issues yet myself, but then again, I've haven't been in a private sector job long enough to know this was even an issue with this - though when I have applied, I've always declared with no problems. I've definitely never had any issues in the public sector, so I'm assuming these concerns mostly exist in the private sector considering the good attitude the public sector has shown towards people like me.

Nov 15, 2010

JayBee 587 posts

Topic: General Discussion / Travel to China

I think I did my first insurance through Diabetes UK's insurance supplier - that was going to Japan. My second trip abroad was sorted out by the boyfriend so I'm not sure who we were insured with.

Neither were particularly pricey if I remembe correctly though.

Nov 15, 2010

JayBee 587 posts

Topic: Carbohydrate Counting / McD's

I used to keep the tray paper with that information on in my kit when I was visiting them a lot more than I do now! XD

Wish places that I eat at now would do this.. eg, Spud U Like. Blinkin' jackets! XD

Nov 14, 2010

lindacollins 4 posts

Topic: General Discussion / Blood Sugars

Any suggestions would be welcome. thanx. Linda x

Nov 14, 2010

meltow 78 posts

Topic: Carbohydrate Counting / Red Wine

I usually enjoy half a bottle of red on a Friday and Saturday night [call me "billy no-mates"!] - a treat after another gruelling week at work! I'm no expert at wine, and I don't have any variety I favour.
From experience, I now tend to count a half bottle of red wine as 1 CP. The CP for the wine is added together with my CP's for my meal, and my ratioed dose of insulin taken before eating. It seems to work for me, as I don't have any distinct BG howlers, high or low, either evening or before bed.

Nov 14, 2010

Sam 64 posts

Topic: General Discussion / Metformin

Hi Guys
Wondering if anyone else is on MF? I've been on it a while and taking 1000mg at dinner time along with insulin. Was at my DAFNE apt last week and took my diary in and spoke to the Sister. Basically my BG is all over the place and I couldn't see a pattern. They suggested taking one tablet at dinner time and the other in the morning. I have to say major difference and my BGs are single figures however I feel ill. Sicky feeling, weak, burping, more hypos and dipping round about lunch and late at night so I have enough readings to see a pattern and I can reduce my ratios from 2:1 -1:5 and lower if needs be. I just wanted to know if anyone else went through this, really struggling to feel normal and can't pass the ill feeling!!

Sam

Nov 14, 2010

lindacollins 4 posts

Topic: General Discussion / BG RESULTS

It also went abit mad tis morning !

Nov 14, 2010

lindacollins 4 posts

Topic: General Discussion / BG RESULTS

hi paul
thanks for your comments
i always take the same amount of BI but i do seem to vary the hour at which i take it. it ranges from 09.30-11pm sometimes. Would this make a difference ?
Take care, Linda

Nov 14, 2010

bangers 6 posts

Topic: General Discussion / BG RESULTS

Hi Linda

The 26 units of bi seemed to work well on saturday. Did you take less on Thursday night to result in higher levels on Friday? Any other difference between the two days - less/more active?

Good luck

Paul

Nov 14, 2010

Jennifer Iden 11 posts

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

Hi Simon

Ran the update yesterday and love the carb list - an excellent addition!

Jen

Nov 13, 2010

Simon Heller 46 posts

Topic: Questions for HCPs / wound healing

Yes Helen, this doesn't sound like it was anything down to diabetes, just bad luck and hopefully it will be sorted soon. Simon

Nov 13, 2010

john day 54 posts

Topic: General Discussion / BI Changes

Hi ... just following on from Marke's post, I find that if my BGs are trending worse at a particular mealtime it is always a good idea to miss that meal and QA and see what the resulting BG is after 2 and 4 hours. This gives a good idea if the relevant BI is about right or not.... especially if you repeat the exercise a few times to confirm the result.

As a bonus, you also give the digestive system a break and might lose a little weight round the middle if my experience is anything to go by!

Sort the BIs, then ensure you are calculating carbs accurately and the QAs can then be tackled with confidence.

Nov 13, 2010

HelenP 218 posts

Topic: Questions for HCPs / wound healing

What reassured me was the fact that he was less enthusiastic about shooting the cause back to the diabetes/diabetic control. He talked about "anomalies", low grade infection at a critical time and said that the other 19cm had healed well in less than a week. Once things like this reach a certain stage it is very difficult to heal "naturally". He was happy that I did not have any pain and that there was no fever/chills etc. I am hoping for a small "healthy" sinus that can be dealt with in his surgery as a day patient! An early Christmas present. An ant farm will be more difficult! Helen

Nov 13, 2010

lindacollins 4 posts

Topic: General Discussion / BG RESULTS

I have recently started again on the DAFNE regime, atfer a telling off from my GP. Any info and advise would be helpful
Thank you
linda

Nov 13, 2010

marke 681 posts

Topic: Questions for HCPs / wound healing

good luck Helen. Its always better, I think, to know what that the problem is rather than the worry of not knowing. Hopefully these tests will help them to decide on the best course of action.

Nov 13, 2010

marke 681 posts

Topic: Carbohydrate Counting / Red Wine

it always lowers my BG thats why I like drinking it ( well one of the reasons ;^) ). However the occasional bottle raises it, I suspect due to additives in the wine. As Garry says which wine was it and does it do it with all the red wines you drink ?

Nov 13, 2010

marke 681 posts

Topic: Carbohydrate Counting / McD's

just a reminder that in the Carb Counter section of the website is a list of websites that have carb info, including the one above. You are of course welcome to post them here as well, just wanted to remind people....

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Levemir issues There must of been a reason for you to go on Levemir, like the Lantus not lasting the full 24 hours.... The change over from these 2 insulins can be hard as the dose is now split and are weighed out differently, like they are now, more in the morning, less at night... Its basically like starting from the beginnig, the BI dose needs to be established before anything else fits into place...... For me when I changed I started at the overnight readings, no food or QA, just BI, if its holds steady you have the right dose, if not adjust until its right..........then you can move onto the morning dose....miss breakfast and see what your blood does......if it goes up, fire on a unit, then you could maybe miss lunch the next day, or carb free, and see what happpens, just keep adjusting till it holds........... While this BI investigation is going on your bound to have dodgy readings, you just have to try and compensate with th QA until your confident the doses are right........ You mentioned waking up high every morning even with putting up your PM BI dose, probably dawn phenomonon, I have suffered from this since starting DAFNE, theres not much that can be done apart from pump therapy.......speak to your team about dawn phenomonon, they might have better advice.... good luck

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / BG RESULTS I would agree with previous posts regarding BI timings, my control go tmuch better when I made sure I was getting the 12 hour split... There could be other factors involved, but for now, try and take your doses say at 6:30am and pm give or take an hour....and see what happens then....

Nov 15, 2010 Garry 328 posts	Topic: General Discussion / BG RESULTS Think you have hit the nail on the head with your last post. With the limited information given I reckon that you need balance up the timings of your BI to 12 and 12 hours. We see that Friday morning BI to night BI was 14Â½ hours and Friday night BI to Saturday morning was only 7 hours. Hence during Saturday day time you likely had two separate doses of BI active at the same time. Saturday morning BI to night BI was 16 hours and Saturday night BI to Sunday morning was 10 hours...quite a difference. Personally speaking, I take my morning Lantus BI at breakfast and evening BI at dinner and find that this often ends up as a good 12 hour split... rarely more than an hour out. You may find that when things steady out that some additional BI changes are needed. But wait and see the impact of one change at a time of course. I think most of us find that a BI split at 50:50 is also beneficial. Would discuss any changes with your HCP to have their support and give you the confidence to make any changes needed. Good luck. Keep us posted with your progress. Regards Garry

Nov 15, 2010 MelissaF 56 posts	Topic: Questions for HCPs / Levemir issues Hi, 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. I've been using it for about 5 months now and I still can't get the hang of it. It's difficult to explain but I feel that my results on it are much less predictable than on the Lantus and I seem to be getting many more extreme highs than I feel that I used to on the Lantus with less justification. It feels like I get a more extreme reaction with highs and lows and obviously what I'm striving for is a more constant level. Just as I think that I've got the right BI levels and it seems to be working, I need to alter them again for seemingly no reason. There seems to be no consistancy. In particular I'm having a real problem with my BG results first thing in the morning. I'm waking each morning with readings of 15 and above and increasing my evening BI doesn't seem to be having an effect. I also find it hard having 2 injections of BI a day as I find it less easy to judge doses. I'm wondering if there is anything related to Levemir that might be causing this and any reason why things on Lantus seemed to be more predictable? I know that Levemir is generally seen as a "better" insulin but could there be any reason why I'm better suited to the Lantus. My DAFNE educator is keen for me to keep trying with it but my results seem to be getting worse and worse and it's really disheartening. I also find it hard to apply the DAFNE principles as the results seem to be totally unpredictable. I'm currently taking 9 units of Levemir at night and 3 in the morning. Any help or advice would be really appreciated. It's really getting me down. Many thanks, Melissa

Nov 15, 2010 karaway 7 posts	Topic: Questions for HCPs / BGL's prior to menstration I am a 31 year old female and I have only graduated from DAFNE in the last few days. I am due for my period in a week or so and over the last two days I have found that my lunch and dinner time ratio seems to be wrong. I am getting in the 14's and it doesn't seem to be coming down when I test four hours later. I am so mad at myself for not asking about this during my course. What should I do?

Nov 15, 2010 HelenP 218 posts	Topic: Questions for HCPs / wound healing Well, have I had an interesting day! Had an ultrasound and sinogram and the radiologist (who also happened to be a surgeon doing a sub speciality) could only get a "yellow" cannula into the "hole". He found a sinus that was "6mL" and running just under the skin to the left of the "hole". Compared to a 10mL syringe that's not very big. He strongly advised me to return to my GP (he has sent a copy of his report to: the plastic surgeon (referring doctor), the original surgeon and the GP) before I discuss the results with the plastic surgeon next Friday as I may well get a different opinion. He described it as line ball and that I had to consider what I would achieve having the surgery. I got the distinct impression that he would not touch it. The "hole" is almost closed over and once it does the body deals with the sinus differently. If there is "infection" there and as I have not had any antibiotics in over two months I seem to be dealing with it OK. He knew I was an insulin dependent diabetic but was not concerned about the possibility of the infection getting a hold if my BGs were OK. They are and my TDD is back around what it was pre original surgery. Could be opening another can of worms! Not sure what the GP will say but I believe he is very conservative. Helen

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / McD's The majority of carbs there is the actual potatoe,, should be the same every visit, thats how I know mcdonalds so well..........6 for large chips, 4 for the quarter pounder bun, 3 for any bun smaller than that.

Nov 15, 2010 JayBee 587 posts	Topic: General Discussion / Job Hunting I've always been told that it makes you more likely to get an interview if you do declare you're a diabetic, so I've never held it back whenever I've applied for a job. I think it's very irresponsible not to tell them - I mean, what if you hypo'd in the middle of the interview? XD Not had any issues yet myself, but then again, I've haven't been in a private sector job long enough to know this was even an issue with this - though when I have applied, I've always declared with no problems. I've definitely never had any issues in the public sector, so I'm assuming these concerns mostly exist in the private sector considering the good attitude the public sector has shown towards people like me.

Nov 15, 2010 JayBee 587 posts	Topic: General Discussion / Travel to China I think I did my first insurance through Diabetes UK's insurance supplier - that was going to Japan. My second trip abroad was sorted out by the boyfriend so I'm not sure who we were insured with. Neither were particularly pricey if I remembe correctly though.

Nov 15, 2010 JayBee 587 posts	Topic: Carbohydrate Counting / McD's I used to keep the tray paper with that information on in my kit when I was visiting them a lot more than I do now! XD Wish places that I eat at now would do this.. eg, Spud U Like. Blinkin' jackets! XD

Nov 14, 2010 lindacollins 4 posts	Topic: General Discussion / Blood Sugars Any suggestions would be welcome. thanx. Linda x

Nov 14, 2010 meltow 78 posts	Topic: Carbohydrate Counting / Red Wine I usually enjoy half a bottle of red on a Friday and Saturday night [call me "billy no-mates"!] - a treat after another gruelling week at work! I'm no expert at wine, and I don't have any variety I favour. From experience, I now tend to count a half bottle of red wine as 1 CP. The CP for the wine is added together with my CP's for my meal, and my ratioed dose of insulin taken before eating. It seems to work for me, as I don't have any distinct BG howlers, high or low, either evening or before bed.

Nov 14, 2010 Sam 64 posts	Topic: General Discussion / Metformin Hi Guys Wondering if anyone else is on MF? I've been on it a while and taking 1000mg at dinner time along with insulin. Was at my DAFNE apt last week and took my diary in and spoke to the Sister. Basically my BG is all over the place and I couldn't see a pattern. They suggested taking one tablet at dinner time and the other in the morning. I have to say major difference and my BGs are single figures however I feel ill. Sicky feeling, weak, burping, more hypos and dipping round about lunch and late at night so I have enough readings to see a pattern and I can reduce my ratios from 2:1 -1:5 and lower if needs be. I just wanted to know if anyone else went through this, really struggling to feel normal and can't pass the ill feeling!! Sam

Nov 14, 2010 lindacollins 4 posts	Topic: General Discussion / BG RESULTS It also went abit mad tis morning !

Nov 14, 2010 lindacollins 4 posts	Topic: General Discussion / BG RESULTS hi paul thanks for your comments i always take the same amount of BI but i do seem to vary the hour at which i take it. it ranges from 09.30-11pm sometimes. Would this make a difference ? Take care, Linda

Nov 14, 2010 bangers 6 posts	Topic: General Discussion / BG RESULTS Hi Linda The 26 units of bi seemed to work well on saturday. Did you take less on Thursday night to result in higher levels on Friday? Any other difference between the two days - less/more active? Good luck Paul

Nov 14, 2010 Jennifer Iden 11 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi Simon Ran the update yesterday and love the carb list - an excellent addition! Jen

Nov 13, 2010 Simon Heller 46 posts	Topic: Questions for HCPs / wound healing Yes Helen, this doesn't sound like it was anything down to diabetes, just bad luck and hopefully it will be sorted soon. Simon

Nov 13, 2010 john day 54 posts	Topic: General Discussion / BI Changes Hi ... just following on from Marke's post, I find that if my BGs are trending worse at a particular mealtime it is always a good idea to miss that meal and QA and see what the resulting BG is after 2 and 4 hours. This gives a good idea if the relevant BI is about right or not.... especially if you repeat the exercise a few times to confirm the result. As a bonus, you also give the digestive system a break and might lose a little weight round the middle if my experience is anything to go by! Sort the BIs, then ensure you are calculating carbs accurately and the QAs can then be tackled with confidence.

Nov 13, 2010 HelenP 218 posts	Topic: Questions for HCPs / wound healing What reassured me was the fact that he was less enthusiastic about shooting the cause back to the diabetes/diabetic control. He talked about "anomalies", low grade infection at a critical time and said that the other 19cm had healed well in less than a week. Once things like this reach a certain stage it is very difficult to heal "naturally". He was happy that I did not have any pain and that there was no fever/chills etc. I am hoping for a small "healthy" sinus that can be dealt with in his surgery as a day patient! An early Christmas present. An ant farm will be more difficult! Helen

Nov 13, 2010 lindacollins 4 posts	Topic: General Discussion / BG RESULTS I have recently started again on the DAFNE regime, atfer a telling off from my GP. Any info and advise would be helpful Thank you linda

Nov 13, 2010 marke 681 posts	Topic: Questions for HCPs / wound healing good luck Helen. Its always better, I think, to know what that the problem is rather than the worry of not knowing. Hopefully these tests will help them to decide on the best course of action.

Nov 13, 2010 marke 681 posts	Topic: Carbohydrate Counting / Red Wine it always lowers my BG thats why I like drinking it ( well one of the reasons ;^) ). However the occasional bottle raises it, I suspect due to additives in the wine. As Garry says which wine was it and does it do it with all the red wines you drink ?

Nov 13, 2010 marke 681 posts	Topic: Carbohydrate Counting / McD's just a reminder that in the Carb Counter section of the website is a list of websites that have carb info, including the one above. You are of course welcome to post them here as well, just wanted to remind people....