Recent Posts - DAFNE Online

Nov 15, 2010

MelissaF 56 posts

Topic: Questions for HCPs / Levemir issues

Thank you Diet (if I can call you that!). I take QA when I wake up as I'm usually so concerned by my BG levels that I feel the need to reduce them asap so that dose is a corrective dose. I don't always manage to eat breakfast straight away otherwise I would take the corrective dose with that. The breakfast dose is based on the CP portions I'm eating, assuming that the corrective dose will be working on correcting the high sugar levels.

You're absolutely right, I always feel like I'm chasing my tail. I would love to feel that I could stabilise things a bit more.

Do you have any feedback on Levemir versus Lantus?

Thanks again.

Nov 15, 2010

MelissaF 56 posts

Topic: Questions for HCPs / Levemir issues

I've never been told that about Levemir - how annoying! I've always taken it at those times and no-one's told me any different. Thank you, I will try that from now on.

I was told that Levemir lasted for 18 hours. Is it definitely 12?

I also didn't know that about correcting high blood sugar but that makes a lot of sense. I usually calculate to 1 unit dropping 3 mmol/l but I have wondered why this doesn't seem to work when my BG is very high.

Thank you for that. I will try both of those things and see what happens.

Did you change from Lantus to Levemir? Do you find that Levemir is the best option for you do you think?

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / help please

Hey,

Your results seem all over the place, some morning you hold steady, or, not hold steady , but wake up roughly as you went to sleep.

I am tempted to say either try your background dose in the morning, to see th effects and maybe also to split the dose to see if its a coverage issue. On one injection so assuming Lantus which takes 2-3 days to see any effect of dose change. You have been changing the dose by the day, you cant do that, you need to change and observe for a few days, thats if its Lantus.

The problem is it works some days and doesnt other.

How would you say your carb counting skills are......could you give an example of one of the meals displayed...I hope that doesnt sound cheecky.

Nov 15, 2010

diet_79 8 posts

Topic: Questions for HCPs / Levemir issues

HI Melissa,

A few things to remember, dont correct high bg after hypo otherwise you will be chasing your bg levels. Is there any reason you take QA when you wake up and with CP's at breakfast. You may be building up your insulin, QA peaks around 90mins and this is when you are taking another dose.

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Levemir issues

I can see it, well done.........

My observations:

You are not giving your Levemir doses 12 hours apart, this is important as it only last that long, give or take....

It would be hard to say when the best time is, you need routine. I get up at 6.30am during the week, so I take my AM dose then and then at about 5 when dinner is served, 11 hours but close......

Make sure you get the timings right to within an hour, that means you wont run out at night which sends you high, and you wont overlap in the afternoon sending you low.

Another thing is corrections, my course didnt mention this and I had to find out for myself.

The higher you blood sugar is the more insulin you need (insulin resistance). Everyones different, but the rule I am followong is as follows;

<10mmol/l - correction = 1 unit drops 2.5 mmol/l
10-15mmol/l - correction = 1 unit drops 2 mmol/l
15+mmol/l - correction = 1 unit drops 1.5 mmol/l

I think you should adopt similar rules for correctionm, see what happens, you might get positive results there. And definetly try and get your BI dose 12 hours apart, it makes a difference.

See what the results are like with those two ideas, I think you might see some change.....

If there isnt then you can look at the doses again.......

Nov 15, 2010

grandma carol 61 posts

Topic: General Discussion / help please

I was told to drop BI agen by DAFNE nurse as I was still geting low in the mornings I had put BI back up because I had high reading all the time and was realy unwell. SO I have droped it agen and up they are going anybody got any idears what to do thanks

Nov 15, 2010

MelissaF 56 posts

Topic: Questions for HCPs / Levemir issues

They were down to a reasonable level a few weeks ago (under 10) and now they're back up again to 15/16.

I've put the last 4 days into a diary. I think I've attached it. Can you let me know?

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Levemir issues

You will probabvly find that if you on target before bed, you will stay like that till the early hours, 3,4,5 in the morning, the hormones kick in and the liver starts dumping glucose to help start the day, so if it is dawn phenomonon it wont be all night....

If you keep upping your night BI, there will be a point where you go low over night, 3am test needed, thats when you know its too much......

You say you have brought your morning reading s down, what are they at now.....?

Nov 15, 2010

MelissaF 56 posts

Topic: Questions for HCPs / Levemir issues

I would rather wake up with a decent result rather than use a higher ration or corrective dose at breakfast. My logic being that if I'm running too high overnight then that's making my BG readings dangerously high for 8 hours a day which presumably is having a bad effect both on my HbA1c as well as my general health.

I've not tried posting results yet but I'm sure that I can work out how to. I'll give it a go.

There don't seem to be any specific patterns other than the highs in the mornings. I've brought them down by upping my evening BI but then they come back again. I could really do with working out why this changes to such a degree. It's rather like what happened in the later stages of my pregnancy (when my body was presumably becoming more resistant to the insulin and my results were harder and harder to predict) but I'm definitely not pregnant.

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Levemir issues

So is there any patterns in your results.......sometimes there can be days like that, but it ususally gets better.

Antother thing could be the ratios, you say you wake up high, I bet you need more than the standard 1:1 at breakfast time....have you considered that.....

Is there any chance of you posting 3 day sworth of results, do you know how to do that....?

Nov 15, 2010

MelissaF 56 posts

Topic: Questions for HCPs / Levemir issues

1:1 for all 3 meals at the moment...

How long would you say that it would take to aclimatise to an insulin in your experience? I thought that, after 5 months or so, I'd given it a pretty good shot! I've been testing regularly, writing everything down and reviewing it all for all that time as well which is why it's a bit disheartening. The problem is that fairly often I can't find any reason for things happening or things seem to change from day to day which makes finding patterns and applying DAFNE really difficult. Things seem to be a lot more unpredictable on the Levemir and it makes it hard to analyse.

Nov 15, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Levemir issues

If you think it was purely just your commitment then you should maybe ask to go back, or tell them your going back to Lantus......

Lantus and Levemir are the same pretty much in that they have almost no peaking time and hold your blood sugars steady........the difference is that Lantus doesnt always last for the 24 hours you need it to last in everyone..........hence the split.......its not un heard of to actually split lantus too...

I wouldnt give up so easily though......its all about testing and writing things down, then you can see whats going on and can give reasons for the results......

As I said previously, start with your overnight test, 3AM, make sure you dont eat or take quick acting and see what happens, do an hourly one if you need to, then you will know if its right or wrong....

What ratios are you on throughout the day on QA....?

Nov 15, 2010

MelissaF 56 posts

Topic: Questions for HCPs / Levemir issues

Hi,

Many thanks for your response - much appreciated.

I understand that it's hard adjusting to a new insulin but it's been months now and it seems to be getting worse rather than better. Surely it should have settled down by now?

Also, I thought that I had managed to stabilise my levels - for a few weeks my readings were good at a dose of 7 at night and 2 in the morning. Then it all changed again. Why would I constantly need to keep changing my BI doses when everything else is consistant? Surely they should be more regular? Otherwise it starts having to be as flexible as the QA. I know that you can alter the dose if necessary but surely it shouldn't have to be all the time? Otherwise you're just juggling all the time and your levels are constantly all over the place.

I think the reason that Levemir was suggested was because my control wasn't good. But the reason for that was that I had been taking less care of myself. My control is better now but I think that's purely because I'm spending a lot more time on it rather than because of the change of insulin. I can't help thinking that my control might be even better if I reverted to Lantus and spent all this time on it still.

Do you know what advantages Levemir has over Lantus? As I mentioned I find the 2 doses really hard to manage as well.

Thanks again,

Melissa

Nov 15, 2010

novorapidboi26 1,819 posts

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

I cant speak from experience but from talking to other diabetics they confirmed that the menstrual cycle does effect thier BGLs, some for a day or two, some for longer....

Talk to you DAFNE team about it....

I think its all about getting to know how you respond at this time, by testing etc...eventually you will be able to predict your BGL behaviour and compensate accordingly.

Good Luck...

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 15, 2010 MelissaF 56 posts	Topic: Questions for HCPs / Levemir issues Thank you Diet (if I can call you that!). I take QA when I wake up as I'm usually so concerned by my BG levels that I feel the need to reduce them asap so that dose is a corrective dose. I don't always manage to eat breakfast straight away otherwise I would take the corrective dose with that. The breakfast dose is based on the CP portions I'm eating, assuming that the corrective dose will be working on correcting the high sugar levels. You're absolutely right, I always feel like I'm chasing my tail. I would love to feel that I could stabilise things a bit more. Do you have any feedback on Levemir versus Lantus? Thanks again.

Nov 15, 2010 MelissaF 56 posts	Topic: Questions for HCPs / Levemir issues I've never been told that about Levemir - how annoying! I've always taken it at those times and no-one's told me any different. Thank you, I will try that from now on. I was told that Levemir lasted for 18 hours. Is it definitely 12? I also didn't know that about correcting high blood sugar but that makes a lot of sense. I usually calculate to 1 unit dropping 3 mmol/l but I have wondered why this doesn't seem to work when my BG is very high. Thank you for that. I will try both of those things and see what happens. Did you change from Lantus to Levemir? Do you find that Levemir is the best option for you do you think?

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / help please Hey, Your results seem all over the place, some morning you hold steady, or, not hold steady , but wake up roughly as you went to sleep. I am tempted to say either try your background dose in the morning, to see th effects and maybe also to split the dose to see if its a coverage issue. On one injection so assuming Lantus which takes 2-3 days to see any effect of dose change. You have been changing the dose by the day, you cant do that, you need to change and observe for a few days, thats if its Lantus. The problem is it works some days and doesnt other. How would you say your carb counting skills are......could you give an example of one of the meals displayed...I hope that doesnt sound cheecky.

Nov 15, 2010 diet_79 8 posts	Topic: Questions for HCPs / Levemir issues HI Melissa, A few things to remember, dont correct high bg after hypo otherwise you will be chasing your bg levels. Is there any reason you take QA when you wake up and with CP's at breakfast. You may be building up your insulin, QA peaks around 90mins and this is when you are taking another dose.

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Levemir issues I can see it, well done......... My observations: You are not giving your Levemir doses 12 hours apart, this is important as it only last that long, give or take.... It would be hard to say when the best time is, you need routine. I get up at 6.30am during the week, so I take my AM dose then and then at about 5 when dinner is served, 11 hours but close...... Make sure you get the timings right to within an hour, that means you wont run out at night which sends you high, and you wont overlap in the afternoon sending you low. Another thing is corrections, my course didnt mention this and I had to find out for myself. The higher you blood sugar is the more insulin you need (insulin resistance). Everyones different, but the rule I am followong is as follows; <10mmol/l - correction = 1 unit drops 2.5 mmol/l 10-15mmol/l - correction = 1 unit drops 2 mmol/l 15+mmol/l - correction = 1 unit drops 1.5 mmol/l I think you should adopt similar rules for correctionm, see what happens, you might get positive results there. And definetly try and get your BI dose 12 hours apart, it makes a difference. See what the results are like with those two ideas, I think you might see some change..... If there isnt then you can look at the doses again.......

Nov 15, 2010 grandma carol 61 posts	Topic: General Discussion / help please I was told to drop BI agen by DAFNE nurse as I was still geting low in the mornings I had put BI back up because I had high reading all the time and was realy unwell. SO I have droped it agen and up they are going anybody got any idears what to do thanks

Nov 15, 2010 MelissaF 56 posts	Topic: Questions for HCPs / Levemir issues They were down to a reasonable level a few weeks ago (under 10) and now they're back up again to 15/16. I've put the last 4 days into a diary. I think I've attached it. Can you let me know?

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Levemir issues You will probabvly find that if you on target before bed, you will stay like that till the early hours, 3,4,5 in the morning, the hormones kick in and the liver starts dumping glucose to help start the day, so if it is dawn phenomonon it wont be all night.... If you keep upping your night BI, there will be a point where you go low over night, 3am test needed, thats when you know its too much...... You say you have brought your morning reading s down, what are they at now.....?

Nov 15, 2010 MelissaF 56 posts	Topic: Questions for HCPs / Levemir issues I would rather wake up with a decent result rather than use a higher ration or corrective dose at breakfast. My logic being that if I'm running too high overnight then that's making my BG readings dangerously high for 8 hours a day which presumably is having a bad effect both on my HbA1c as well as my general health. I've not tried posting results yet but I'm sure that I can work out how to. I'll give it a go. There don't seem to be any specific patterns other than the highs in the mornings. I've brought them down by upping my evening BI but then they come back again. I could really do with working out why this changes to such a degree. It's rather like what happened in the later stages of my pregnancy (when my body was presumably becoming more resistant to the insulin and my results were harder and harder to predict) but I'm definitely not pregnant.

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Levemir issues So is there any patterns in your results.......sometimes there can be days like that, but it ususally gets better. Antother thing could be the ratios, you say you wake up high, I bet you need more than the standard 1:1 at breakfast time....have you considered that..... Is there any chance of you posting 3 day sworth of results, do you know how to do that....?

Nov 15, 2010 MelissaF 56 posts	Topic: Questions for HCPs / Levemir issues 1:1 for all 3 meals at the moment... How long would you say that it would take to aclimatise to an insulin in your experience? I thought that, after 5 months or so, I'd given it a pretty good shot! I've been testing regularly, writing everything down and reviewing it all for all that time as well which is why it's a bit disheartening. The problem is that fairly often I can't find any reason for things happening or things seem to change from day to day which makes finding patterns and applying DAFNE really difficult. Things seem to be a lot more unpredictable on the Levemir and it makes it hard to analyse.

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Levemir issues If you think it was purely just your commitment then you should maybe ask to go back, or tell them your going back to Lantus...... Lantus and Levemir are the same pretty much in that they have almost no peaking time and hold your blood sugars steady........the difference is that Lantus doesnt always last for the 24 hours you need it to last in everyone..........hence the split.......its not un heard of to actually split lantus too... I wouldnt give up so easily though......its all about testing and writing things down, then you can see whats going on and can give reasons for the results...... As I said previously, start with your overnight test, 3AM, make sure you dont eat or take quick acting and see what happens, do an hourly one if you need to, then you will know if its right or wrong.... What ratios are you on throughout the day on QA....?

Nov 15, 2010 MelissaF 56 posts	Topic: Questions for HCPs / Levemir issues Hi, Many thanks for your response - much appreciated. I understand that it's hard adjusting to a new insulin but it's been months now and it seems to be getting worse rather than better. Surely it should have settled down by now? Also, I thought that I had managed to stabilise my levels - for a few weeks my readings were good at a dose of 7 at night and 2 in the morning. Then it all changed again. Why would I constantly need to keep changing my BI doses when everything else is consistant? Surely they should be more regular? Otherwise it starts having to be as flexible as the QA. I know that you can alter the dose if necessary but surely it shouldn't have to be all the time? Otherwise you're just juggling all the time and your levels are constantly all over the place. I think the reason that Levemir was suggested was because my control wasn't good. But the reason for that was that I had been taking less care of myself. My control is better now but I think that's purely because I'm spending a lot more time on it rather than because of the change of insulin. I can't help thinking that my control might be even better if I reverted to Lantus and spent all this time on it still. Do you know what advantages Levemir has over Lantus? As I mentioned I find the 2 doses really hard to manage as well. Thanks again, Melissa

Nov 15, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / BGL's prior to menstration I cant speak from experience but from talking to other diabetics they confirmed that the menstrual cycle does effect thier BGLs, some for a day or two, some for longer.... Talk to you DAFNE team about it.... I think its all about getting to know how you respond at this time, by testing etc...eventually you will be able to predict your BGL behaviour and compensate accordingly. Good Luck...

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