Recent Posts - DAFNE Online

Oct 28, 2010

Brum_Taffy 13 posts

Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?"

"what's a lipo? lol"- so sorry to go all jargonistic on you David- a rubbery lump under your skin at injection sites, which stops insulin getting in reliably.

One of the telling stats from a large international patient survey was that 75% of those not rotating got them, but 25% of those doing it all perfectly still got them... clearly we still don't know enough about why they happen, despite many theories.

I certainly understand and empathise with the comments re habit, ease, familiarity, "laziness"! Plus I can see the "if it ain't broken" approach is appealing.

What I don't know is how much of a difference these factors can make in the average person, but from my experiences I believe it can be dramatic in some.

I imagine many docs feel uncomfortable discussing these 'nitty-gritty' components of care, after all, you guys know much more about this than we do... !!! LOL

Oct 27, 2010

HelenP 218 posts

Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?"

Hi,
I think they are fair questions but it is difficult to change a practice when you know you have no problems doing it the old way. I used to change syringes every time (in the olden days) and it was a "burden" to take stuff with me (where do you dispose of the syringe etc). Then the pens came in and I only change needles when the pen is empty! (lantus up to 9-10 injections) and the novorapid when the pen gets blunt or when I think of it...whenever). For me it is not a question of cost...it is convenience...so much easier to just throw the pen into the handbag sidepocket without all the other diabetes stuff. Similarly with the meter just throw it in. Use the lancet multiple times also. I have never had a problem. I would need to be persuaded that there was some advantage to me to change. Lantus tends to go in the abdomen (more because of the clothing I am wearing at the time) and novorapid in the stomach. Hey, but no hard and fast rules. I have no lipos and I hold the pen in for longer if I am out...probably because i don't want a blob of blood on clothing!

I only know one diabetic who is changing needles etc, using alco wipes etc all the time the rest fall somewhere between me and him. It is a topic we discuss. A few admit to lying because we know what you want to hear! Another topic is where do you carry all the gear. The best I have seen is a zippered carryall about 20x15x3 cm but that does not fit in a pocket and takes up a fair amount of space in a handbag. Good for travelling though. Pragmatics!
Good luck.

Sunny side up!

Helen

Oct 27, 2010

SimonC 78 posts

Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?"

I am afraid I am one of those that only change the needle bit when I change the vial - suspect that this goes back to the time when the insulin was free but the needles you had to pay for. I know and understand and accept all the arguments for changing them after every injection but it is a habit (and I am lazy) that I just can't stop.

I do change my sites but I must admit in a random fashion - I used to only use the side of my leg, as there was no fat what so ever on my stomach (this started 20 years ago) and the syringes hurt a lot in the stomach, obviously with the passage of time there is now fat on my stomach and I can use it and so I do vary now between the stomach and leg, and also move around these sites - but not in a systematic way.

I think these subjects are for discussion and should be discussed, they are with me, but as my HBA1c results have always been very good (have been down to 5.9, currently 6.2, and never higher than 7), the team have never pushed too hard to make me change as clearly what I am doing is working.

I don't know why people are sensitive about it though.

Oct 27, 2010

DavidMansfield 3 posts

Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?"

hey I'm getting into this. 2 posts in as many days after a weak or more of just reading Razz

I think it'd be great if my consultant bothered to talk to me about these things. For 12 years I've been scared to ask about rotating injection sites because when I've tried I've been looked at like an idiot or given a book for 3 year olds which mentions its important but gives no actual tips/guides. I've even been told (while laying in hospital with DKA) that I'm over-doing my stomach injections and that the skin is "obviously" too hard & lumpy when it felt normal to me before & after said advice but the Dr rushed off before I could ask for more information.

I did used to re-use needles but mostly out of being disorganised & not having the new needles readily available whereas now I've read a leaflet (while waiting to see the Doc at a check-up) that explained how important it is & sorted out a place with ready access to the needles as soon as I got home - though actually when I go out I might still use a needle twice or maybe three times because of the hassle of finding somewhere to put a used needle. storing a replacement is easy enough but finding somewhere safe to put the original just isn't particularly easy in my experience. I do like the finger prick needles i use now which come in a set of 6 somewhat like a gun barrell so I only need one & it'll last for a day or more. Not sure if an injection needle could work in this way though.

Needle on the pen - pretty much links to above answer I guess.

Rotate - already mentioned

what's a lipo? lol

and 2-3 seconds max?! I was specifically told to hold it in at least 6 seconds & that's what I've been doing for years. Scared now.

I also imagine many people find it tough to get their GP to allow them enough needles for the amount of injections we (probably) each do these days. Everything on a prescription seems to come with an "as little as possible" idea in my experience (though my GP's actually brilliant with everything - just a shame she doesn't deal with my repeat prescription orders & is often baffled when I mention that others have cocked it up)

I just noticed you also asked "Do people with diabetes find these questions sensitive? If so, why is that?"

I'd say no-one wants to hear that they're doing it wrong when for the most part diabetics I've met have been told "here's some needles, you have to do injections with your meals" and that's it. By this I mean that several diabetics seem to have been left to work it all out for themselves so it could appear to be a more personal than intended dig when you tell them they're wrong. You've probably noticed from my earlier answers that I'm seeing things (eg lipos) for the first time here so there's definitely a lack of information being handed out.

"How should us docs approach a person who is not using their pen device well, and try to persuade them to make some changes?"

I can only answer this for how I would like to be taught & that would be to not rush to "omg! if you carry on like this you'll be dead by the end of the month" and more of a sensible explanation of what exactly I'm doing wrong & why its wrong & what to do about it. Again I find that the consultants I see just rush to get me out again & would more often go for an answer of "ask the Diabetes Nurses" than doing anything themselves.

Hope this has helped & I aplogogise if its lengthy & rambly

edit: forgot the whole true point of the topic for a second there...Scrambled!! & with ham & cheese or not at all!

Oct 27, 2010

Brum_Taffy 13 posts

Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?"

Question- "What do you do with your pen device in the morning?"

I presented on new injection device guidelines at a medical meeting last week. Us docs love to give people the 'third degree' about doses, carb counting, exercise etc., but in my view we have been slow to think about the 'mundane' issues of needle re-use, needle length, proper rotation of sites [i.e. not just randomly moving], injection technique, how long you hold it in, lipos at injection sites and so on. After discussing this with some diabetes nurse colleagues, I thought I would begin to explore these issues with the people with diabetes I meet in consultations.

One week on, to my surprise the great majority of people I have met and asked very honestly tell me that they regularly
-reuse needles, sometimes for 5+ injections
-leave the needle on the pen (insulin was dripping from the needle and bubbles had got into the insulin chamber) between injections
-do not rotate injection sites (but do pick a new random site each injection)
-continue to use lipos, even when they know what they are and acknowledge that the lipo may stop insulin getting in well
-hold the pen in for 2-3 seconds max

I seem to have 'kicked a hornet's nest', since even though people are very open about what they do with their pen device, I have found it very hard to persuade people to change. One patient accused me of being in the pocket of the pharmaceutical industry by suggesting he change needles each injection! A handful of these folk are DAFNE grads who acknowledge these issues were discussed on the course.

I had the feeling I was straying into sensitive territory, and I couldn't understand why that is.

So I need your help!

Are these fair subjects for discussion in a consultation?
Do your diabetes teams discuss these issues with you?
Do people with diabetes find these questions sensitive? If so, why is that?
How should us docs approach a person who is not using their pen device well, and try to persuade them to make some changes?

When I understand the issue better, I'd like to have a go at making some educational material, written, video etc. in case it may help. Anyone know of anything out there 'off-the-shelf'?

To answer my original question- "I like mine with a kiss!" Smile

Oct 27, 2010

Brum_Taffy 13 posts

Topic: General Discussion / "Diabetes results to you" Your help requested

Your replies have been thoughtful and most generous- everything I'd expect from DAFNE graduates, thank you all so much!

This is a final call for using the link to register a preference- it looks like one design is well ahead, so we plan to make a decision tomorrow am so we can order the artwork to be mocked-up and then our pilot can begin.

I'm always amazed how few diabetes teams communicate directly with people with diabetes. I have been writing all my clinic letters to people with diabetes for several years, hopefully in terms people can understand (copied to their GP) with a full meds list, latest test results with interpretations and agreed action plan. It is the only way to travel!

This idea came from hearing Douglas Smallwood (DUK) giving a speech at a conference and recounting a contact with a doc who was reticent to share DS's blood test result with him. It made me ask myself why can't we get results to people BEFORE the consultation, rather than 'breaking the news' within it. So now my patients who want it can have A1c within 5 days of having blood taken (AND if the Trust/PCT agree its worth the ~50p or so per paper result, sms is free).

Whether we can do that for more than just A1c.... maybe the next project! So few of the people I see understand A1c at present. It makes me very sad and needs much work and focus to turn it around.

I'll keep you updated on progress Smile

Oct 27, 2010

SimonC 78 posts

Topic: General Discussion / "Diabetes results to you" Your help requested

I quite liked the ruler design - as it shows the scale is a continuum.

My clinic send me all my results in a letter - and a copy to my GP, I find it really useful as I keep them all, and can see the trends myself, not only for the HBA1c, but the cholesterol as well.

Oct 27, 2010

novorapidboi26 1,816 posts

Topic: General Discussion / Blood sugars since dafne and pump

Well I suppose it can never be perfect as our needs change by the hour, all depends on what hormones and what levels of hormones are washing around at the time......

By the sounds of it though, your hitting the nail square on the head............

Oct 27, 2010

Jennypenny 34 posts

Topic: General Discussion / "Diabetes results to you" Your help requested

I agree Traffic Light system more straight forward , hope this helps

Oct 27, 2010

Jennypenny 34 posts

Topic: General Discussion / Blood sugars since dafne and pump

Yep hourly testing had to up rates between 11ish and 2 ish, still tweaking not perfect yet by any means

Oct 27, 2010

Garry 328 posts

Topic: General Discussion / "Diabetes results to you" Your help requested

I think that the general public would find the 'Traffic Light' version on the right easier to understand.
We can all directly relate to and understand this simple system - which is in everyday use.
The language used as section headers on this page are more striking too and for me appear to appropriately describe the action which needs be undertaken.

Oct 27, 2010

novorapidboi26 1,816 posts

Topic: General Discussion / Driving BG

Dont know if there is a high.....legally.....everyone is different and although i feel rough when i hit 15, i can still function normally......my control used to be quite bad but never has problems with ketoacidosis or any side effect from that....

Thats not to say you wont, if you feel unable to function at a certain level, get some insulin in you...........

Oct 27, 2010

novorapidboi26 1,816 posts

Topic: General Discussion / Blood sugars since dafne and pump

I meant tweaking, sorry........

So you suffered DP, how did you establish your basal rate overnight, hourly tests? At what time do you need to up the delivery rate......

Oct 27, 2010

Jennypenny 34 posts

Topic: General Discussion / Insulin Pumps

Yes i had to do DAFNE before i fitted the criteria for a pump , but doing dafne and then getting the pump have been the 2 best things i have done for my diabetes , i have NEVER had such good blood sugars in all my 30 years as a type 1 diabetic .

Oct 27, 2010

Jennypenny 34 posts

Topic: General Discussion / Blood sugars since dafne and pump

No for someone who has suffered with dp , even my night time sugars have been good

Oct 27, 2010

Derek Brown 32 posts

Topic: General Discussion / Driving BG

I know we've been advised a minimum level for BG before driving, but what about a maximum?

I can wake up in the morning with high-ish BG's but feel fine and drive to work as normal. I've never had any mishap, scares, accidents etc but just realised I'd never been advised if there was a "too high"

Oct 27, 2010

HelenP 218 posts

Topic: General Discussion / Insulin Pumps

I don't think you can get one free as the injection routine is adequate. You occasionally see appeals for funds to enable children to go on pumps. The individual pays for the "accessories" but they are subsidised by the govt. Goodnight..test and off to bed. Helen

Oct 27, 2010

novorapidboi26 1,816 posts

Topic: General Discussion / Insulin Pumps

So it is the same as here pretty much....

The NHS provides free healthcare for all (Medicare), and if you want it faster or something more specialised you go private (health fund- some kind of insurance or money up front).........

Theres not many people that I am aware of that have paid for their own pump or went through privately, that I know of in the UK, no doubt there has been.......

It seems really pricey for you, could you get it free, but have to wait, and who pays for all the things that come with the pump, canullas, tubing etc..........

Oct 27, 2010

HelenP 218 posts

Topic: General Discussion / Insulin Pumps

Where do I start with the health system?

This has not been a good year for me. The diabetes, cancer diagnosis followed by fairly serious surgery, non healing incision and now the pump issue. All up I am out of pocket about $1100 for Dr visits and I spend about $150-$160 a month on medication, strips, needles etc. The actual hospital stay (1 week) was completely covered by my health fund. I have been a member since my early 30s and currently pay just less than $2500 a year. I am hoping they pay for the pump in its entirety. First visit to the Diabetes Educator (necessary to get the pump) will cost $200 and I am not sure how much I will be able to claim. Conservative estimate for the whole year will put me out of pocket between $5-6000.

As I am a retiree (but not a pensioner) once I reach $1126 out of pocket expenses for Dr visits I will get 80% of what the Dr charges back. I have a visit scheduled for 11/11/2010 to get a certificate entitling me to drive. It will (hopefully) be endorsed with "recognises hypoglycaemia...fit to drive". The Dr will charge $66 and I will be out of pocket about half of that. if I reach the threshold before then I will get $52.90 back. Roll on 2011 and the cure by whatever avenue!

So basically we have two platforms...universal health care (Medicare) for all Australian citizens ( and extras! I am assuming you Brits come under the Medicare umbrella but I could be wrong). Then if you want to be able to choose your own Dr, go to the dentist, optometrist etc you join a health fund. There is a tax deduction if you have private health insurance. If you are really sick you get into the public system very quickly but if you require non urgent treatment (eg hip replacement) you are put on a waiting list that can mean a very long wait. Get your pump before you come!

I will hopefully know more on 18/11/2010 but I am being fairly aggressively pursued by a pump manufacturer who is offering to walk me through the process and iron out potential glitches. heaven protect me from sales persons!
Helen

Oct 27, 2010

novorapidboi26 1,816 posts

Topic: General Discussion / Insulin Pumps

I think the only way forward is ginetics to be honest............stem cell research, as I understand is the utilizing of cells that can essentially turn into any cell and perform any function.........

Then what?

Our own antibodies will still be instructed to attack the newly formed cells...........short term yes, cure no........:-(

So how long till you find out about the pump...

Also what is the healthcare system like in australia, I though similar to the UK......(maybe hoping to immagrate one day...lol)

Oct 27, 2010

HelenP 218 posts

Topic: General Discussion / Insulin Pumps

Yep the pump is just until the cure!

Oct 27, 2010

novorapidboi26 1,816 posts

Topic: General Discussion / Blood sugars since dafne and pump

well done from me.............

was there much weaking with your basal doses overnight?

Oct 27, 2010

novorapidboi26 1,816 posts

Topic: General Discussion / Insulin Pumps

lol......nothing less...........

Oct 27, 2010

HelenP 218 posts

Topic: General Discussion / Insulin Pumps

I am constantly surprised when talking to other diabetics the number of them who have not heard about Dafne. I did my course in july 2008 (a work colleague had been referred by her Endo and spoke very highly of the protocols). I understood that there was funding available to run a trial and I was part of that trial. The hospital where I did the course (Mater) no longer offers the course but the Royal Brisbane is currently funded to run Dafne courses. Judging from this forum it seems Dafne is more pervasive in Britain...or at least that is how it seems to me.

I have been a diabetic for more than half my life and am amazed at how far we have come. I had an aunt (diabetic) who "lived" on boiled cabbage in the 50's and look where we are now. Roll on stem cell research! I want nothing less than a CURE!

Helen

Oct 27, 2010

Kentbabe 10 posts

Topic: General Discussion / "Diabetes results to you" Your help requested

hiya David, I prefer the one on the left as it seams to be easier to read nd understand karen

Oct 28, 2010 Brum_Taffy 13 posts	Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?" "what's a lipo? lol"- so sorry to go all jargonistic on you David- a rubbery lump under your skin at injection sites, which stops insulin getting in reliably. One of the telling stats from a large international patient survey was that 75% of those not rotating got them, but 25% of those doing it all perfectly still got them... clearly we still don't know enough about why they happen, despite many theories. I certainly understand and empathise with the comments re habit, ease, familiarity, "laziness"! Plus I can see the "if it ain't broken" approach is appealing. What I don't know is how much of a difference these factors can make in the average person, but from my experiences I believe it can be dramatic in some. I imagine many docs feel uncomfortable discussing these 'nitty-gritty' components of care, after all, you guys know much more about this than we do... !!! LOL

Oct 27, 2010 HelenP 218 posts	Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?" Hi, I think they are fair questions but it is difficult to change a practice when you know you have no problems doing it the old way. I used to change syringes every time (in the olden days) and it was a "burden" to take stuff with me (where do you dispose of the syringe etc). Then the pens came in and I only change needles when the pen is empty! (lantus up to 9-10 injections) and the novorapid when the pen gets blunt or when I think of it...whenever). For me it is not a question of cost...it is convenience...so much easier to just throw the pen into the handbag sidepocket without all the other diabetes stuff. Similarly with the meter just throw it in. Use the lancet multiple times also. I have never had a problem. I would need to be persuaded that there was some advantage to me to change. Lantus tends to go in the abdomen (more because of the clothing I am wearing at the time) and novorapid in the stomach. Hey, but no hard and fast rules. I have no lipos and I hold the pen in for longer if I am out...probably because i don't want a blob of blood on clothing! I only know one diabetic who is changing needles etc, using alco wipes etc all the time the rest fall somewhere between me and him. It is a topic we discuss. A few admit to lying because we know what you want to hear! Another topic is where do you carry all the gear. The best I have seen is a zippered carryall about 20x15x3 cm but that does not fit in a pocket and takes up a fair amount of space in a handbag. Good for travelling though. Pragmatics! Good luck. Sunny side up! Helen

Oct 27, 2010 SimonC 78 posts	Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?" I am afraid I am one of those that only change the needle bit when I change the vial - suspect that this goes back to the time when the insulin was free but the needles you had to pay for. I know and understand and accept all the arguments for changing them after every injection but it is a habit (and I am lazy) that I just can't stop. I do change my sites but I must admit in a random fashion - I used to only use the side of my leg, as there was no fat what so ever on my stomach (this started 20 years ago) and the syringes hurt a lot in the stomach, obviously with the passage of time there is now fat on my stomach and I can use it and so I do vary now between the stomach and leg, and also move around these sites - but not in a systematic way. I think these subjects are for discussion and should be discussed, they are with me, but as my HBA1c results have always been very good (have been down to 5.9, currently 6.2, and never higher than 7), the team have never pushed too hard to make me change as clearly what I am doing is working. I don't know why people are sensitive about it though.

Oct 27, 2010 DavidMansfield 3 posts	Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?" hey I'm getting into this. 2 posts in as many days after a weak or more of just reading I think it'd be great if my consultant bothered to talk to me about these things. For 12 years I've been scared to ask about rotating injection sites because when I've tried I've been looked at like an idiot or given a book for 3 year olds which mentions its important but gives no actual tips/guides. I've even been told (while laying in hospital with DKA) that I'm over-doing my stomach injections and that the skin is "obviously" too hard & lumpy when it felt normal to me before & after said advice but the Dr rushed off before I could ask for more information. I did used to re-use needles but mostly out of being disorganised & not having the new needles readily available whereas now I've read a leaflet (while waiting to see the Doc at a check-up) that explained how important it is & sorted out a place with ready access to the needles as soon as I got home - though actually when I go out I might still use a needle twice or maybe three times because of the hassle of finding somewhere to put a used needle. storing a replacement is easy enough but finding somewhere safe to put the original just isn't particularly easy in my experience. I do like the finger prick needles i use now which come in a set of 6 somewhat like a gun barrell so I only need one & it'll last for a day or more. Not sure if an injection needle could work in this way though. Needle on the pen - pretty much links to above answer I guess. Rotate - already mentioned what's a lipo? lol and 2-3 seconds max?! I was specifically told to hold it in at least 6 seconds & that's what I've been doing for years. Scared now. I also imagine many people find it tough to get their GP to allow them enough needles for the amount of injections we (probably) each do these days. Everything on a prescription seems to come with an "as little as possible" idea in my experience (though my GP's actually brilliant with everything - just a shame she doesn't deal with my repeat prescription orders & is often baffled when I mention that others have cocked it up) I just noticed you also asked "Do people with diabetes find these questions sensitive? If so, why is that?" I'd say no-one wants to hear that they're doing it wrong when for the most part diabetics I've met have been told "here's some needles, you have to do injections with your meals" and that's it. By this I mean that several diabetics seem to have been left to work it all out for themselves so it could appear to be a more personal than intended dig when you tell them they're wrong. You've probably noticed from my earlier answers that I'm seeing things (eg lipos) for the first time here so there's definitely a lack of information being handed out. "How should us docs approach a person who is not using their pen device well, and try to persuade them to make some changes?" I can only answer this for how I would like to be taught & that would be to not rush to "omg! if you carry on like this you'll be dead by the end of the month" and more of a sensible explanation of what exactly I'm doing wrong & why its wrong & what to do about it. Again I find that the consultants I see just rush to get me out again & would more often go for an answer of "ask the Diabetes Nurses" than doing anything themselves. Hope this has helped & I aplogogise if its lengthy & rambly edit: forgot the whole true point of the topic for a second there...Scrambled!! & with ham & cheese or not at all!

Oct 27, 2010 Brum_Taffy 13 posts	Topic: General Discussion / Please sing to the tune of "How do you like your eggs in the Morning?" Question- "What do you do with your pen device in the morning?" I presented on new injection device guidelines at a medical meeting last week. Us docs love to give people the 'third degree' about doses, carb counting, exercise etc., but in my view we have been slow to think about the 'mundane' issues of needle re-use, needle length, proper rotation of sites [i.e. not just randomly moving], injection technique, how long you hold it in, lipos at injection sites and so on. After discussing this with some diabetes nurse colleagues, I thought I would begin to explore these issues with the people with diabetes I meet in consultations. One week on, to my surprise the great majority of people I have met and asked very honestly tell me that they regularly -reuse needles, sometimes for 5+ injections -leave the needle on the pen (insulin was dripping from the needle and bubbles had got into the insulin chamber) between injections -do not rotate injection sites (but do pick a new random site each injection) -continue to use lipos, even when they know what they are and acknowledge that the lipo may stop insulin getting in well -hold the pen in for 2-3 seconds max I seem to have 'kicked a hornet's nest', since even though people are very open about what they do with their pen device, I have found it very hard to persuade people to change. One patient accused me of being in the pocket of the pharmaceutical industry by suggesting he change needles each injection! A handful of these folk are DAFNE grads who acknowledge these issues were discussed on the course. I had the feeling I was straying into sensitive territory, and I couldn't understand why that is. So I need your help! Are these fair subjects for discussion in a consultation? Do your diabetes teams discuss these issues with you? Do people with diabetes find these questions sensitive? If so, why is that? How should us docs approach a person who is not using their pen device well, and try to persuade them to make some changes? When I understand the issue better, I'd like to have a go at making some educational material, written, video etc. in case it may help. Anyone know of anything out there 'off-the-shelf'? To answer my original question- "I like mine with a kiss!"

Oct 27, 2010 Brum_Taffy 13 posts	Topic: General Discussion / "Diabetes results to you" Your help requested Your replies have been thoughtful and most generous- everything I'd expect from DAFNE graduates, thank you all so much! This is a final call for using the link to register a preference- it looks like one design is well ahead, so we plan to make a decision tomorrow am so we can order the artwork to be mocked-up and then our pilot can begin. I'm always amazed how few diabetes teams communicate directly with people with diabetes. I have been writing all my clinic letters to people with diabetes for several years, hopefully in terms people can understand (copied to their GP) with a full meds list, latest test results with interpretations and agreed action plan. It is the only way to travel! This idea came from hearing Douglas Smallwood (DUK) giving a speech at a conference and recounting a contact with a doc who was reticent to share DS's blood test result with him. It made me ask myself why can't we get results to people BEFORE the consultation, rather than 'breaking the news' within it. So now my patients who want it can have A1c within 5 days of having blood taken (AND if the Trust/PCT agree its worth the ~50p or so per paper result, sms is free). Whether we can do that for more than just A1c.... maybe the next project! So few of the people I see understand A1c at present. It makes me very sad and needs much work and focus to turn it around. I'll keep you updated on progress

Oct 27, 2010 SimonC 78 posts	Topic: General Discussion / "Diabetes results to you" Your help requested I quite liked the ruler design - as it shows the scale is a continuum. My clinic send me all my results in a letter - and a copy to my GP, I find it really useful as I keep them all, and can see the trends myself, not only for the HBA1c, but the cholesterol as well.

Oct 27, 2010 novorapidboi26 1,816 posts	Topic: General Discussion / Blood sugars since dafne and pump Well I suppose it can never be perfect as our needs change by the hour, all depends on what hormones and what levels of hormones are washing around at the time...... By the sounds of it though, your hitting the nail square on the head............

Oct 27, 2010 Jennypenny 34 posts	Topic: General Discussion / "Diabetes results to you" Your help requested I agree Traffic Light system more straight forward , hope this helps

Oct 27, 2010 Jennypenny 34 posts	Topic: General Discussion / Blood sugars since dafne and pump Yep hourly testing had to up rates between 11ish and 2 ish, still tweaking not perfect yet by any means

Oct 27, 2010 Garry 328 posts	Topic: General Discussion / "Diabetes results to you" Your help requested I think that the general public would find the 'Traffic Light' version on the right easier to understand. We can all directly relate to and understand this simple system - which is in everyday use. The language used as section headers on this page are more striking too and for me appear to appropriately describe the action which needs be undertaken.

Oct 27, 2010 novorapidboi26 1,816 posts	Topic: General Discussion / Driving BG Dont know if there is a high.....legally.....everyone is different and although i feel rough when i hit 15, i can still function normally......my control used to be quite bad but never has problems with ketoacidosis or any side effect from that.... Thats not to say you wont, if you feel unable to function at a certain level, get some insulin in you...........

Oct 27, 2010 novorapidboi26 1,816 posts	Topic: General Discussion / Blood sugars since dafne and pump I meant tweaking, sorry........ So you suffered DP, how did you establish your basal rate overnight, hourly tests? At what time do you need to up the delivery rate......

Oct 27, 2010 Jennypenny 34 posts	Topic: General Discussion / Insulin Pumps Yes i had to do DAFNE before i fitted the criteria for a pump , but doing dafne and then getting the pump have been the 2 best things i have done for my diabetes , i have NEVER had such good blood sugars in all my 30 years as a type 1 diabetic .

Oct 27, 2010 Jennypenny 34 posts	Topic: General Discussion / Blood sugars since dafne and pump No for someone who has suffered with dp , even my night time sugars have been good

Oct 27, 2010 Derek Brown 32 posts	Topic: General Discussion / Driving BG I know we've been advised a minimum level for BG before driving, but what about a maximum? I can wake up in the morning with high-ish BG's but feel fine and drive to work as normal. I've never had any mishap, scares, accidents etc but just realised I'd never been advised if there was a "too high"

Oct 27, 2010 HelenP 218 posts	Topic: General Discussion / Insulin Pumps I don't think you can get one free as the injection routine is adequate. You occasionally see appeals for funds to enable children to go on pumps. The individual pays for the "accessories" but they are subsidised by the govt. Goodnight..test and off to bed. Helen

Oct 27, 2010 novorapidboi26 1,816 posts	Topic: General Discussion / Insulin Pumps So it is the same as here pretty much.... The NHS provides free healthcare for all (Medicare), and if you want it faster or something more specialised you go private (health fund- some kind of insurance or money up front)......... Theres not many people that I am aware of that have paid for their own pump or went through privately, that I know of in the UK, no doubt there has been....... It seems really pricey for you, could you get it free, but have to wait, and who pays for all the things that come with the pump, canullas, tubing etc..........

Oct 27, 2010 HelenP 218 posts	Topic: General Discussion / Insulin Pumps Where do I start with the health system? This has not been a good year for me. The diabetes, cancer diagnosis followed by fairly serious surgery, non healing incision and now the pump issue. All up I am out of pocket about $1100 for Dr visits and I spend about $150-$160 a month on medication, strips, needles etc. The actual hospital stay (1 week) was completely covered by my health fund. I have been a member since my early 30s and currently pay just less than $2500 a year. I am hoping they pay for the pump in its entirety. First visit to the Diabetes Educator (necessary to get the pump) will cost $200 and I am not sure how much I will be able to claim. Conservative estimate for the whole year will put me out of pocket between $5-6000. As I am a retiree (but not a pensioner) once I reach $1126 out of pocket expenses for Dr visits I will get 80% of what the Dr charges back. I have a visit scheduled for 11/11/2010 to get a certificate entitling me to drive. It will (hopefully) be endorsed with "recognises hypoglycaemia...fit to drive". The Dr will charge $66 and I will be out of pocket about half of that. if I reach the threshold before then I will get $52.90 back. Roll on 2011 and the cure by whatever avenue! So basically we have two platforms...universal health care (Medicare) for all Australian citizens ( and extras! I am assuming you Brits come under the Medicare umbrella but I could be wrong). Then if you want to be able to choose your own Dr, go to the dentist, optometrist etc you join a health fund. There is a tax deduction if you have private health insurance. If you are really sick you get into the public system very quickly but if you require non urgent treatment (eg hip replacement) you are put on a waiting list that can mean a very long wait. Get your pump before you come! I will hopefully know more on 18/11/2010 but I am being fairly aggressively pursued by a pump manufacturer who is offering to walk me through the process and iron out potential glitches. heaven protect me from sales persons! Helen

Oct 27, 2010 novorapidboi26 1,816 posts	Topic: General Discussion / Insulin Pumps I think the only way forward is ginetics to be honest............stem cell research, as I understand is the utilizing of cells that can essentially turn into any cell and perform any function......... Then what? Our own antibodies will still be instructed to attack the newly formed cells...........short term yes, cure no........:-( So how long till you find out about the pump... Also what is the healthcare system like in australia, I though similar to the UK......(maybe hoping to immagrate one day...lol)

Oct 27, 2010 HelenP 218 posts	Topic: General Discussion / Insulin Pumps Yep the pump is just until the cure!

Oct 27, 2010 novorapidboi26 1,816 posts	Topic: General Discussion / Blood sugars since dafne and pump well done from me............. was there much weaking with your basal doses overnight?

Oct 27, 2010 novorapidboi26 1,816 posts	Topic: General Discussion / Insulin Pumps lol......nothing less...........

Oct 27, 2010 HelenP 218 posts	Topic: General Discussion / Insulin Pumps I am constantly surprised when talking to other diabetics the number of them who have not heard about Dafne. I did my course in july 2008 (a work colleague had been referred by her Endo and spoke very highly of the protocols). I understood that there was funding available to run a trial and I was part of that trial. The hospital where I did the course (Mater) no longer offers the course but the Royal Brisbane is currently funded to run Dafne courses. Judging from this forum it seems Dafne is more pervasive in Britain...or at least that is how it seems to me. I have been a diabetic for more than half my life and am amazed at how far we have come. I had an aunt (diabetic) who "lived" on boiled cabbage in the 50's and look where we are now. Roll on stem cell research! I want nothing less than a CURE! Helen

Oct 27, 2010 Kentbabe 10 posts	Topic: General Discussion / "Diabetes results to you" Your help requested hiya David, I prefer the one on the left as it seams to be easier to read nd understand karen