Recent Posts - DAFNE Online

Sep 28, 2010

Annette Bell 72 posts

Topic: DUAG Committee / First draft of DUG letter

Here is the link to my first attempt at writing the letter as promised. Annette :-)

Dear DUG member.doc

Sep 28, 2010

HelenP 218 posts

Topic: Questions for HCPs / wound healing

Thanks Simon,

In spite of my best efforts the BGs are not as good as they have been and I am currently having multiple (up to 8-10) injections a day (the pump you have when you don't have a pump). I have largely kept myself out of trouble (a few hypos in the early mornings) but living this way is no fun. The higher readings are also having an effect on my confidence to manage the diabetes. The reason I am doing the multiple injections (and multiple tests) is that there simply is no pattern to base increases on. I have also modified my eating in that I do not eat anything that I do not have a carb label to dictate the insulin.

The pit/sinus is not infected. So I am really only dealing with the lack of healing (I think).

Thanks for the encouragement. I will keep you all posted.
Helen

Sep 28, 2010

Simon Heller 46 posts

Topic: Questions for HCPs / wound healing

Hi Helen
I am no surgeon but Marke is right. Longstanding diabetes doesn't affect healing unless your blood glucose control is uneven with lots of high glucose values. The cells which fight infection (and those leading to healing and the formation of scar tissue), unsurprisingly work most effectively at a glucose of 5-8 mmol/l. I guess a poor blood supply might also increase the chances of infection but not in the site you mention. If you had impaired kidney function from diabetes that might also add to susceptibility but I guess that isn't an issue there. the low grade infection could be adding to your insulin requirements as well as a bit of emotional stress but as you say insulin doses should fall as things resolve, indeed, this might be the first sign that the infection is improving. I think you are doing all the right things. ATB Simon

Sep 28, 2010

Luggerz 10 posts

Topic: Carbohydrate Counting / Iphone Apps

I've got the Carbs and Cals app and the Dafne app. Just started to load results into the Dafne App and when I try to load results for yesterday it crashes.

Marc

Sep 27, 2010

marke 686 posts

Topic: DUAG Committee / Diabetes UK Volunteer conference Scotland - DUAG attendance?

I guess this is something that would need feedback from Brian ( who is on holiday for at least another week) or Peter. I would point out that is not a one off, there are volunteering conferences all over the country in the coming months. I really should know all the dates since I get sent them in my Diabetes UK voluntary group role, but at the moment can't find the details.
Thats not to say I disagree with Gill, just that I'm not sure if we should just target one event. This obviously needs to be a chair/vice-chair decision.

Sep 27, 2010

marke 686 posts

Topic: Questions for HCPs / wound healing

Helen, i would say your altered insulin requirement is almost certainly do to what you are going through. The stress both emotionally and physically is bound to be having an effect. Its good to hear you GP is supportive but it would be good to hear a Diabetes Consultants take on all of this. There are a lot of factors involved here and its an area where someone with a deep understanding of Diabetes and the effects of things like surgery etc could provide valuable input. They could also probably give you an idea how long the effects on your insulin requirements might last. Perhaps your DAFNE Educator can help with some information ?
I can only wish you well with your recovery and ask that you keep us posted on your progress.

Sep 27, 2010

marke 686 posts

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

now come on Karl, your just being silly now. I rate Simons abilties but more than angry birds ? Its just not possible to use anything more than
that unless of course you have completed ALL the levels ;^)

Sep 27, 2010

SimonC 78 posts

Topic: Carbohydrate Counting / Iphone Apps

I bought the book about 4 months ago - and used it a load when on holiday - eating out a lot, it was very useful.

Sep 27, 2010

marke 686 posts

Topic: Carbohydrate Counting / Iphone Apps

there is, if you want to spend Â£4.99 for something you will be able to get free in the near future (without the pictures of course) feel free too.
Personally I think Â£4.99 for an iphone app is more than a little excessive.

Sep 27, 2010

Becki 1 post

Topic: Carbohydrate Counting / Iphone Apps

Hi, there's an app called carbs and cals it's based on a book of the same name, the app is Â£4.99 and I highly recommend it......if u r not sure have a nose at the actual book in whs or waterstones

Sep 27, 2010

Annette Bell 72 posts

Topic: DUAG Committee / Welcome and Thank You

Hi I can access this no problem. When I write this letter I need to know to whom or where DUG members should reply, and also what do we actually want to know? Are we just asking for general willingness to help should the need arise, or are there specific questions? How long do you want this letter to be? I assume you don't want a long description of what DUAG's aims are? Sorry if I seem a bit vague - but I got home and realised I didn't really have a clear idea of what we actually want to put in this letter or what format it should take. Is it just informative, or are we seeking specific information? If the latter, who should be receiving this info?
Annette

Sep 27, 2010

Karl 83 posts

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

Have to congratulate you on this app - by far the most used app on my phone (even more than angry birds :-)) - the keypad entry changed it totally for me. Not using my written diary anymore.

Sep 27, 2010

Jennifer Iden 11 posts

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

Upgrade to the the iPhone ap makes recording so much simpler, thanks! Although like Karl, I have found that if I change my insulun intake the ratio doesn't update unless I delete the entry and submit a second time...

Sep 27, 2010

Steven 18 posts

Topic: Site Development / Online BG Diaries

Having said that, the second page of readings were accepted without complaint! :-/

Sep 27, 2010

Steven 18 posts

Topic: Site Development / Online BG Diaries

Hi Simon,

I don't seem to be able to leave the date field blank in the diary any more - has something broken?!!?

Thanks
Steven

Sep 27, 2010

digth 19 posts

Topic: DUAG Committee / Diabetes UK Volunteer conference Scotland - DUAG attendance?

Dear All

I wonder if this (see below) is something DUAG would consider attending as exhibitors? We would try to get a discount on the price of exhibiting; may be a good way of raising the profile of DAFNE and DUAG in Scotland.

" Diabetes UK Scotland Volunteering Conference; 27th November 2010 Dean Park Hotel, Chapel Lever, Kirkcaldy, KY2 6QW. The conferences offer the opportunity to hear inspirational speakers, meet others and find out more about Diabetes UK Scotlandâ€™s work. These events will also provide an opportunity for Diabetes UK to say thank you to all its volunteers and recognise the support and contribution our volunteers give to supporting people living with diabetes in Scotland. We are expecting around 130 attendees as well as members of staff from across Diabetes UK and speakers within the field of diabetes research in Scotland. Exhibition space is Â£250 + vat."

We will nee dot know quickly (deadline for applications 1 Nov.
if you want to go to book a spot.

Gill

Sep 27, 2010

Dr Jez McCole 11 posts

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

Developments and updates really making the app quicker and easier to use thanks Simon. The recalculation of the ratio would be a good tweak.
The summary stats are really nice. Any chance of average by entry type, such as average before lunch, average before tea etc? Thanks. I'm DAFNE'ing again!!
Jez

Sep 26, 2010

Simon 578 posts

Topic: Carbohydrate Counting / Iphone Apps

Hi Brien, thanks for letting me know about that - it's already been raised by other users, so I've submitted a fix to the Apple store, should be appearing on shelves in the next couple of days.

Sep 26, 2010

Peter 109 posts

Topic: Questions for HCPs / High bgl in the morning.

Paula,
I would suggest that your evening dose of Levemir is beginning to run out before your morning dose becomes effective, especially when the eveing does is taken between 20:00 and 21:00 (as in most days above) but the morning dose varies between 08:00 and 12:00. That combined with the dawn effect is causing yo to have insufficient insulin available in the early morning. You say that you've increased the evening Levemir, but that resulkts in low sugars, but don't explain when. The one example shown has a low(ish) reading at 12:30 which could be more to do with the correction at 09:30 than too much Levemir.
I know that I found it much easier to achivee more consistent control if I kept the timing of my morning dose of Levemir consistent on weekdays and weekends. It is a bit of a pain having to set the alarm to get up early on Saturday and Sunday just to have an injection, but the resuklts have made it worthwhile, and going back to sleep afterwards is not too difficult.
If it were me, I'd stick with the increased Levelmir does in the evening, and find a consistent time to inject in the morning to see if that helps. NB. That would be nearer 08:00 than 12:00 as, for me, it's effects do reduce after 12 hours.
Good luck.

Sep 26, 2010

HelenP 218 posts

Topic: Questions for HCPs / wound healing

Thanks, Marke,
I don't see anyone at the hospital but I do have a private endocrinologist. When the surgery was scheduled I was between endocrinologists (the old one...I had had him for thirty two years, retired!) I have seen the new one since the surgery and he (Dafne supporter) was happy to leave "the pit" to the surgeon. I understand that the absolute last resort is a surgical repair but according to the surgeon (saw him a week ago and am scheduled to see him in another 3 weeks) says we are a long way from that. He said that what the GP was doing was what he would do!

I really like my GP. He is a bit rattled by Dafne and my propensity to fiddle with doses but other than that he asks appropriate questions and seems happy to leave it to me and the endocrinologist. The GP has not suggested I go back to the endocrinologist for advice over the "pit". (Do you detect my absolute frustration?)

My need for insulin seems to vary quite a bit. Two weeks after surgery (eating as usual) my TDD was 85-88 currently it is over 105! I have about 10CPs a day. I was relieved and confident. I trust it will drop back to somewhere around 90 in the not too distant future.

The GP is supportive of the Dafne protocols and I suspect he has done his homework since taking me on. Currently I am attending his surgery twice a week and under his supervision/direction it (the pit) is being attended to by a nurse. I can't do it at home...not enough hands. His assessment is that it is not getting any better but it is also not getting worse. It is not infected. Any advice I get from here I will discuss with the GP.

Emotionally this is throwing me. The surgery was for cancer (no radiation/no chemotherapy) and the diagnosis was followed a week later by the surgery. It is probably more complicated than just "the pit". This situation is also probably not helping my BGs.

I have just reread this and it looks a bit like a dog's breakfast but I hope it is all there.

Thanks for the psychotherapy!

Helen

Sep 26, 2010

oilly 2 posts

Topic: Carbohydrate Counting / porridge

I have porridge oats every morning for breakfast, my counting and dose works well for me, 40 grams of dried oats is 3 CPs, throw in a handful of raisins (25g to be precise) and that's another 1.5 CPs, add half an apple and half a nectarine another 1 CP, a dollop of natural yogurt another 1/2 CP, a teaspoon honey, 1/2 Cp and your milk another 1/2 CP, total value='s 7CPS and yummy

Sep 26, 2010

oilly 2 posts

Topic: Carbohydrate Counting / Sultanas

i am a sultana/raisin addict, every morning i have a good handful with my muesli, i've since had to start weighing them to get my CPs and dose right, 25g of raisins, which would scantily cover the bottom of a breakfast bowl is worth 1.5 cps

Sep 26, 2010

marke 686 posts

Topic: General Discussion / Split background insulin

I'm glad to hear you will be seeing the hospital thursday, just because I would like them to confrim what you are doing in case you have
any problems. Not that I'm suggesting you will. I am on Levemir which it now seems commonly accepted does not last 24 hours in a lot
of people and so a lot of people are on a split dose. Less people on Lantus split their dose I think, but I'm happy to be corrected by others.
As I said before, I think you will need to give it a few more days before you can spot any patterns and it will probably take a couple of days
before the changes you have made will have full effect. There is nothing wrong with making changes, thats part of what DAFNE is about.
Its just always a good idea to ensure those that support you at the hospital etc, know you have made these changes. Let us know if
the change works for you, since I'm sure others have considered it but not felt confident enough to do it.

Sep 26, 2010

Peter 109 posts

Topic: DUAG Committee / Welcome and Thank You

Thanks Mark. I have no problems in accessing this.

Sep 28, 2010 Annette Bell 72 posts	Topic: DUAG Committee / First draft of DUG letter Here is the link to my first attempt at writing the letter as promised. Annette :-) Dear DUG member.doc

Sep 28, 2010 HelenP 218 posts	Topic: Questions for HCPs / wound healing Thanks Simon, In spite of my best efforts the BGs are not as good as they have been and I am currently having multiple (up to 8-10) injections a day (the pump you have when you don't have a pump). I have largely kept myself out of trouble (a few hypos in the early mornings) but living this way is no fun. The higher readings are also having an effect on my confidence to manage the diabetes. The reason I am doing the multiple injections (and multiple tests) is that there simply is no pattern to base increases on. I have also modified my eating in that I do not eat anything that I do not have a carb label to dictate the insulin. The pit/sinus is not infected. So I am really only dealing with the lack of healing (I think). Thanks for the encouragement. I will keep you all posted. Helen

Sep 28, 2010 Simon Heller 46 posts	Topic: Questions for HCPs / wound healing Hi Helen I am no surgeon but Marke is right. Longstanding diabetes doesn't affect healing unless your blood glucose control is uneven with lots of high glucose values. The cells which fight infection (and those leading to healing and the formation of scar tissue), unsurprisingly work most effectively at a glucose of 5-8 mmol/l. I guess a poor blood supply might also increase the chances of infection but not in the site you mention. If you had impaired kidney function from diabetes that might also add to susceptibility but I guess that isn't an issue there. the low grade infection could be adding to your insulin requirements as well as a bit of emotional stress but as you say insulin doses should fall as things resolve, indeed, this might be the first sign that the infection is improving. I think you are doing all the right things. ATB Simon

Sep 28, 2010 Luggerz 10 posts	Topic: Carbohydrate Counting / Iphone Apps I've got the Carbs and Cals app and the Dafne app. Just started to load results into the Dafne App and when I try to load results for yesterday it crashes. Marc

Sep 27, 2010 marke 686 posts	Topic: DUAG Committee / Diabetes UK Volunteer conference Scotland - DUAG attendance? I guess this is something that would need feedback from Brian ( who is on holiday for at least another week) or Peter. I would point out that is not a one off, there are volunteering conferences all over the country in the coming months. I really should know all the dates since I get sent them in my Diabetes UK voluntary group role, but at the moment can't find the details. Thats not to say I disagree with Gill, just that I'm not sure if we should just target one event. This obviously needs to be a chair/vice-chair decision.

Sep 27, 2010 marke 686 posts	Topic: Questions for HCPs / wound healing Helen, i would say your altered insulin requirement is almost certainly do to what you are going through. The stress both emotionally and physically is bound to be having an effect. Its good to hear you GP is supportive but it would be good to hear a Diabetes Consultants take on all of this. There are a lot of factors involved here and its an area where someone with a deep understanding of Diabetes and the effects of things like surgery etc could provide valuable input. They could also probably give you an idea how long the effects on your insulin requirements might last. Perhaps your DAFNE Educator can help with some information ? I can only wish you well with your recovery and ask that you keep us posted on your progress.

Sep 27, 2010 marke 686 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed now come on Karl, your just being silly now. I rate Simons abilties but more than angry birds ? Its just not possible to use anything more than that unless of course you have completed ALL the levels ;^)

Sep 27, 2010 SimonC 78 posts	Topic: Carbohydrate Counting / Iphone Apps I bought the book about 4 months ago - and used it a load when on holiday - eating out a lot, it was very useful.

Sep 27, 2010 marke 686 posts	Topic: Carbohydrate Counting / Iphone Apps there is, if you want to spend Â£4.99 for something you will be able to get free in the near future (without the pictures of course) feel free too. Personally I think Â£4.99 for an iphone app is more than a little excessive.

Sep 27, 2010 Becki 1 post	Topic: Carbohydrate Counting / Iphone Apps Hi, there's an app called carbs and cals it's based on a book of the same name, the app is Â£4.99 and I highly recommend it......if u r not sure have a nose at the actual book in whs or waterstones

Sep 27, 2010 Annette Bell 72 posts	Topic: DUAG Committee / Welcome and Thank You Hi I can access this no problem. When I write this letter I need to know to whom or where DUG members should reply, and also what do we actually want to know? Are we just asking for general willingness to help should the need arise, or are there specific questions? How long do you want this letter to be? I assume you don't want a long description of what DUAG's aims are? Sorry if I seem a bit vague - but I got home and realised I didn't really have a clear idea of what we actually want to put in this letter or what format it should take. Is it just informative, or are we seeking specific information? If the latter, who should be receiving this info? Annette

Sep 27, 2010 Karl 83 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Have to congratulate you on this app - by far the most used app on my phone (even more than angry birds :-)) - the keypad entry changed it totally for me. Not using my written diary anymore.

Sep 27, 2010 Jennifer Iden 11 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Upgrade to the the iPhone ap makes recording so much simpler, thanks! Although like Karl, I have found that if I change my insulun intake the ratio doesn't update unless I delete the entry and submit a second time...

Sep 27, 2010 Steven 18 posts	Topic: Site Development / Online BG Diaries Having said that, the second page of readings were accepted without complaint! :-/

Sep 27, 2010 Steven 18 posts	Topic: Site Development / Online BG Diaries Hi Simon, I don't seem to be able to leave the date field blank in the diary any more - has something broken?!!? Thanks Steven

Sep 27, 2010 digth 19 posts	Topic: DUAG Committee / Diabetes UK Volunteer conference Scotland - DUAG attendance? Dear All I wonder if this (see below) is something DUAG would consider attending as exhibitors? We would try to get a discount on the price of exhibiting; may be a good way of raising the profile of DAFNE and DUAG in Scotland. " Diabetes UK Scotland Volunteering Conference; 27th November 2010 Dean Park Hotel, Chapel Lever, Kirkcaldy, KY2 6QW. The conferences offer the opportunity to hear inspirational speakers, meet others and find out more about Diabetes UK Scotlandâ€™s work. These events will also provide an opportunity for Diabetes UK to say thank you to all its volunteers and recognise the support and contribution our volunteers give to supporting people living with diabetes in Scotland. We are expecting around 130 attendees as well as members of staff from across Diabetes UK and speakers within the field of diabetes research in Scotland. Exhibition space is Â£250 + vat." We will nee dot know quickly (deadline for applications 1 Nov. if you want to go to book a spot. Gill

Sep 27, 2010 Dr Jez McCole 11 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Developments and updates really making the app quicker and easier to use thanks Simon. The recalculation of the ratio would be a good tweak. The summary stats are really nice. Any chance of average by entry type, such as average before lunch, average before tea etc? Thanks. I'm DAFNE'ing again!! Jez

Sep 26, 2010 Simon 578 posts	Topic: Carbohydrate Counting / Iphone Apps Hi Brien, thanks for letting me know about that - it's already been raised by other users, so I've submitted a fix to the Apple store, should be appearing on shelves in the next couple of days.

Sep 26, 2010 Peter 109 posts	Topic: Questions for HCPs / High bgl in the morning. Paula, I would suggest that your evening dose of Levemir is beginning to run out before your morning dose becomes effective, especially when the eveing does is taken between 20:00 and 21:00 (as in most days above) but the morning dose varies between 08:00 and 12:00. That combined with the dawn effect is causing yo to have insufficient insulin available in the early morning. You say that you've increased the evening Levemir, but that resulkts in low sugars, but don't explain when. The one example shown has a low(ish) reading at 12:30 which could be more to do with the correction at 09:30 than too much Levemir. I know that I found it much easier to achivee more consistent control if I kept the timing of my morning dose of Levemir consistent on weekdays and weekends. It is a bit of a pain having to set the alarm to get up early on Saturday and Sunday just to have an injection, but the resuklts have made it worthwhile, and going back to sleep afterwards is not too difficult. If it were me, I'd stick with the increased Levelmir does in the evening, and find a consistent time to inject in the morning to see if that helps. NB. That would be nearer 08:00 than 12:00 as, for me, it's effects do reduce after 12 hours. Good luck.

Sep 26, 2010 HelenP 218 posts	Topic: Questions for HCPs / wound healing Thanks, Marke, I don't see anyone at the hospital but I do have a private endocrinologist. When the surgery was scheduled I was between endocrinologists (the old one...I had had him for thirty two years, retired!) I have seen the new one since the surgery and he (Dafne supporter) was happy to leave "the pit" to the surgeon. I understand that the absolute last resort is a surgical repair but according to the surgeon (saw him a week ago and am scheduled to see him in another 3 weeks) says we are a long way from that. He said that what the GP was doing was what he would do! I really like my GP. He is a bit rattled by Dafne and my propensity to fiddle with doses but other than that he asks appropriate questions and seems happy to leave it to me and the endocrinologist. The GP has not suggested I go back to the endocrinologist for advice over the "pit". (Do you detect my absolute frustration?) My need for insulin seems to vary quite a bit. Two weeks after surgery (eating as usual) my TDD was 85-88 currently it is over 105! I have about 10CPs a day. I was relieved and confident. I trust it will drop back to somewhere around 90 in the not too distant future. The GP is supportive of the Dafne protocols and I suspect he has done his homework since taking me on. Currently I am attending his surgery twice a week and under his supervision/direction it (the pit) is being attended to by a nurse. I can't do it at home...not enough hands. His assessment is that it is not getting any better but it is also not getting worse. It is not infected. Any advice I get from here I will discuss with the GP. Emotionally this is throwing me. The surgery was for cancer (no radiation/no chemotherapy) and the diagnosis was followed a week later by the surgery. It is probably more complicated than just "the pit". This situation is also probably not helping my BGs. I have just reread this and it looks a bit like a dog's breakfast but I hope it is all there. Thanks for the psychotherapy! Helen

Sep 26, 2010 oilly 2 posts	Topic: Carbohydrate Counting / porridge I have porridge oats every morning for breakfast, my counting and dose works well for me, 40 grams of dried oats is 3 CPs, throw in a handful of raisins (25g to be precise) and that's another 1.5 CPs, add half an apple and half a nectarine another 1 CP, a dollop of natural yogurt another 1/2 CP, a teaspoon honey, 1/2 Cp and your milk another 1/2 CP, total value='s 7CPS and yummy

Sep 26, 2010 oilly 2 posts	Topic: Carbohydrate Counting / Sultanas i am a sultana/raisin addict, every morning i have a good handful with my muesli, i've since had to start weighing them to get my CPs and dose right, 25g of raisins, which would scantily cover the bottom of a breakfast bowl is worth 1.5 cps

Sep 26, 2010 marke 686 posts	Topic: General Discussion / Split background insulin I'm glad to hear you will be seeing the hospital thursday, just because I would like them to confrim what you are doing in case you have any problems. Not that I'm suggesting you will. I am on Levemir which it now seems commonly accepted does not last 24 hours in a lot of people and so a lot of people are on a split dose. Less people on Lantus split their dose I think, but I'm happy to be corrected by others. As I said before, I think you will need to give it a few more days before you can spot any patterns and it will probably take a couple of days before the changes you have made will have full effect. There is nothing wrong with making changes, thats part of what DAFNE is about. Its just always a good idea to ensure those that support you at the hospital etc, know you have made these changes. Let us know if the change works for you, since I'm sure others have considered it but not felt confident enough to do it.

Sep 26, 2010 Peter 109 posts	Topic: DUAG Committee / Welcome and Thank You Thanks Mark. I have no problems in accessing this.