Recent Posts - DAFNE Online

Sep 20, 2010

Benton Fred 7 posts

Hi everyone. My name is Fred and I'm a DAFNE graduate from Newcastle. I'm 34 now and was diagnosed in 2007. I was treated for type 2 for two years before my GP finally realized that there was something wrong when my HbA1c would go below 10!
My initial reaction to DAFNE is fantastic!! We so need to spread the word to other Type 1's. My BG level hasn't been above 8 this weekend.
Anyway this is my first week in the big wide world "alone" so we'll see what happens eh?
C U all soon. X

Fred

Sep 19, 2010

Simon Heller 46 posts

Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present

You could although 7 injections might be considered a bit excessive by some, it was done in a clinical trial and got pretty good control for those who put up with it but hasn't caught on, on the basis that it is not really practical. Simon

Sep 18, 2010

marke 681 posts

Topic: DUAG Committee / DUAG Presentation Template

As an example of the fact you can reference documents here is the template powepoint I sent
before the September meeting. Just click on the name below:

DAFNE Action User Group.pps

Sep 18, 2010

Alan 49 284 posts

Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present

Instead of 'free mixing', why can't you give yourself your dose of QA insulin and then the small dose of BI from a different pen?

Alan

Sep 17, 2010

Simon Heller 46 posts

Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present

Sorry about the jargon, it means using a traditional syringe and needle (not many people using disposable syringes any more) and drawing up the two different insulins from vials. very complicated and old fashioned and impractical.

Sep 17, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present

what do you mean by free mixing of insulin??

Sep 17, 2010

kid127 25 posts

Topic: Questions for HCPs / Alternative injection sites

thanks for the replies to this. since i posted i was moved on to 5mm needles which helped but i've also been referred for a pump which should fix the problem altogether hopefully!

i was having random highs and lows that i couldnt sort using dafne principles but after talking it over with the pump nuse she thinks its all down to my injection sites

i'll try your tip until i get the pump tho heather b, thanks!

Sep 17, 2010

Simon Heller 46 posts

Topic: Questions for HCPs / dawn phenomenon... how to stop the rise?

I don't think a 2 day carb free approach is a great idea as cutting out carbs from the diet will tend to reduce blood glucose more generally and provide an artificially low glucose profile, a 12-24h period should be sufficient to measure the effect of background insulin alone. I also agree that twice daily Detemir is probably the best of relatively limited long acting insulins. At least two of the insulin companies are working on even longer acting insulins but whether they will prove more useful is yet to be shown. Simon

Sep 17, 2010

Simon Heller 46 posts

Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present

Actually there is some evidence that multiple small doses of an insulin such as Humulin I or Insulatard with each meal alongside quick acting insulin does work pretty well but it does involve free mixing of insulin in syringes so not terribly practical. on the basis that an insulin pump replaces background insulin most effectively then probably for those who are prepared to be pushing the envelope in terms of glucose control and effective self management, this is probably the best solution, that is if a pump is acceptable. Simon

Sep 17, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Mystery!!!!!!!!!!!!!!

It seems to be getting that way now...last week was not as consistent...........I will be trying the higher ratio today at lunchtime...........

I really wanted to reduce my TDD...........oh well.....needs must and all that...

Cheers Si.......

Sep 16, 2010

Simon 578 posts

Topic: General Discussion / Mystery!!!!!!!!!!!!!!

Hi novorapidboi, have you tried upping you ratio at lunchtime to 2:1? The rise from Lunch to the next reading seems to be pretty consistent in how much it goes up (for the last 2 days anyway)

Sep 16, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Mystery!!!!!!!!!!!!!!

Those two days were identical in terms of food and activity before and during lunch....... its a pain.....

Usually I am about 12-15, but the last week and a half I have been rising with those high numbers, 17 yesterday, 13 today.....had some wine last nght though explaining the drop......

I have done 3 am bloods every now and again and they are fine, its seems to be the 4 and 5 am it will start to rise.........I agree it does seem excessive, and its a struggle to get going......

Might need a pump soon.......

Sep 16, 2010

Mark2 23 posts

Topic: General Discussion / Mystery!!!!!!!!!!!!!!

Interesting novorapidboi. The main worry in that small sample is the readings you are getting in mornings - very high. Going to bed with 3.5 and waking up with 17.3. This is very unusual. It is vaguely possible that you are going LOW overnight, and you liver is releasing sugar to cover for this low. Its such a huge rise that you are seeing. Pretty dangerous I have to say. Try setting an alarm overnight and testing at 3 or 4 in the morning might help you to decipher what is going on.

As for the inconsistency over lunch - it could be a variety of things affecting this. Alcohol - excersise for example. The huge rise in the morning and its subsequent recovery will affect things also.

Sep 16, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Insulin Pumps

I have no direct experience with a pump but I believe it would be good for you seeing as you are so sensitive to insulin...........

The doses that can be delivered are minute........and hopefully as you adjust to getting the dose right you will see a rise in avergae sugar levels ,which might make you feel rough but will give you back your hypo awareness.......

To me is sounds like your only option to really get a hold of it........

I am a member of www.diabetessupport.co.uk....

They have a pumping section in thier forum where many a pumper is there to give advice and support, a few are using the medtronic, hope to see you there..........

Sep 16, 2010

Davejg 6 posts

Topic: General Discussion / Insulin Pumps

I have been diabetic for 38 years and have just been offered a pump but am really unsure about it.
I am very sensitive to insulin and 1 unit can make a huge difference. Have lost all warning signs of hypos and have been as low as 1.2 still standing but somewhat confused ,below 2 is a regular occurence and as I live on my own could be quite dangerous. I dont know why but my insulin /cp ratio changes from day to day. I work hard at trying to keep control but seem to be fighting a losing battle my HB is 8 at the moment and has rarely been much higher than that but this is only because of large swings in my blood sugars. I was told to run my blood sugars higher but this will end with nasty complications .
I have searched for information on the internet but seems very sketchy and mainly american based.
I have been told i would be getting a medtronic pump but cant find anything that usefull on the internet.
I am a bit of a techno phope have trouble with a mobile phone so god knows how i woold get on with something that is basically going to keep me alive .
Really want to know if they really are a lot better for maintaining a good and stable blood glucose.
At the moment I am just a little scared and very depressed

Sep 16, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / I want an insulin pump

Congratulations jenny.........

The stories I have heard have been all positive........takes a while to get doses bang on but once your there you will never go back.......

I am still injecting, but depending on the next 6 months reading I think I may be enquiring....

Keep us updated............

Sep 16, 2010

Jennypenny 34 posts

Topic: General Discussion / I want an insulin pump

I now know that i have funding for my pump , i go and get it on the 28th of september , a little bit anxious now its getting nearer but hopefully i will see big changes . Fingers crossed .....

Sep 15, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Mystery!!!!!!!!!!!!!!

Dont you just love the unpredictability of diabetes....

Focusing on the post lunch readings at about 14:00.

I have the same thing for lunch everyday.......

Sep 14, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Introductions

Welcome maria...........thats unfortunate you couldnt get the full benefits of the course and it may be unlikely you could get any special attention from your health care proffesionals if the course is in high demand.........

Remember the course handbook is on the website, so you can read through it and ask questions as they arise on the forum, as well as graduates there are HCPs here who can give you there professional opinion. Not seen alot on here lately but that will be down to how busy they are rolling out DAFNE and attending clinics........

Glad to have you on board........feel free to ask lots of questions.........

Sep 14, 2010

Heather B 20 posts

Topic: Questions for HCPs / Alternative injection sites

Hello, Its maybe a bit late to reply to this post now but I've had the same issues as you with regards to painful injection sites as I too am really thin and it is really difficult for me to find enough fat to inject comfortably in to (I also use the 6mm needles). At my DAFNE course recently a nurse had a look at my injection sites (which were all marked with purple bruises) and suggested that my injection technique could be improved to make the injections less painful. She thought that I might be injecting with too much force for such a thin area. I have since been practicing by resting the needle on my skin and then very gently but quickly sliding the needle into my skin, it still stings slightly for a few seconds afterwards but I am definitely bruising much less often and the sting doesn't last nearly as long as it did before. Perhaps you could try being more gentle with your injections too and see if it then less painful, we really don't need any force at all on thin areas as there is no real resistance there. I hope it gets easier.

Sep 14, 2010

maria51 22 posts

Topic: General Discussion / Introductions

Hey All, my name's Maria from Melbourne Australia. I've had Type 1 for 14 months & finished Dafne in August but can't say I "graduated" as I missed alot of what was being said because of 50% hearing loss (listening to too many live bands) but the stuff I did hear, is actually working to some extent ! Need to go back & do another stint at Dafne (with a hearing aid) as I still don't know enough to keep my BGLs stable for my satisfaction.
I just have to say that this forum, & reading how you guys give support to one another, is truly amazing ! Being partly deaf isolates me from people, but being deaf & dealing with diabetes was too much to handle as I knew no one else who had it, until I was connected to this site. WOW, now I can "listen" & learn more from all of you. I'm not isolated anymore ! ! Cheers Smile

Sep 14, 2010

Widster 23 posts

Topic: General Discussion / Introductions

Hi Heather,

Just to let you know that i am currently 39 years old and i was diagnosed when i was 33 too. I also went on the DAFNE course a year after diagnosis. It works well for me although my HbA1c has gone up recently as i have become a bit lazy although now trying to get it back on track. Good luck with it all. You are not alone!

Cheers,
Paul

Sep 14, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / loosing the plot!

Cant really add to whats been said, but ask that you fire up the results again with the full diary completed......

I say that assuming you have actually eaten over the weekend, but you might not have.......

I suspect a problem with your basal (detemir) dose.......I think the dose and timing of this should be experimented on with the help of your team if you need it..........

Sep 20, 2010 Benton Fred 7 posts	Topic: General Discussion / Hello! Hi everyone. My name is Fred and I'm a DAFNE graduate from Newcastle. I'm 34 now and was diagnosed in 2007. I was treated for type 2 for two years before my GP finally realized that there was something wrong when my HbA1c would go below 10! My initial reaction to DAFNE is fantastic!! We so need to spread the word to other Type 1's. My BG level hasn't been above 8 this weekend. Anyway this is my first week in the big wide world "alone" so we'll see what happens eh? C U all soon. X Fred

Sep 19, 2010 Simon Heller 46 posts	Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present You could although 7 injections might be considered a bit excessive by some, it was done in a clinical trial and got pretty good control for those who put up with it but hasn't caught on, on the basis that it is not really practical. Simon

Sep 18, 2010 marke 681 posts	Topic: DUAG Committee / DUAG Presentation Template As an example of the fact you can reference documents here is the template powepoint I sent before the September meeting. Just click on the name below: DAFNE Action User Group.pps

Sep 18, 2010 Alan 49 284 posts	Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present Instead of 'free mixing', why can't you give yourself your dose of QA insulin and then the small dose of BI from a different pen? Alan

Sep 17, 2010 Simon Heller 46 posts	Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present Sorry about the jargon, it means using a traditional syringe and needle (not many people using disposable syringes any more) and drawing up the two different insulins from vials. very complicated and old fashioned and impractical.

Sep 17, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present what do you mean by free mixing of insulin??

Sep 17, 2010 kid127 25 posts	Topic: Questions for HCPs / Alternative injection sites thanks for the replies to this. since i posted i was moved on to 5mm needles which helped but i've also been referred for a pump which should fix the problem altogether hopefully! i was having random highs and lows that i couldnt sort using dafne principles but after talking it over with the pump nuse she thinks its all down to my injection sites i'll try your tip until i get the pump tho heather b, thanks!

Sep 17, 2010 Simon Heller 46 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? I don't think a 2 day carb free approach is a great idea as cutting out carbs from the diet will tend to reduce blood glucose more generally and provide an artificially low glucose profile, a 12-24h period should be sufficient to measure the effect of background insulin alone. I also agree that twice daily Detemir is probably the best of relatively limited long acting insulins. At least two of the insulin companies are working on even longer acting insulins but whether they will prove more useful is yet to be shown. Simon

Sep 17, 2010 Simon Heller 46 posts	Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present Actually there is some evidence that multiple small doses of an insulin such as Humulin I or Insulatard with each meal alongside quick acting insulin does work pretty well but it does involve free mixing of insulin in syringes so not terribly practical. on the basis that an insulin pump replaces background insulin most effectively then probably for those who are prepared to be pushing the envelope in terms of glucose control and effective self management, this is probably the best solution, that is if a pump is acceptable. Simon

Sep 17, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Mystery!!!!!!!!!!!!!! It seems to be getting that way now...last week was not as consistent...........I will be trying the higher ratio today at lunchtime........... I really wanted to reduce my TDD...........oh well.....needs must and all that... Cheers Si.......

Sep 16, 2010 Simon 578 posts	Topic: General Discussion / Mystery!!!!!!!!!!!!!! Hi novorapidboi, have you tried upping you ratio at lunchtime to 2:1? The rise from Lunch to the next reading seems to be pretty consistent in how much it goes up (for the last 2 days anyway)

Sep 16, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Mystery!!!!!!!!!!!!!! Those two days were identical in terms of food and activity before and during lunch....... its a pain..... Usually I am about 12-15, but the last week and a half I have been rising with those high numbers, 17 yesterday, 13 today.....had some wine last nght though explaining the drop...... I have done 3 am bloods every now and again and they are fine, its seems to be the 4 and 5 am it will start to rise.........I agree it does seem excessive, and its a struggle to get going...... Might need a pump soon.......

Sep 16, 2010 Mark2 23 posts	Topic: General Discussion / Mystery!!!!!!!!!!!!!! Interesting novorapidboi. The main worry in that small sample is the readings you are getting in mornings - very high. Going to bed with 3.5 and waking up with 17.3. This is very unusual. It is vaguely possible that you are going LOW overnight, and you liver is releasing sugar to cover for this low. Its such a huge rise that you are seeing. Pretty dangerous I have to say. Try setting an alarm overnight and testing at 3 or 4 in the morning might help you to decipher what is going on. As for the inconsistency over lunch - it could be a variety of things affecting this. Alcohol - excersise for example. The huge rise in the morning and its subsequent recovery will affect things also.

Sep 16, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Insulin Pumps I have no direct experience with a pump but I believe it would be good for you seeing as you are so sensitive to insulin........... The doses that can be delivered are minute........and hopefully as you adjust to getting the dose right you will see a rise in avergae sugar levels ,which might make you feel rough but will give you back your hypo awareness....... To me is sounds like your only option to really get a hold of it........ I am a member of www.diabetessupport.co.uk.... They have a pumping section in thier forum where many a pumper is there to give advice and support, a few are using the medtronic, hope to see you there..........

Sep 16, 2010 Davejg 6 posts	Topic: General Discussion / Insulin Pumps I have been diabetic for 38 years and have just been offered a pump but am really unsure about it. I am very sensitive to insulin and 1 unit can make a huge difference. Have lost all warning signs of hypos and have been as low as 1.2 still standing but somewhat confused ,below 2 is a regular occurence and as I live on my own could be quite dangerous. I dont know why but my insulin /cp ratio changes from day to day. I work hard at trying to keep control but seem to be fighting a losing battle my HB is 8 at the moment and has rarely been much higher than that but this is only because of large swings in my blood sugars. I was told to run my blood sugars higher but this will end with nasty complications . I have searched for information on the internet but seems very sketchy and mainly american based. I have been told i would be getting a medtronic pump but cant find anything that usefull on the internet. I am a bit of a techno phope have trouble with a mobile phone so god knows how i woold get on with something that is basically going to keep me alive . Really want to know if they really are a lot better for maintaining a good and stable blood glucose. At the moment I am just a little scared and very depressed

Sep 16, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / I want an insulin pump Congratulations jenny......... The stories I have heard have been all positive........takes a while to get doses bang on but once your there you will never go back....... I am still injecting, but depending on the next 6 months reading I think I may be enquiring.... Keep us updated............

Sep 16, 2010 Jennypenny 34 posts	Topic: General Discussion / I want an insulin pump I now know that i have funding for my pump , i go and get it on the 28th of september , a little bit anxious now its getting nearer but hopefully i will see big changes . Fingers crossed .....

Sep 15, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Mystery!!!!!!!!!!!!!! Dont you just love the unpredictability of diabetes.... Focusing on the post lunch readings at about 14:00. I have the same thing for lunch everyday.......

Sep 14, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Introductions Welcome maria...........thats unfortunate you couldnt get the full benefits of the course and it may be unlikely you could get any special attention from your health care proffesionals if the course is in high demand......... Remember the course handbook is on the website, so you can read through it and ask questions as they arise on the forum, as well as graduates there are HCPs here who can give you there professional opinion. Not seen alot on here lately but that will be down to how busy they are rolling out DAFNE and attending clinics........ Glad to have you on board........feel free to ask lots of questions.........

Sep 14, 2010 Heather B 20 posts	Topic: Questions for HCPs / Alternative injection sites Hello, Its maybe a bit late to reply to this post now but I've had the same issues as you with regards to painful injection sites as I too am really thin and it is really difficult for me to find enough fat to inject comfortably in to (I also use the 6mm needles). At my DAFNE course recently a nurse had a look at my injection sites (which were all marked with purple bruises) and suggested that my injection technique could be improved to make the injections less painful. She thought that I might be injecting with too much force for such a thin area. I have since been practicing by resting the needle on my skin and then very gently but quickly sliding the needle into my skin, it still stings slightly for a few seconds afterwards but I am definitely bruising much less often and the sting doesn't last nearly as long as it did before. Perhaps you could try being more gentle with your injections too and see if it then less painful, we really don't need any force at all on thin areas as there is no real resistance there. I hope it gets easier.

Sep 14, 2010 maria51 22 posts	Topic: General Discussion / Introductions Hey All, my name's Maria from Melbourne Australia. I've had Type 1 for 14 months & finished Dafne in August but can't say I "graduated" as I missed alot of what was being said because of 50% hearing loss (listening to too many live bands) but the stuff I did hear, is actually working to some extent ! Need to go back & do another stint at Dafne (with a hearing aid) as I still don't know enough to keep my BGLs stable for my satisfaction. I just have to say that this forum, & reading how you guys give support to one another, is truly amazing ! Being partly deaf isolates me from people, but being deaf & dealing with diabetes was too much to handle as I knew no one else who had it, until I was connected to this site. WOW, now I can "listen" & learn more from all of you. I'm not isolated anymore ! ! Cheers

Sep 14, 2010 Widster 23 posts	Topic: General Discussion / Introductions Hi Heather, Just to let you know that i am currently 39 years old and i was diagnosed when i was 33 too. I also went on the DAFNE course a year after diagnosis. It works well for me although my HbA1c has gone up recently as i have become a bit lazy although now trying to get it back on track. Good luck with it all. You are not alone! Cheers, Paul

Sep 14, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / loosing the plot! Cant really add to whats been said, but ask that you fire up the results again with the full diary completed...... I say that assuming you have actually eaten over the weekend, but you might not have....... I suspect a problem with your basal (detemir) dose.......I think the dose and timing of this should be experimented on with the help of your team if you need it..........