Recent Posts - DAFNE Online

Sep 11, 2010

gasmark 2 posts

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

Hi I've just recently started using the iPhone app
Great idea but all I can do is input readings
Then I don't know where they go?
How do you view the multiple readings?
How do you sync it with the online diary?
And any chance of incorporating graphs
Mark
Graduate 2009

Sep 11, 2010

stacyedgington 5 posts

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

well it was suggested to me on here, and I did check with my doctor and they said it is an option, I just had to monitor myself very closely and I did snack on greens just no carbs and nothing with additives in so I could be as basically fasting as possible. I thought it was odd but my doctors said that there shouldnt be an issue if im not injecting QA. The thing is nobody knows exactly how long carbs have an affect on people, and it could change from person to person, thats apparently why they say 2 days, so your system is completely clear.
AAAanywhos, I do not know, I have had diabetes for... a long time, but this whole watching it thing is quite new to me, and im learning from everyone so maybe my docs were idiots, but I didnt find it too hard as I dont eat big meals anyway, so yay! haha.

Yeah I found it very strange about the fact that everyone on my course knew I was suffering from really low BG levels as I woke with the Lantus but to be honest it wasn't daily, it was happening twice a week on average, and the rest of the time i wasnt really checking my BG levels on waking up... during the DAFNE week I was, and I found that every morning it was significantly higher (around 20-24) then my evening BG levels... with no real explanation as my 2am bg levels were around the same (6- Cool

as my bedtime levels. However, pre dafne my lantus dose had been 42, and on the thursday before the dafne nurses dropped me to 30, and during the dafne week to 25, which could explain why it happened so suddenly that the high levels occured, cause it was being masked by a massive dose of lantus previously that wasnt allowing the BG levels to rise?.

I am on split dose levemir yes... I think looking at my bg levels it was the obvious thing to do really and I am happy doing that extra injection for the freedom I get with it compared to Lantus. Its soooo difficult all the DAFNE stuff, such a steep learning curve hey!

Sep 10, 2010

marke 684 posts

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

stacy, 'told on here to do it' ? when and by whom, it doesnt sound like very sound advice to me and I would never try it without checking with my DAFNE Educator/Diabetes Team first. I don't agree that carbs you eat can have an effect in excess of 24 hours, thats a very strange idea. I can see the benefit of a carb free meal to check BI but not 2 days of it.
I'm not sure that you can prove your its your BI or dawn apart from maybe testing at 3am, at this time your BG is usually at its lowest and
should not go lower if your BI is correct, however as always there are always exceptions. Generally dawn would kick in around 5am but again not guaranteed. This would normally push up your BG, due to hormones bouncing around getting you read to get up and start the day.
Still if you have already done the 2 day fast then at least it would give you an fairly good idea how your BI is working and as novoboi says
not sure we would have the dedication to do that ! Hopefully it was worth it.
Its also strange that you didn't get it with Lantus, since its apparently not something that comes and goes but rather something that happens consistently all the time. However Lantus is supposed to have a longer profile than levimir, so that 'might' explain. Are you on a split dose of levemir ? Since in many people including me it doesn't last 24 hours and needs splitting into 2 doses to make it 'last' the full 24 hours.

Sep 10, 2010

novorapidboi26 1,819 posts

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

I dont know if i could do that...........if you take your single dose at night or if your split you can see if it works if you rise the same as you went to bed with................have you tried that............I suppose it might be hard to establish if it works if your suffering from dawn phenomonon...........oh its a hard life..................

Sep 10, 2010

stacyedgington 5 posts

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

id been told on here to do it, apparently you dont eat for 2 days, and therefore dont do any of your fast acting insulin... just your BI. then you can see whether the bi is working, cause if it is you shouldnt see a rise or fall in your bg all day. they say do it for 2 days cause obviously on the first day things can still be influencing your bg's from the previous day, but by the second it should all be down to the bi. Then you can see that it definately isn't your background insulin being too low causing the rise from bed time bg levels to morning bg levels. x

Sep 10, 2010

ThunderBolt 28 posts

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

Sorry folks. Me again. You'll probably be getting sick of me by now but I've just had a thought and as I'll more than likely forget it it's best I post now.Â

Further to the start/end day idea, would it be better to have a button - if that's the right word - to start or end a days entry? The reason I say this is that you may well get up or go to bed at different times. Especially if you work shifts for example.Â

Sep 10, 2010

ThunderBolt 28 posts

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

Thanks for the encouragement regarding the ratios.Â

BI reminders sound a great idea. Especially when you're making alterations as I for one have reverted back to a dose from a day or 2 before when I've forgot about the alteration I made. I know I know. I'm a berk. Heheh!

Thanks to you both as well for the positive feedback on the start day times. I feel like a computer programmer without the hard work or knowledge. Â

Nice one Simon. Thanks again... Again!

Sep 10, 2010

novorapidboi26 1,819 posts

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

2 day fast, how does that work?

Sep 10, 2010

stacyedgington 5 posts

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

and well done novo!!! I just read your morning bg... awesome!!!

Sep 10, 2010

stacyedgington 5 posts

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

Thank you novo...
Pre DAFNE I was on Lantus, and the exact opposite was happening... I would be waking up with lows of around 1.5, its so odd!

I've been trying everything you suggested... a pre bedtime snack with quick acting didnt make any difference, but I did do a 2 day fast and the high morning glucose levels didn't happen. So I'm wondering if it is something to do with my fast acting not being right. I am going to try eating a carb free dinner for a few days and see if that makes any difference. Im also gonna have to try and stop sleeping through my alarm at 2am and check my bg to see if it is rising or not then. They had said on the DAFNE course that I was a prime candidate for a pump as I exercise a lot and cant manage my insulin around it very well, so maybe that is an option. Anyways. Thank you so much for the advice, your a star!

Martina... I haven't ever been woken with a high, but that sounds awful! I would reccomend you taking the advice novo gave me and play around a bit with seeing what the cause is. The 2 day fast I had was hard, but it has cleared a lot up for me so i would deffo reccomend that. xx

Sep 10, 2010

Simon 578 posts

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

Hi both,

I usually go to bed quite late so can identify with this too. I've just submitted the latest update to the app store for approval so this won't be in that version, however should hit the next one. If I'm right - you're after a setting the say when the 'day' starts and ends - so in the settings part you could enter a time, then the diary would be grouped by periods of that time?

On the BI remembering - yep good idea, I'll put it on the list for the next version too.

Simon

Sep 10, 2010

novorapidboi26 1,819 posts

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

Thats quite strange to get a high at 2am, and even stranger to be woken by it, must of been really high....

I think you should up your evening dose of background, assuming your on a split dose......if not on split I would consider it so your getting the most out of the background when you need it in the small hours...

This morning I woke up with a 9.2 which is good for me......I was 13.2 before bed, so I took 2 units of novo and actually dropped by background 4 units (i had previously increased it to try and tackle dawn).......

I am hoping I can achieve a smiliar result again.....I feel so much better this morning.........

Sep 9, 2010

angelaallison 7 posts

Topic: General Discussion / Diabetes Power Product Awareness Event

Hello,

In October 2010 in Chorley Lancashire, we are hosting a Diabetes Product Awareness Event for anyone who has diabetes or cares for someone with diabetes. Bayer, Roche, Animas, Medtronic, Lifescan, Home Diagnostics, Juvela (gluten free food) for further details, please visit www.diabetespower.org.uk

The event is free. Please come along or if you know anyone who may be interested please pass on the information.

Best wishes

Angela

Sep 9, 2010

Dr Jez McCole 11 posts

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

That sounds like a great idea Thunderbolt - I would find my end of day BI shots being recorded in the right place then too.
Keep going with the ratios - having different ratios for each meal is not uncommon and once you've cracked it you'll find things fall into place a little easier. Doesnt remove the need for corrections from time to time though. My QA:CP ratios are breakfast 0.5:1 - Lunch 1:1 - and tea 2:1! But you soon remember it.

Can I also suggest that since BI doses don't vary as much as QA ones that the previous BI for morning and previous BI for evening is remembered as a starting point for the following day's entry? Not sure if that's possible or not and it would only be a convenience thing.

Sep 9, 2010

Martina 1 post

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

I have also experienced the 'dawn' phenomenon, but sometimes I wake with a high headache around 2am and correct with Novorapid, but it seems to have little effect, and I end up correcting again before the night is out. Has anyone else had this problem?
Martina

Sep 9, 2010

ThunderBolt 28 posts

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

I see now why you say CP then BG. It's just a matter of getting used to it I suppose. My results are a bit high at the moment and I think I'm going to have to play around with my ratios - maybe having different ratios at different times of the day. Oh ''eck!!!

I do have one suggestion though that I think a lot of people would find useful. I'm not much of a sleeper and find I do a lot of testing after midnight so perhaps a start of day time could be added so that the before bed results don't show as before before breakfast.Â

Top work though. I'm still getting my feet wet but I'm getting there!

Sep 8, 2010

Dr Jez McCole 11 posts

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

If all is running well and the QA:CP ratios are right then there won't be much in the way of correctional doses to add to the QA BI totals.
However, in the real world, a corrective dose is making up for the inaccuracies of the previous QA:CP ratio.
In terms of the purpose behind knowing your TDD - it is all about what you have needed to keep your sugar controlled. The weighting of corrective doses in the overall calculation for TDD, that is in turn then used in subdivided doses on a sick day, should be so small that it makes little difference. If it makes a big difference then someone's ratios or BIs are well off anyway and any corrections ought to be counted.
All the best
Jez

Sep 8, 2010

Garry 328 posts

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

Rightly or wrongly! -
I have taken the rules to imply that it includes corrective QA
- it seems logical to me that if you are building up over a number of days to bringing in sick day rules to include any correctives that you have had to apply over the preceding day in order to get hold of the situation quickly.
Welcome any corrective response from HCP please.

Regards Garry

Sep 8, 2010

Simon 578 posts

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

I'm just working on the summary report for the BG, and have a question - does the TDD include corrective doses of QA? The handbook seems unclear and just gives the formula Total QA + Total BI in a day...

I've never had to calculate my own TDD so haven't come across this before.

Sep 8, 2010

Simon 578 posts

Topic: Carbohydrate Counting / Iphone Apps

Hi Brien - good spot, that will be fixed for the next update.

Sep 8, 2010

Brien Molloy 4 posts

Topic: Carbohydrate Counting / Iphone Apps

One small snag if it is left running in background overnight when you input the next day the results won't show up until the is fully closed by double clicking the home button and then holding down an app until a horz red line appears. Still great app and with carb food cp access of web page np need to carry my cp book

Sep 8, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / McD's

your lucky, my local mcdonalds staff wouldnt know what i was talking about.......

Most buns are 3CP and the bigger ones are 4CP............

Sep 8, 2010

Stew B 125 posts

Topic: Carbohydrate Counting / McD's

Not that I'm obsessed you understand... found ourselves at our local McD's again yesterday evening and chose the current special from the menu, only to discover that it hadn't made it onto the nutrition list. Undaunted Mrs B approached a staff member, and the duty manager went off to his office and came back with the carb value for me. Worth knowing..

Sep 11, 2010 gasmark 2 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi I've just recently started using the iPhone app Great idea but all I can do is input readings Then I don't know where they go? How do you view the multiple readings? How do you sync it with the online diary? And any chance of incorporating graphs Mark Graduate 2009

Sep 11, 2010 stacyedgington 5 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? well it was suggested to me on here, and I did check with my doctor and they said it is an option, I just had to monitor myself very closely and I did snack on greens just no carbs and nothing with additives in so I could be as basically fasting as possible. I thought it was odd but my doctors said that there shouldnt be an issue if im not injecting QA. The thing is nobody knows exactly how long carbs have an affect on people, and it could change from person to person, thats apparently why they say 2 days, so your system is completely clear. AAAanywhos, I do not know, I have had diabetes for... a long time, but this whole watching it thing is quite new to me, and im learning from everyone so maybe my docs were idiots, but I didnt find it too hard as I dont eat big meals anyway, so yay! haha. Yeah I found it very strange about the fact that everyone on my course knew I was suffering from really low BG levels as I woke with the Lantus but to be honest it wasn't daily, it was happening twice a week on average, and the rest of the time i wasnt really checking my BG levels on waking up... during the DAFNE week I was, and I found that every morning it was significantly higher (around 20-24) then my evening BG levels... with no real explanation as my 2am bg levels were around the same (6- as my bedtime levels. However, pre dafne my lantus dose had been 42, and on the thursday before the dafne nurses dropped me to 30, and during the dafne week to 25, which could explain why it happened so suddenly that the high levels occured, cause it was being masked by a massive dose of lantus previously that wasnt allowing the BG levels to rise?. I am on split dose levemir yes... I think looking at my bg levels it was the obvious thing to do really and I am happy doing that extra injection for the freedom I get with it compared to Lantus. Its soooo difficult all the DAFNE stuff, such a steep learning curve hey!

Sep 10, 2010 marke 684 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? stacy, 'told on here to do it' ? when and by whom, it doesnt sound like very sound advice to me and I would never try it without checking with my DAFNE Educator/Diabetes Team first. I don't agree that carbs you eat can have an effect in excess of 24 hours, thats a very strange idea. I can see the benefit of a carb free meal to check BI but not 2 days of it. I'm not sure that you can prove your its your BI or dawn apart from maybe testing at 3am, at this time your BG is usually at its lowest and should not go lower if your BI is correct, however as always there are always exceptions. Generally dawn would kick in around 5am but again not guaranteed. This would normally push up your BG, due to hormones bouncing around getting you read to get up and start the day. Still if you have already done the 2 day fast then at least it would give you an fairly good idea how your BI is working and as novoboi says not sure we would have the dedication to do that ! Hopefully it was worth it. Its also strange that you didn't get it with Lantus, since its apparently not something that comes and goes but rather something that happens consistently all the time. However Lantus is supposed to have a longer profile than levimir, so that 'might' explain. Are you on a split dose of levemir ? Since in many people including me it doesn't last 24 hours and needs splitting into 2 doses to make it 'last' the full 24 hours.

Sep 10, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? I dont know if i could do that...........if you take your single dose at night or if your split you can see if it works if you rise the same as you went to bed with................have you tried that............I suppose it might be hard to establish if it works if your suffering from dawn phenomonon...........oh its a hard life..................

Sep 10, 2010 stacyedgington 5 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? id been told on here to do it, apparently you dont eat for 2 days, and therefore dont do any of your fast acting insulin... just your BI. then you can see whether the bi is working, cause if it is you shouldnt see a rise or fall in your bg all day. they say do it for 2 days cause obviously on the first day things can still be influencing your bg's from the previous day, but by the second it should all be down to the bi. Then you can see that it definately isn't your background insulin being too low causing the rise from bed time bg levels to morning bg levels. x

Sep 10, 2010 ThunderBolt 28 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Sorry folks. Me again. You'll probably be getting sick of me by now but I've just had a thought and as I'll more than likely forget it it's best I post now.Â Further to the start/end day idea, would it be better to have a button - if that's the right word - to start or end a days entry? The reason I say this is that you may well get up or go to bed at different times. Especially if you work shifts for example.Â

Sep 10, 2010 ThunderBolt 28 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Thanks for the encouragement regarding the ratios.Â BI reminders sound a great idea. Especially when you're making alterations as I for one have reverted back to a dose from a day or 2 before when I've forgot about the alteration I made. I know I know. I'm a berk. Heheh! Thanks to you both as well for the positive feedback on the start day times. I feel like a computer programmer without the hard work or knowledge. Â Nice one Simon. Thanks again... Again!

Sep 10, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? 2 day fast, how does that work?

Sep 10, 2010 stacyedgington 5 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? and well done novo!!! I just read your morning bg... awesome!!!

Sep 10, 2010 stacyedgington 5 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? Thank you novo... Pre DAFNE I was on Lantus, and the exact opposite was happening... I would be waking up with lows of around 1.5, its so odd! I've been trying everything you suggested... a pre bedtime snack with quick acting didnt make any difference, but I did do a 2 day fast and the high morning glucose levels didn't happen. So I'm wondering if it is something to do with my fast acting not being right. I am going to try eating a carb free dinner for a few days and see if that makes any difference. Im also gonna have to try and stop sleeping through my alarm at 2am and check my bg to see if it is rising or not then. They had said on the DAFNE course that I was a prime candidate for a pump as I exercise a lot and cant manage my insulin around it very well, so maybe that is an option. Anyways. Thank you so much for the advice, your a star! Martina... I haven't ever been woken with a high, but that sounds awful! I would reccomend you taking the advice novo gave me and play around a bit with seeing what the cause is. The 2 day fast I had was hard, but it has cleared a lot up for me so i would deffo reccomend that. xx

Sep 10, 2010 Simon 578 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Hi both, I usually go to bed quite late so can identify with this too. I've just submitted the latest update to the app store for approval so this won't be in that version, however should hit the next one. If I'm right - you're after a setting the say when the 'day' starts and ends - so in the settings part you could enter a time, then the diary would be grouped by periods of that time? On the BI remembering - yep good idea, I'll put it on the list for the next version too. Simon

Sep 10, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? Thats quite strange to get a high at 2am, and even stranger to be woken by it, must of been really high.... I think you should up your evening dose of background, assuming your on a split dose......if not on split I would consider it so your getting the most out of the background when you need it in the small hours... This morning I woke up with a 9.2 which is good for me......I was 13.2 before bed, so I took 2 units of novo and actually dropped by background 4 units (i had previously increased it to try and tackle dawn)....... I am hoping I can achieve a smiliar result again.....I feel so much better this morning.........

Sep 9, 2010 angelaallison 7 posts	Topic: General Discussion / Diabetes Power Product Awareness Event Hello, In October 2010 in Chorley Lancashire, we are hosting a Diabetes Product Awareness Event for anyone who has diabetes or cares for someone with diabetes. Bayer, Roche, Animas, Medtronic, Lifescan, Home Diagnostics, Juvela (gluten free food) for further details, please visit www.diabetespower.org.uk The event is free. Please come along or if you know anyone who may be interested please pass on the information. Best wishes Angela

Sep 9, 2010 Dr Jez McCole 11 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed That sounds like a great idea Thunderbolt - I would find my end of day BI shots being recorded in the right place then too. Keep going with the ratios - having different ratios for each meal is not uncommon and once you've cracked it you'll find things fall into place a little easier. Doesnt remove the need for corrections from time to time though. My QA:CP ratios are breakfast 0.5:1 - Lunch 1:1 - and tea 2:1! But you soon remember it. Can I also suggest that since BI doses don't vary as much as QA ones that the previous BI for morning and previous BI for evening is remembered as a starting point for the following day's entry? Not sure if that's possible or not and it would only be a convenience thing.

Sep 9, 2010 Martina 1 post	Topic: Questions for HCPs / dawn phenomenon... how to stop the rise? I have also experienced the 'dawn' phenomenon, but sometimes I wake with a high headache around 2am and correct with Novorapid, but it seems to have little effect, and I end up correcting again before the night is out. Has anyone else had this problem? Martina

Sep 9, 2010 ThunderBolt 28 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed I see now why you say CP then BG. It's just a matter of getting used to it I suppose. My results are a bit high at the moment and I think I'm going to have to play around with my ratios - maybe having different ratios at different times of the day. Oh ''eck!!! I do have one suggestion though that I think a lot of people would find useful. I'm not much of a sleeper and find I do a lot of testing after midnight so perhaps a start of day time could be added so that the before bed results don't show as before before breakfast.Â Top work though. I'm still getting my feet wet but I'm getting there!

Sep 8, 2010 Dr Jez McCole 11 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed If all is running well and the QA:CP ratios are right then there won't be much in the way of correctional doses to add to the QA BI totals. However, in the real world, a corrective dose is making up for the inaccuracies of the previous QA:CP ratio. In terms of the purpose behind knowing your TDD - it is all about what you have needed to keep your sugar controlled. The weighting of corrective doses in the overall calculation for TDD, that is in turn then used in subdivided doses on a sick day, should be so small that it makes little difference. If it makes a big difference then someone's ratios or BIs are well off anyway and any corrections ought to be counted. All the best Jez

Sep 8, 2010 Garry 328 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed Rightly or wrongly! - I have taken the rules to imply that it includes corrective QA - it seems logical to me that if you are building up over a number of days to bringing in sick day rules to include any correctives that you have had to apply over the preceding day in order to get hold of the situation quickly. Welcome any corrective response from HCP please. Regards Garry

Sep 8, 2010 Simon 578 posts	Topic: Site Development / DAFNE Online iPhone application - help with content/design needed I'm just working on the summary report for the BG, and have a question - does the TDD include corrective doses of QA? The handbook seems unclear and just gives the formula Total QA + Total BI in a day... I've never had to calculate my own TDD so haven't come across this before.

Sep 8, 2010 Simon 578 posts	Topic: Carbohydrate Counting / Iphone Apps Hi Brien - good spot, that will be fixed for the next update.

Sep 8, 2010 Brien Molloy 4 posts	Topic: Carbohydrate Counting / Iphone Apps One small snag if it is left running in background overnight when you input the next day the results won't show up until the is fully closed by double clicking the home button and then holding down an app until a horz red line appears. Still great app and with carb food cp access of web page np need to carry my cp book

Sep 8, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / McD's your lucky, my local mcdonalds staff wouldnt know what i was talking about....... Most buns are 3CP and the bigger ones are 4CP............

Sep 8, 2010 Stew B 125 posts	Topic: Carbohydrate Counting / McD's Not that I'm obsessed you understand... found ourselves at our local McD's again yesterday evening and chose the current special from the menu, only to discover that it hadn't made it onto the nutrition list. Undaunted Mrs B approached a staff member, and the duty manager went off to his office and came back with the carb value for me. Worth knowing..