Recent Posts - DAFNE Online

Jul 28, 2010

ekuser 3 posts

Topic: General Discussion / Carbs and cals book

I managed to obtain a copy from an ebay seller. I searched for the book and found a seller selling slight "seconds" (per seller: have minor cosmetic marks or slightly damaged ie small printing smears to the jacket, tiny dinks to the spine, or very slight page mis-alignment) for only Â£6.99 free p &p! Might be worth a look :-)

Jul 28, 2010

meltow 78 posts

Topic: General Discussion / Correction between meals?

I tend not to use a correction dose between meals, but will make the correction at the next meal time. For me this tends to work better, because I am never certain when my fast acting insulin has actually stopped working. I feel if I were to take a correction dose between meals, I might just be adding insulin to insulin, which could result in too much, and I ain't keen on hypos! I haven't had your experience where my BG has gone up rather than down.
I always test BG before bed, and will take a correction dose if needed. Bed is usually about 4 or 5 hours after my last dose of fast acting insulin, so I am fairly confident the active period of my teatime jab will have been and gone!

Jul 28, 2010

PNThompson 57 posts

Topic: General Discussion / Correction between meals?

I usually test between meals, when I have changed my ratio or the BI to ensure that I don't run too high.
I was quite high mid morning but came back to range by lunchtime. Don't think you should correct, but if you eat something then obviously you will have to inject, but wouldn't suggest correcting then either until you work out some form of pattern to decide whether or not you need to.

Jul 28, 2010

Ffi010 8 posts

Topic: General Discussion / Correction between meals?

Hi,
I realise I shouldn't correct inbetween meals but sometimes (out of curiosity mainly) I will test my BG inbetween meals.
If it is around 13 I dont correct, but I have done it before and it has shot up to 19! and then my next BG will have fallen by my next meal, even though a little higher than target, but I was wondering if I should be correcting this inbetween meals?
it only occasionally happens with no real reason why.
I am now getting a little paronoid/worried. can anyone help?
thank you

Jul 28, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Stress & Hyperglycemia

Hey, sorry to hear about your dad, must be hard an you.

Something needs to change to get those readings down.

I would probably start with my BI insulin, easier if on levemir to notice a change.

I would do that because I would not want to change any ration of QA if I thought they might settle back down again.

If that causes problems, then you will have to adjust your QA ratios starting from your morning reading. It looks like your best time of the day is dinner.

Also on the Monday 26 you took 12 BI units, this is a mistake?

It must be hard to focus on yourself when your family needs all your support.

Try the BI, then the QA, thats my opinion...

The floor is open............

Jul 27, 2010

Jo Penn 24 posts

Topic: General Discussion / How good is dafne

For me - this has been a life saver... feel fantastic losing about 2kg a fortnight too..
reduction in QA ; hopefully reduction in HBA1c

Jul 27, 2010

Jo Penn 24 posts

Topic: Questions for HCPs / Stress & Hyperglycemia

I am having problems controlling my sugars due to stress with a family situation (dad been recently dxd with cancer) and am feeling rather :-S about this at the moment...

Any tips?

Jul 27, 2010

weffer25 1 post

Topic: General Discussion / DAFNE and Employers

I am a nurse and I worked Friday, Saturday, Sunday nightshifts so that I could attend the course during the week. It was exhausting but because the roster had been done by the time I knew I was attending the course, all I could do was change my shifts to this.

Jul 27, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Insulin resistace and Alergy?

I had similar, all be it smaller symptoms when on Levemir, and someone in my dafne classroom would not go on it either as she was allergic to it......

Its quite common I think, for Levemir anyway, there must be something in it.....

If its a pain, you will just need to change insulin...

I think the lumps might be a reaction to the insulin as opposed to actual static insulin, and I dont think your QA will be affected as you wont be injecting on those sites wth a bad reaction.??

Jul 27, 2010

Ffi010 8 posts

Topic: Questions for HCPs / Insulin resistace and Alergy?

Hi,

Since doing Dafne my blood sugars have come down but I am concerned that I may be building a resistance. I was on Solostar and wasthen put onto Levemir and have found that it stings alot when i inject. Also I have small (little smaller than a ping pong ball) lumps where I inject, i have changed to longer needles (and changing sites) and this hasnt helped.

could I be alergic? could my body be storing the insulin in that one area? and could these lumps prevent my novorapid from absorbing properly?

THank you

Jul 26, 2010

Judith23 7 posts

Topic: General Discussion / Target range?

Hi Jo, yes thats right - i think thats probably why you are struggling to get a clear reading for any of your bloods, as you seem to snack regularly throughout the day and dont have a clear 4 hours between food / QA in order to see if you can hit the target range - so I would presume that you ain't gonna hit it - but your HCP should be able to advise better than I.

Just on the subject of split BI - Paul is right the tide seems to be turning, I was encouraged to split on my dafne course; but more recently my dafne nurse advised that I may want to go back to just one dose at night (wont bore with all the details, but basically was hypo at 16:30 for a few days so reduced my BI to only 2 units at 10am, leaving me with 8u at 10pm - she suggested to see how it went but I may find it more hassel than its worth to give that 2 in the morning). She said that younger people may need the split due to their growth hormones - and unfortunatley I aint that young anymore!! Not sure whether this applies to you Jo or not??

Jul 26, 2010

marke 681 posts

Topic: Questions for HCPs / Humilin I and morning sugars

Hi, the best person to reply to this is Simon Heller, but I know hes a busy chap. Hopefully he will be able to respond to you at some stage as I know he knows a lot about this.
As I understand it, Dawn starts at about 4-5am when your body starts preparing itself for waking up. It should be around this time that your BG starts to rise as loads of hormones start bouncing around your body. Therefore, changing your BI injections will NOT give the sugars less time to rise. In an ideal world you would magically inject QA at about 4-5am when the hormonal activity starts, however since you are asleep this is not easy. In addition I would guess that if you regularly woke up at 4-5am the hormonal process would just start earlier.
This I appreciate doesn't provide an answer, but then I only understand the basics ( just about) rather than the details of the process and how it affects BG. Hopefully someone with a more detailed understanding can provide advice on the best course of action.

Jul 26, 2010

Jo Penn 24 posts

Topic: General Discussion / Target range?

Judity - you and Paul have a valid point re- BG before bed.. but my DAFNE educator also stated that... but sometimes I go to bed early and it less than 3-4 hours after QA injection (or peak) so inaccurate reading...

Jul 26, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Humilin I and morning sugars

I experience dawn phenomonon........and I am constanlty trying to find a way to beat it......

Started of of Lantus, then split it with Levemir, then finally moved to humlilin I to take advantage of its peak two hours after injecing so as to drop me enough over night that I would wake up as close to target as possible.

9 times out of 10 I am in double figures still.

My question is this. At 6.30 in the morning I take my morning BI dose, and then 12 hours later at dinner I take my evening dose, would it be better to take my evening dose as close to bedtime as possible so as to reduce the time my sugars have to climb, this would also mean bringing my morning dose forward.

Jul 25, 2010

GR156 3 posts

Topic: Carbohydrate Counting / Sultanas

Cheers for that.

The next time they turn up in a recipe I'll give it a try.

Jul 25, 2010

Simon 578 posts

Topic: DAFNE Online Mobile / Mobile Feature Requests

Hi Alex,

What phone do you have? We're currently working on an iPhone app which contains a diary and carb list.

Thanks,

Simon

Jul 25, 2010

AlexLawson 2 posts

Topic: DAFNE Online Mobile / Mobile Feature Requests

Would it be possible to get a diary app so you could keep a note pf your blood sugars on the move then transfer th to your paper diary at a later date

Jul 25, 2010

PNThompson 57 posts

Topic: General Discussion / Target range?

I was unsure whether or not to suggest splitting the Lantus, but I did prior to attending DAFNE, as the hospital felt that my Lantus might be running out too early. During DAFNE I went back to just one injection.

As Judith mentioned, I have found that if I snack, I have trouble ensuring that I get the ration right, as sometimes I hypo, sometimes my BGs goes high.

Jul 25, 2010

Judith23 7 posts

Topic: General Discussion / Target range?

Hi Jo,

I use Lantus and split my dose to take it at a gap fo 12 hours, which has helped me, as I felt it was running out too.

As Paul, I wonder what is happening to your bloods at night - do you do any tests before you go to sleep so you get a view on what your bloods are up to - compared to what you wake up on?

I have noticed if I have a snack, and inject, when its time for my lunch or other main meal my QA wont always have had time to work so if I also corrected at lunch /dinner etc I would hypo later on? Don't know if anyone else has found this?

Judith

Jul 25, 2010

Jo Penn 24 posts

Topic: General Discussion / Target range?

I am doing 3am checks and about 10-12 ish...
Am on Lantus at the moment, have been thinking it is running out for a while....

Will try 2:1 for lunch from tomo...

Correction is 2u if below 12; 3u if 12.9-14; 6 if over 15

Will call diabetic team for some ideas... maybe levemir might solve some of the issues

Jul 25, 2010

PNThompson 57 posts

Topic: General Discussion / Target range?

Jo,

Looking at these readings, I wonder if the BI is correct, as you are always high in the morning, though at times my readings are high before bed, but drop over the night, so mine, at times seem too high.
Try having a 03:00am test, as you may be having a hypo overnight which is generating the high readings first thing.
What Background Insulin are you on, as it may be running out at the end of the 24 Hours.
I have now change the time of the Background Insulin to the same time as Dinner to make things a little easier.
A lot of the lunch-time reading are only just out of range, so it seems that the morning injection is close to being spot on.
Some of the corrections may not be high enough, and what factor are you using when calculating the correction.
1 unit per 2-3mmol. When correcting, do you calculate to the middle of the range?
Your lunch-time reading on the 20th was 7.6, and is just out of range, and at a ratio of 1:1.5, I feel your injection should have been 7+1.

I use a computerised spreadsheet to calculate my injections, based on meal, ratio, and any adjustment.
Are you counting the CPs correctly? Maybe you are not counting some foods that do contain carbs?

If you have access to a computer, I could send you a copy of this spreadsheet if you think it might help.
See, sometimes I found that when calculating the Insulin, I found that manually I sometimes had some issues with rounding up or down the figures.
i.e, the calculation may consist of a figure of 6.39 and required an adjustment of 1.4, but where some of the calculations would round these down to 7, the figure would be closer to 8 (7.79).
Manually this isn't that clear, as calculating the CPs, you know the correct figures, but calculating the adjustment is what I originally found difficult.

The spreadsheet is in both Windows and Apple Mac formats, so if you would like to try let me know.

Paul

Jul 25, 2010

Jo Penn 24 posts

Topic: General Discussion / Target range?

Here

Jul 25, 2010

Jo Penn 24 posts

Topic: General Discussion / Target range?

Here you go

Jul 24, 2010

Harry1974 1 post

Topic: General Discussion / How good is dafne

Hi everyone,

This is my first post. I just completed my DAFNE week this Friday. I have been diabetic for 13 years and it was a real revelation to undergo the training. Nobody had ever taught me about Dose adjustment before. I can understand now why it is a legal requirement (as someone posted earlier) in Germany for diabetics to train in DAFNE.

I am very positive about the future. My QA insulin is now anything between 25% to 50% of what I would have taken before DAFNE week and my BG seems to be within target with only an occasional correction required.

I now feel full of energy compared to just 8 days ago and am increasing my activity which is only going to help my diabetes control.

In my view DAFNE is GREAT!!!

Regards

Harry

Jul 28, 2010 ekuser 3 posts	Topic: General Discussion / Carbs and cals book I managed to obtain a copy from an ebay seller. I searched for the book and found a seller selling slight "seconds" (per seller: have minor cosmetic marks or slightly damaged ie small printing smears to the jacket, tiny dinks to the spine, or very slight page mis-alignment) for only Â£6.99 free p &p! Might be worth a look :-)

Jul 28, 2010 meltow 78 posts	Topic: General Discussion / Correction between meals? I tend not to use a correction dose between meals, but will make the correction at the next meal time. For me this tends to work better, because I am never certain when my fast acting insulin has actually stopped working. I feel if I were to take a correction dose between meals, I might just be adding insulin to insulin, which could result in too much, and I ain't keen on hypos! I haven't had your experience where my BG has gone up rather than down. I always test BG before bed, and will take a correction dose if needed. Bed is usually about 4 or 5 hours after my last dose of fast acting insulin, so I am fairly confident the active period of my teatime jab will have been and gone!

Jul 28, 2010 PNThompson 57 posts	Topic: General Discussion / Correction between meals? I usually test between meals, when I have changed my ratio or the BI to ensure that I don't run too high. I was quite high mid morning but came back to range by lunchtime. Don't think you should correct, but if you eat something then obviously you will have to inject, but wouldn't suggest correcting then either until you work out some form of pattern to decide whether or not you need to.

Jul 28, 2010 Ffi010 8 posts	Topic: General Discussion / Correction between meals? Hi, I realise I shouldn't correct inbetween meals but sometimes (out of curiosity mainly) I will test my BG inbetween meals. If it is around 13 I dont correct, but I have done it before and it has shot up to 19! and then my next BG will have fallen by my next meal, even though a little higher than target, but I was wondering if I should be correcting this inbetween meals? it only occasionally happens with no real reason why. I am now getting a little paronoid/worried. can anyone help? thank you

Jul 28, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Stress & Hyperglycemia Hey, sorry to hear about your dad, must be hard an you. Something needs to change to get those readings down. I would probably start with my BI insulin, easier if on levemir to notice a change. I would do that because I would not want to change any ration of QA if I thought they might settle back down again. If that causes problems, then you will have to adjust your QA ratios starting from your morning reading. It looks like your best time of the day is dinner. Also on the Monday 26 you took 12 BI units, this is a mistake? It must be hard to focus on yourself when your family needs all your support. Try the BI, then the QA, thats my opinion... The floor is open............

Jul 27, 2010 Jo Penn 24 posts	Topic: General Discussion / How good is dafne For me - this has been a life saver... feel fantastic losing about 2kg a fortnight too.. reduction in QA ; hopefully reduction in HBA1c

Jul 27, 2010 Jo Penn 24 posts	Topic: Questions for HCPs / Stress & Hyperglycemia I am having problems controlling my sugars due to stress with a family situation (dad been recently dxd with cancer) and am feeling rather :-S about this at the moment... Any tips?

Jul 27, 2010 weffer25 1 post	Topic: General Discussion / DAFNE and Employers I am a nurse and I worked Friday, Saturday, Sunday nightshifts so that I could attend the course during the week. It was exhausting but because the roster had been done by the time I knew I was attending the course, all I could do was change my shifts to this.

Jul 27, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Insulin resistace and Alergy? I had similar, all be it smaller symptoms when on Levemir, and someone in my dafne classroom would not go on it either as she was allergic to it...... Its quite common I think, for Levemir anyway, there must be something in it..... If its a pain, you will just need to change insulin... I think the lumps might be a reaction to the insulin as opposed to actual static insulin, and I dont think your QA will be affected as you wont be injecting on those sites wth a bad reaction.??

Jul 27, 2010 Ffi010 8 posts	Topic: Questions for HCPs / Insulin resistace and Alergy? Hi, Since doing Dafne my blood sugars have come down but I am concerned that I may be building a resistance. I was on Solostar and wasthen put onto Levemir and have found that it stings alot when i inject. Also I have small (little smaller than a ping pong ball) lumps where I inject, i have changed to longer needles (and changing sites) and this hasnt helped. could I be alergic? could my body be storing the insulin in that one area? and could these lumps prevent my novorapid from absorbing properly? THank you

Jul 26, 2010 Judith23 7 posts	Topic: General Discussion / Target range? Hi Jo, yes thats right - i think thats probably why you are struggling to get a clear reading for any of your bloods, as you seem to snack regularly throughout the day and dont have a clear 4 hours between food / QA in order to see if you can hit the target range - so I would presume that you ain't gonna hit it - but your HCP should be able to advise better than I. Just on the subject of split BI - Paul is right the tide seems to be turning, I was encouraged to split on my dafne course; but more recently my dafne nurse advised that I may want to go back to just one dose at night (wont bore with all the details, but basically was hypo at 16:30 for a few days so reduced my BI to only 2 units at 10am, leaving me with 8u at 10pm - she suggested to see how it went but I may find it more hassel than its worth to give that 2 in the morning). She said that younger people may need the split due to their growth hormones - and unfortunatley I aint that young anymore!! Not sure whether this applies to you Jo or not??

Jul 26, 2010 marke 681 posts	Topic: Questions for HCPs / Humilin I and morning sugars Hi, the best person to reply to this is Simon Heller, but I know hes a busy chap. Hopefully he will be able to respond to you at some stage as I know he knows a lot about this. As I understand it, Dawn starts at about 4-5am when your body starts preparing itself for waking up. It should be around this time that your BG starts to rise as loads of hormones start bouncing around your body. Therefore, changing your BI injections will NOT give the sugars less time to rise. In an ideal world you would magically inject QA at about 4-5am when the hormonal activity starts, however since you are asleep this is not easy. In addition I would guess that if you regularly woke up at 4-5am the hormonal process would just start earlier. This I appreciate doesn't provide an answer, but then I only understand the basics ( just about) rather than the details of the process and how it affects BG. Hopefully someone with a more detailed understanding can provide advice on the best course of action.

Jul 26, 2010 Jo Penn 24 posts	Topic: General Discussion / Target range? Judity - you and Paul have a valid point re- BG before bed.. but my DAFNE educator also stated that... but sometimes I go to bed early and it less than 3-4 hours after QA injection (or peak) so inaccurate reading...

Jul 26, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Humilin I and morning sugars I experience dawn phenomonon........and I am constanlty trying to find a way to beat it...... Started of of Lantus, then split it with Levemir, then finally moved to humlilin I to take advantage of its peak two hours after injecing so as to drop me enough over night that I would wake up as close to target as possible. 9 times out of 10 I am in double figures still. My question is this. At 6.30 in the morning I take my morning BI dose, and then 12 hours later at dinner I take my evening dose, would it be better to take my evening dose as close to bedtime as possible so as to reduce the time my sugars have to climb, this would also mean bringing my morning dose forward.

Jul 25, 2010 GR156 3 posts	Topic: Carbohydrate Counting / Sultanas Cheers for that. The next time they turn up in a recipe I'll give it a try.

Jul 25, 2010 Simon 578 posts	Topic: DAFNE Online Mobile / Mobile Feature Requests Hi Alex, What phone do you have? We're currently working on an iPhone app which contains a diary and carb list. Thanks, Simon

Jul 25, 2010 AlexLawson 2 posts	Topic: DAFNE Online Mobile / Mobile Feature Requests Would it be possible to get a diary app so you could keep a note pf your blood sugars on the move then transfer th to your paper diary at a later date

Jul 25, 2010 PNThompson 57 posts	Topic: General Discussion / Target range? I was unsure whether or not to suggest splitting the Lantus, but I did prior to attending DAFNE, as the hospital felt that my Lantus might be running out too early. During DAFNE I went back to just one injection. As Judith mentioned, I have found that if I snack, I have trouble ensuring that I get the ration right, as sometimes I hypo, sometimes my BGs goes high.

Jul 25, 2010 Judith23 7 posts	Topic: General Discussion / Target range? Hi Jo, I use Lantus and split my dose to take it at a gap fo 12 hours, which has helped me, as I felt it was running out too. As Paul, I wonder what is happening to your bloods at night - do you do any tests before you go to sleep so you get a view on what your bloods are up to - compared to what you wake up on? I have noticed if I have a snack, and inject, when its time for my lunch or other main meal my QA wont always have had time to work so if I also corrected at lunch /dinner etc I would hypo later on? Don't know if anyone else has found this? Judith

Jul 25, 2010 Jo Penn 24 posts	Topic: General Discussion / Target range? I am doing 3am checks and about 10-12 ish... Am on Lantus at the moment, have been thinking it is running out for a while.... Will try 2:1 for lunch from tomo... Correction is 2u if below 12; 3u if 12.9-14; 6 if over 15 Will call diabetic team for some ideas... maybe levemir might solve some of the issues

Jul 25, 2010 PNThompson 57 posts	Topic: General Discussion / Target range? Jo, Looking at these readings, I wonder if the BI is correct, as you are always high in the morning, though at times my readings are high before bed, but drop over the night, so mine, at times seem too high. Try having a 03:00am test, as you may be having a hypo overnight which is generating the high readings first thing. What Background Insulin are you on, as it may be running out at the end of the 24 Hours. I have now change the time of the Background Insulin to the same time as Dinner to make things a little easier. A lot of the lunch-time reading are only just out of range, so it seems that the morning injection is close to being spot on. Some of the corrections may not be high enough, and what factor are you using when calculating the correction. 1 unit per 2-3mmol. When correcting, do you calculate to the middle of the range? Your lunch-time reading on the 20th was 7.6, and is just out of range, and at a ratio of 1:1.5, I feel your injection should have been 7+1. I use a computerised spreadsheet to calculate my injections, based on meal, ratio, and any adjustment. Are you counting the CPs correctly? Maybe you are not counting some foods that do contain carbs? If you have access to a computer, I could send you a copy of this spreadsheet if you think it might help. See, sometimes I found that when calculating the Insulin, I found that manually I sometimes had some issues with rounding up or down the figures. i.e, the calculation may consist of a figure of 6.39 and required an adjustment of 1.4, but where some of the calculations would round these down to 7, the figure would be closer to 8 (7.79). Manually this isn't that clear, as calculating the CPs, you know the correct figures, but calculating the adjustment is what I originally found difficult. The spreadsheet is in both Windows and Apple Mac formats, so if you would like to try let me know. Paul

Jul 25, 2010 Jo Penn 24 posts	Topic: General Discussion / Target range? Here

Jul 25, 2010 Jo Penn 24 posts	Topic: General Discussion / Target range? Here you go

Jul 24, 2010 Harry1974 1 post	Topic: General Discussion / How good is dafne Hi everyone, This is my first post. I just completed my DAFNE week this Friday. I have been diabetic for 13 years and it was a real revelation to undergo the training. Nobody had ever taught me about Dose adjustment before. I can understand now why it is a legal requirement (as someone posted earlier) in Germany for diabetics to train in DAFNE. I am very positive about the future. My QA insulin is now anything between 25% to 50% of what I would have taken before DAFNE week and my BG seems to be within target with only an occasional correction required. I now feel full of energy compared to just 8 days ago and am increasing my activity which is only going to help my diabetes control. In my view DAFNE is GREAT!!! Regards Harry