Recent Posts - DAFNE Online

Jul 15, 2010

Graeme 2 posts

Topic: General Discussion / Need a kick up the backside! :(

Derek,

I am currently doing DAFNE at Southern General. It has been a great boost meeting others with similar problems and discussing potential improvements. I would urge you to work at your control and keep striving for the best you can get. My best friend died about 10 years ago after a long and painful fight against complications brought on by poor control.

Best wishes and keep striving for the best you can

Graeme

Jul 15, 2010

Graeme 2 posts

Topic: General Discussion / DAFNE and Employers

Hi,

I am currently doing the DAFNE course at Southern General, I got 2 days paid and had to take 3 from annaul leave / flexi leave entitlement

Jul 15, 2010

Caroline 29 posts

Topic: General Discussion / Adjusting Dosages

I haven't really played around with the Lantus... it seems to be within a good range from bed to morning just these past few days, so think that is ok for the time being. I will continue to do plenty of blood tests and monitor my sugars and adjust accordingly. Thank you ever so much for your help and support.

Jul 15, 2010

Nat 30 posts

Topic: Questions for HCPs / Night hypo and Morning BG

I did think that you change it straight away as I had a night hypo last week and emailed in for confirmation that I was right and they said it was the first thing I should do and never risk a night hypo!

Jul 15, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Adjusting Dosages

There are different target ranges for different times of day but ideally you want to be 5.5, so you subtract that from your reading (10) and that gives you 4.5.

1 unit drops you between 2-3 mmol/l, so assume 3, so that would mean you would correct with 1 unit...........

try that for now................the higher you are the less 1 unit brings you down, or thats the case for the majority of people........

Are you confident your lantus keeps you steady overnight....................??

Jul 15, 2010

twitch_101 1 post

Topic: General Discussion / Diabetes.............

I settled with condition on a good day and on a bad day its a disease Razz

Jul 15, 2010

Caroline 29 posts

Topic: General Discussion / Adjusting Dosages

I am on Novorapid for the quick acting insulin and Lantus at night time. I have increased the morning insulin from 1c: 2units to 1c :3 units, so hopefully I will get there. I think its knowing how much to adjust by to try and keep in range. If my blood sugar reading is above 10, how much would you take to bring it down again? Im pulling figures out of the air and risk an unwanted hypo.

Jul 15, 2010

Caroline 29 posts

Topic: General Discussion / Adjusting Dosages

Thank you very much for all your advice. I am on the waiting list... which could take me into next year! I have been advised to try this method (without a manual) so apologies if my recordings do not make sense. I do mean 1 is 10g. I usually have 30 carbs for breakfast, 40 for lunch and 40 for dinner. My Diabetic Specialist thought this was a right way for me to try it now as a works occupational therapist recommended I tried an aktins diet of not eating carbs for breakfast or lunch but having large carb dinner (thereby only taking insulin twice a day)! I am at the end of my tether with what advice to take as I feel so exhausted most of the time. Sorry to rant on... I will try and obtain a manual from somewhere. Thanks again, I really appreciate speaking to other diabetics in my situation.

Jul 15, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Adjusting Dosages

Sorry about that, I didnt know what privelages each user class had, makes sense I suppose................

I however was given the basics of dafne a year before attending by my dietician, even then it made a big difference.......

The course cements it all together.........

Jul 15, 2010

marke 686 posts

Topic: Questions for HCPs / Night hypo and Morning BG

I have also requested that its added to the Hypo section as well as its current location to ensure people like me don't miss it ! This is the benefit of having it online and having thousands of people reading it !

Jul 15, 2010

marke 686 posts

Topic: General Discussion / Adjusting Dosages

all, sorry she can't read the DAFNE manual without going on the course and the hospital should NOT tell her to 'try the DAFNE way' without sending her on the course !
Caroline did they say they were going to put you on the waiting list for the course ? There is so much to take in and understand you really do need to attend the course. Everyone is welcome to advise and help you thats what the site is for, but ultimately you need the support of a DAFNE team and that means going on the course.

Unfortunately 'users' do not get access to the DAFNE Online manual only 'graduates', this is to protect them as well as DAFNE Central.

Jul 15, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Adjusting Dosages

Hey there,

My advice is get on the course and in the meantime have a read at the DAFNE manual.

As I am settled with the dafne principals I am struggling to make sense of your sugars as they are not displayed the way a dafne student would.

For example corrections being shown as +1 or +2 onto your QA.

Your QA insulin is lower than your carb intake, this might be because your writing the carbs down wrong, 1CP being ten grams of carbohydrate. (Nat and Karl noticed this too and explained)

Recording the results in the easiest way possible is paramount in order to spot patterns and also to allow other to help you easily.

Looking closely at the results you are using the principals correctly, which is brilliant.

The first thing I would do is make sure your BI is right, your on one dose so that means Lantus more than likely.

If you take you BI at bed with no food inside you or QA insulin and you wake up with the same reading as you went to bed with you can bet that its doing its job.

If not then you need to up or down the dose a few units, because its lantus (I am assuming), you will have to wait a few days to see the effects, continue until you are held steady over night.

Then you can start with your QA insulin, if the BI alterations didnt iron out your highs through the day then you can start with the lunchtime reading, is it high 3 consecutive days?, if so ratio needs to go up at breakfast, and this works vice versa, if low, ratio down.

Eventually you will get it, then move onto the dinner, altering the lunchtime dose.........

I feel as if I have just rabbled on the basics there so I apologise if you have heard it before......

Have a read at the manual as I say, but it may seem overwhelming if the theory is not explained to you...

DAFNE asap......

Good Luck........

Jul 14, 2010

Karl 83 posts

Topic: General Discussion / Adjusting Dosages

I would guess your CP are in grams? CP should be 1 / 10g

I would say you need to up the dose at lunch as you are high at dinner most days

Are you on a list to get on the course, there is lots to learn - I tried before i went on the course, didn't work that well but since the course (Jan '10) A1C is already down by 2

Jul 14, 2010

Nat 30 posts

Topic: General Discussion / Adjusting Dosages

Hi, I am new to daphne too about 3 weeks in now. I have had diabetes type 1 for 19 years. When we started the course everybody started on the same ratio i.e. for every 10g of carbs you took 1 unit of insulin. When you start seeing a pattern then you can started to change things. Your carb portions look very high are you using the carb counter link to find out what your carbs are? If like on your wednesday reading you had 20 cps (carb portions) for breakfast really you should have taken 20 units of insulin - that is why I am wondering how you are counting your carbs as this is really high. Most cereals and bread would only be about 4 carb portions although some how you managed to keep well controlled until later on in the day.

Jul 14, 2010

Caroline 29 posts

Topic: General Discussion / Adjusting Dosages

Hi wanted your opinion on dosages. I have been an insulin dependant diabetic for 15 years and have been using the old method. As my diabetes is unstable and has been affecting my work life balance my local hospital has advised e to try the dafne way to ontrol my diabetes. I have been using the dafne way for a number of weeks now. I have not been on a course so a bit unsure as to whether I am adjusting my dosages correctly. I am taking 3 units of insulin for 1 carb for breakfast, 2 units of insulin for 1 carb lunchtimes and 2.5 units of insulin for 1 carb at dinner. Does this seem responsible to take a different dosage for different meals? Your help in this matter would be greatly appreciated. Thanks

Jul 14, 2010

Nat 30 posts

Topic: Carbohydrate Counting / Ripness of bananas

I, like novorapidboi26 was told there isn't much in it but I have problems whenever I eat bananas so might be a try it and see situation.

Jul 14, 2010

digth 19 posts

Topic: Questions for HCPs / Night hypo and Morning BG

I have clarified the detail in the handbook step wise approach (as posted by Karl) with the Chair of the DAFNE Educator Group. I can confirm that this informaiton IS CORRECT and is a DAFNE principle for dose adjustment.

Jul 14, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Ripness of bananas

I would think yes, but "negligible" amounts, nothing that would change your insulin........

Anyone else?

Jul 14, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Monster Energy Drink

Damn...........I need to try this jaigermeister stuff.........

Jul 14, 2010

marke 686 posts

Topic: Questions for HCPs / Night hypo and Morning BG

Karl, thanks for the link. I had never noticed this statement before on the diagram and it is NOT mentioned in the section on Hypo's. i have therefore raised it with DAFNE Central and they will come back to me ( and I will pass it on here) with a clarification on this subject. The handbook is due to be revised soon as it happens so its an ideal time to clarify this. If the statement is considered correct then it should be included in the Hypo section as well to ensure consistency and ensure that people ( like me) don't miss it.
I will let you know as soon as I get feedback.

Jul 14, 2010

Mark2 23 posts

Topic: General Discussion / Leaking Novopen ?!?!

I have had a problem with Novopens which seem to leak as well. I've thrown pens away in the past that seemed to have this problem. It never occurred to me that it was just the needle and the rubber on the insulin vial that caused this.

Jul 14, 2010

Ffi010 8 posts

Topic: Carbohydrate Counting / Ripness of bananas

Hi,
I was wondering if there was a difference in CPs between a slightly green banana, ripe and over ripe (slightly brown) banana?
I have been told that there is more sugar in a bruised banana. Does that mean More CPs??

Jul 14, 2010

Ffi010 8 posts

Topic: Carbohydrate Counting / Monster Energy Drink

This stuff is like Red Bull on speed!! Amazing! ha. I often have the low carb one on its own before a long day or before a lecture!
I cant drink a whole can though as it makes me feel sick and shakey, due to the large amounts of caffeine and taurin.
As there is only 2.4g CHO in 100ml (12g in the whole can) I dont inject at all. esp not as a jaiger bomb (also a fav of mine) as not only is there negligable carbs in it but also it is with alcohol. unless you do alot of bombs, say 4+ it wouldnt inject and would be caucious if you did inject.
Hope this helps.

Jul 14, 2010

marke 686 posts

Topic: General Discussion / fiona walkers bg diary

I'm with Mark2 it looks like your BI in the evening is not enough. Given your sensitivity to insulin I would only change it by 1 max (you probably don't have a pen that can do 0.5, but it might be worth looking for one if you are that sensitve). After the change give it a few days to fully see if it has had the desired effect. You may also need to do a 3am test ( sorry) to see how your BG changes over night, sometimes higher BG's in the morning is dawn phenomenom but not always. Probably the BI at night change will do the job, if you start lower you will probably tend to stay lower during the day and if you don't need to constantly correct it will be easier to see if your CP estimates are good or not so good. ( indian food is full of CP's, well it always seems that way to my body anyway ;-) )

Jul 15, 2010 Graeme 2 posts	Topic: General Discussion / Need a kick up the backside! :( Derek, I am currently doing DAFNE at Southern General. It has been a great boost meeting others with similar problems and discussing potential improvements. I would urge you to work at your control and keep striving for the best you can get. My best friend died about 10 years ago after a long and painful fight against complications brought on by poor control. Best wishes and keep striving for the best you can Graeme

Jul 15, 2010 Graeme 2 posts	Topic: General Discussion / DAFNE and Employers Hi, I am currently doing the DAFNE course at Southern General, I got 2 days paid and had to take 3 from annaul leave / flexi leave entitlement

Jul 15, 2010 Caroline 29 posts	Topic: General Discussion / Adjusting Dosages I haven't really played around with the Lantus... it seems to be within a good range from bed to morning just these past few days, so think that is ok for the time being. I will continue to do plenty of blood tests and monitor my sugars and adjust accordingly. Thank you ever so much for your help and support.

Jul 15, 2010 Nat 30 posts	Topic: Questions for HCPs / Night hypo and Morning BG I did think that you change it straight away as I had a night hypo last week and emailed in for confirmation that I was right and they said it was the first thing I should do and never risk a night hypo!

Jul 15, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Adjusting Dosages There are different target ranges for different times of day but ideally you want to be 5.5, so you subtract that from your reading (10) and that gives you 4.5. 1 unit drops you between 2-3 mmol/l, so assume 3, so that would mean you would correct with 1 unit........... try that for now................the higher you are the less 1 unit brings you down, or thats the case for the majority of people........ Are you confident your lantus keeps you steady overnight....................??

Jul 15, 2010 twitch_101 1 post	Topic: General Discussion / Diabetes............. I settled with condition on a good day and on a bad day its a disease

Jul 15, 2010 Caroline 29 posts	Topic: General Discussion / Adjusting Dosages I am on Novorapid for the quick acting insulin and Lantus at night time. I have increased the morning insulin from 1c: 2units to 1c :3 units, so hopefully I will get there. I think its knowing how much to adjust by to try and keep in range. If my blood sugar reading is above 10, how much would you take to bring it down again? Im pulling figures out of the air and risk an unwanted hypo.

Jul 15, 2010 Caroline 29 posts	Topic: General Discussion / Adjusting Dosages Thank you very much for all your advice. I am on the waiting list... which could take me into next year! I have been advised to try this method (without a manual) so apologies if my recordings do not make sense. I do mean 1 is 10g. I usually have 30 carbs for breakfast, 40 for lunch and 40 for dinner. My Diabetic Specialist thought this was a right way for me to try it now as a works occupational therapist recommended I tried an aktins diet of not eating carbs for breakfast or lunch but having large carb dinner (thereby only taking insulin twice a day)! I am at the end of my tether with what advice to take as I feel so exhausted most of the time. Sorry to rant on... I will try and obtain a manual from somewhere. Thanks again, I really appreciate speaking to other diabetics in my situation.

Jul 15, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Adjusting Dosages Sorry about that, I didnt know what privelages each user class had, makes sense I suppose................ I however was given the basics of dafne a year before attending by my dietician, even then it made a big difference....... The course cements it all together.........

Jul 15, 2010 marke 686 posts	Topic: Questions for HCPs / Night hypo and Morning BG I have also requested that its added to the Hypo section as well as its current location to ensure people like me don't miss it ! This is the benefit of having it online and having thousands of people reading it !

Jul 15, 2010 marke 686 posts	Topic: General Discussion / Adjusting Dosages all, sorry she can't read the DAFNE manual without going on the course and the hospital should NOT tell her to 'try the DAFNE way' without sending her on the course ! Caroline did they say they were going to put you on the waiting list for the course ? There is so much to take in and understand you really do need to attend the course. Everyone is welcome to advise and help you thats what the site is for, but ultimately you need the support of a DAFNE team and that means going on the course. Unfortunately 'users' do not get access to the DAFNE Online manual only 'graduates', this is to protect them as well as DAFNE Central.

Jul 15, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Adjusting Dosages Hey there, My advice is get on the course and in the meantime have a read at the DAFNE manual. As I am settled with the dafne principals I am struggling to make sense of your sugars as they are not displayed the way a dafne student would. For example corrections being shown as +1 or +2 onto your QA. Your QA insulin is lower than your carb intake, this might be because your writing the carbs down wrong, 1CP being ten grams of carbohydrate. (Nat and Karl noticed this too and explained) Recording the results in the easiest way possible is paramount in order to spot patterns and also to allow other to help you easily. Looking closely at the results you are using the principals correctly, which is brilliant. The first thing I would do is make sure your BI is right, your on one dose so that means Lantus more than likely. If you take you BI at bed with no food inside you or QA insulin and you wake up with the same reading as you went to bed with you can bet that its doing its job. If not then you need to up or down the dose a few units, because its lantus (I am assuming), you will have to wait a few days to see the effects, continue until you are held steady over night. Then you can start with your QA insulin, if the BI alterations didnt iron out your highs through the day then you can start with the lunchtime reading, is it high 3 consecutive days?, if so ratio needs to go up at breakfast, and this works vice versa, if low, ratio down. Eventually you will get it, then move onto the dinner, altering the lunchtime dose......... I feel as if I have just rabbled on the basics there so I apologise if you have heard it before...... Have a read at the manual as I say, but it may seem overwhelming if the theory is not explained to you... DAFNE asap...... Good Luck........

Jul 14, 2010 Karl 83 posts	Topic: General Discussion / Adjusting Dosages I would guess your CP are in grams? CP should be 1 / 10g I would say you need to up the dose at lunch as you are high at dinner most days Are you on a list to get on the course, there is lots to learn - I tried before i went on the course, didn't work that well but since the course (Jan '10) A1C is already down by 2

Jul 14, 2010 Nat 30 posts	Topic: General Discussion / Adjusting Dosages Hi, I am new to daphne too about 3 weeks in now. I have had diabetes type 1 for 19 years. When we started the course everybody started on the same ratio i.e. for every 10g of carbs you took 1 unit of insulin. When you start seeing a pattern then you can started to change things. Your carb portions look very high are you using the carb counter link to find out what your carbs are? If like on your wednesday reading you had 20 cps (carb portions) for breakfast really you should have taken 20 units of insulin - that is why I am wondering how you are counting your carbs as this is really high. Most cereals and bread would only be about 4 carb portions although some how you managed to keep well controlled until later on in the day.

Jul 14, 2010 Caroline 29 posts	Topic: General Discussion / Adjusting Dosages Hi wanted your opinion on dosages. I have been an insulin dependant diabetic for 15 years and have been using the old method. As my diabetes is unstable and has been affecting my work life balance my local hospital has advised e to try the dafne way to ontrol my diabetes. I have been using the dafne way for a number of weeks now. I have not been on a course so a bit unsure as to whether I am adjusting my dosages correctly. I am taking 3 units of insulin for 1 carb for breakfast, 2 units of insulin for 1 carb lunchtimes and 2.5 units of insulin for 1 carb at dinner. Does this seem responsible to take a different dosage for different meals? Your help in this matter would be greatly appreciated. Thanks

Jul 14, 2010 Nat 30 posts	Topic: Carbohydrate Counting / Ripness of bananas I, like novorapidboi26 was told there isn't much in it but I have problems whenever I eat bananas so might be a try it and see situation.

Jul 14, 2010 digth 19 posts	Topic: Questions for HCPs / Night hypo and Morning BG I have clarified the detail in the handbook step wise approach (as posted by Karl) with the Chair of the DAFNE Educator Group. I can confirm that this informaiton IS CORRECT and is a DAFNE principle for dose adjustment.

Jul 14, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Ripness of bananas I would think yes, but "negligible" amounts, nothing that would change your insulin........ Anyone else?

Jul 14, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Monster Energy Drink Damn...........I need to try this jaigermeister stuff.........

Jul 14, 2010 marke 686 posts	Topic: Questions for HCPs / Night hypo and Morning BG Karl, thanks for the link. I had never noticed this statement before on the diagram and it is NOT mentioned in the section on Hypo's. i have therefore raised it with DAFNE Central and they will come back to me ( and I will pass it on here) with a clarification on this subject. The handbook is due to be revised soon as it happens so its an ideal time to clarify this. If the statement is considered correct then it should be included in the Hypo section as well to ensure consistency and ensure that people ( like me) don't miss it. I will let you know as soon as I get feedback.

Jul 14, 2010 Mark2 23 posts	Topic: General Discussion / Leaking Novopen ?!?! I have had a problem with Novopens which seem to leak as well. I've thrown pens away in the past that seemed to have this problem. It never occurred to me that it was just the needle and the rubber on the insulin vial that caused this.

Jul 14, 2010 Ffi010 8 posts	Topic: Carbohydrate Counting / Ripness of bananas Hi, I was wondering if there was a difference in CPs between a slightly green banana, ripe and over ripe (slightly brown) banana? I have been told that there is more sugar in a bruised banana. Does that mean More CPs??

Jul 14, 2010 Ffi010 8 posts	Topic: Carbohydrate Counting / Monster Energy Drink This stuff is like Red Bull on speed!! Amazing! ha. I often have the low carb one on its own before a long day or before a lecture! I cant drink a whole can though as it makes me feel sick and shakey, due to the large amounts of caffeine and taurin. As there is only 2.4g CHO in 100ml (12g in the whole can) I dont inject at all. esp not as a jaiger bomb (also a fav of mine) as not only is there negligable carbs in it but also it is with alcohol. unless you do alot of bombs, say 4+ it wouldnt inject and would be caucious if you did inject. Hope this helps.

Jul 14, 2010 marke 686 posts	Topic: General Discussion / fiona walkers bg diary I'm with Mark2 it looks like your BI in the evening is not enough. Given your sensitivity to insulin I would only change it by 1 max (you probably don't have a pen that can do 0.5, but it might be worth looking for one if you are that sensitve). After the change give it a few days to fully see if it has had the desired effect. You may also need to do a 3am test ( sorry) to see how your BG changes over night, sometimes higher BG's in the morning is dawn phenomenom but not always. Probably the BI at night change will do the job, if you start lower you will probably tend to stay lower during the day and if you don't need to constantly correct it will be easier to see if your CP estimates are good or not so good. ( indian food is full of CP's, well it always seems that way to my body anyway ;-) )