Recent Posts - DAFNE Online

Jul 13, 2010

marke 681 posts

Topic: Questions for HCPs / Night hypo and Morning BG

Karl, where did you get that quote from the handbook i.e. what section/page ? I can't find it in the online handbook and so am slightly concerned that there is a 'newer' version being given to graduates that is not online. ( Of course I could just be missing it in the handbook :-) )

Jul 13, 2010

marke 681 posts

Topic: Questions for HCPs / Night hypo and Morning BG

bravo, someone else apart from me reads the handbook :-) A very good point. However personally I would still not change my BI without a pattern, my personal experience is I can occasionally get variations in my insulin requirements that go 'back to normal' after a day or so and thus I prefer to be 100% sure I need to change it before I do. Its a personnal choice and I take the point that I am NOT following the official handbook.

Jul 13, 2010

Possum 7 posts

Topic: Questions for HCPs / Graves Disease & Type One-Insulin Dependant

Can anyone say if there is a conection between taking Qick acting at dinner (approx 8pm) and 24 hour bolus (approx 9pm to 9.30pm) and having disturbed sleep through the night?...I wake almost every couple of hours - no hypos
My BGLs are in on target though out the day (HBA1c is 7)but, I feel tired most of the time & wondered if I change my bolus time or split it will it make any diference?

Jul 12, 2010

Karl 83 posts

Topic: Questions for HCPs / Night hypo and Morning BG

You don't need a pattern for a night time Hypo - from the handbook.

Continue to monitor for 48 hours to see if there is a pattern (exception is a night-time hypo, in which case BI should be reduced the following evening).

Jul 12, 2010

marke 681 posts

Topic: Questions for HCPs / Night hypo and Morning BG

I'm with novarapidboi26, to a degree. I suspect you over did the CP's to recover from the hypo. One of the key things they teach on DAFNE is we generally over do Hypo treatment which causes a see-saw effect in blood sugars. I would not change any insulin doses immediately though, if this was a one off then treat it as such. Especially if there were mitigating circumstances. Its fine to adjust doses to treat a pattern but look back and try to find a pattern otherwise its change for change sake rather than being backed up by logic.
Also remember if you are over 'about' 12 then doses and correction doses may have less of an effect than normal. This will vary from person to person so unfortunately the only way to find out is trial and error. If it helps I have the same issue in that if I start the day high I tend to struggle all day, whereas if I start in range I tend to stay in range.

Jul 12, 2010

Nat 30 posts

Topic: Questions for HCPs / Night hypo and Morning BG

Yes I agree I think you over treated your hypo. At 4.00 am you could also be hitting the time when the insulin is more resistent. For a 2.3 hypo I would have just taken the 5 tablets or a carton of fruit juice and perhaps one biscuit and that usually would have brought you up by about 6 and the extra 2 biscuits about another 6 so in all about 12. If you don't know what caused you night hypo I would reduce you BI insulin by 20% unless you know for sure it was due to exercise which might have caught up with you.

Jul 12, 2010

Gaz 2 posts

Topic: General Discussion / Leaking Novopen ?!?!

yeah, that's done it.

cheers.

Jul 12, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Glucose Release Times

This question I suppose is for any dieticians out there.

Is it possible to work out how fast the glucose contained in food is released using the GI value.

This might help me to fine tune the times I take my insulin after eating. (Even though your told to take before)

I can always manage to hit my targets at meal times, if i behave, but in between times are always above target.

Ideally some kind of calculator that took all the different foods going to be eaten then spat out a rough time to inject...bla bla bla....

Silly ideas I know but it would be ideal for when I have my lunch (2 rolls, bag of crisps, youghurt...etc), glucose is being released after the insulin has peaked....

I crave perfection, one of the side effects of DAFNE....

Jul 12, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Night hypo and Morning BG

Hey fifi,

I am just a graduate but like to give my opinion.....

When you woke up low, the correct action to take is 2CPs of quick acting, then test again if you still feel low. If you need more, take another 2.

How many CPs is 5 dextrose tablets and then a further 3 CPs?....... (that may be slow releasing/high GI)

That might be why you were high, maybe together with your bodily response of releasing glucose post hypo and an increased resistance to insulin in the morning.

Is your background right?

I ask this firstly as you went low in the early hours and secondly stayed high after lunch even after correction.

Assuming its a slpit dose you might need to adjust your am and pm doses. Less at night, more in the morning.

If it was me I would have corrected in the morning and just been vigilant in detecting a hypo, but thats just me.

Its all speculation remember, and HCP should give you there opinion.

Jul 12, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Paninis

Just had a look at the link section there, its fantastic....

It has all the main takeaways in there, keep adding ppl...

Jul 12, 2010

Alan 49 284 posts

Topic: General Discussion / Exhaustion

Athena

sounds like a job for your Healthcare Professional

Alan

Jul 12, 2010

Lizzie 87 posts

Topic: General Discussion / Exhaustion

Have your blood sugars stablised since DAFNE?

How are your diet and exercise? What about sleeping? Could it be the recent heatwave draining you?

You say you are worrying about work. This additional stress could affect your diabetes and the diabetes could make your stress worse too. If you have annual leave days, I would take them and work on your blood sugars, and try to relax. Keep in close touch with your dr or nurse if you are unsure.

Jul 12, 2010

Ffi010 8 posts

Topic: Questions for HCPs / Night hypo and Morning BG

I had a hypo in the night at 4am and I was 2.3! I woke up and treated the hypo with 5 dextrose and 3cp,s.
I woke as normal at 8am and I was 22.2!
I understand that through the dafne principals that I should not adjust my insulin, but at 22.2 I was worried that I was going to be high throughout the day. I was. I didn't go below 13 the whole day even though I adjusted my dose at lunch when I was 13.8.
It wasn't until next morning that I was back to single figures.
Is that normal? Did I do the right thing or should I have adjusted it earlier on??
Thank you

Jul 12, 2010

Nat 30 posts

Topic: Carbohydrate Counting / Paninis

Yes I had a paninis and I used the rule that as they were thinner that 2 inches was 10g and it worked out!!!

Jul 12, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Paninis

My advice would be that 1 inch of baguette is 10 grams of carbs, picked that tip up in the dafne class and it has worked for me so far.......

As for paninis probably follows similar rules as above but paninis are smaller and thinner.....

Jul 12, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / Exhaustion

That sound really unfortunate........

I am no expert but the high before bed and in the morning will probably make you feel more tired....

It shouldnt be lasting all day though if your control is reaonable.

Are you hitting targets during the day??

There is the possibility it could be something else but I would put money on that its connected with your blood sugar...

Cafeine might help, or not, as it does not really affect me...

Good luck...

Jul 10, 2010

Leah57 4 posts

Topic: General Discussion / Insulin Pumps

Tell me about it, I've had it for 11 years, I don't know anybody with diabetes, and when I did the Dafne course it was a real eye opener to realise that lots of other people do live with it. Of course, I know other people have it, but talking to people really brought it home for me.

Getting a pump depends on your own personal circumstances, but I will say, that since having the pump, I've lost weight, which I put down to better control with my bloods, which in turn has given me more confidence.

Feel free to have a moan anytime, like you say, it makes a huge difference having somebody who understands it because they also live with it 24/7. Chin up, and keep smiling!

Jul 9, 2010

Nat 30 posts

Topic: General Discussion / Insulin Pumps

I am a mother of 3 and working full time so I certainly do need the flexibility. Thing is even if I do want a pump whether I get one is another thing! I need a pep talk now and again as sometime I do get caught up in my own self pitty and I shouldn't cause as you say I live with it and not around it but it is still only early days and I am trying to lose some weight to so perhaps too much too soon! Thanks for the chat, when you don't have anybody to talk to about things and nobody can understand how it feels to be diabetic unless you are even if you live with someone who has it when they are telling you don't worry you can it and they are tucking into the cupboard full of carbs!!

Jul 9, 2010

Leah57 4 posts

Topic: General Discussion / Insulin Pumps

I was testing 4 times a day before I started on the pump, and having to test more was a worry for me, but I reallly didn't have to do that many more.

In the early days, it was a case of doing some middle of the night one's to work out my overnight basal rates, beacuse of my overnight hypo's, but it wasn't too traumatic, and I'm back to 2-4 tests a day now. I'm lucky enough to have a great diabetes nursing team, who are fairly chilled out, which really helped.

I can't say as I've ever found wearing the pump uncomfortable, and I never even really notice that I'm wearing it, unless the wire snag's on something! Each to their own though, I can see some people wouldn't get on with it. For me, its worth the flexibility I now have.

As for not doing things/going places that you want to and not eating things that you want to, try not to think about it too much. You live with diabetes because you have to, but it should never stop you living your life and doing whatever it is you want to do. God, I sound like a counsellor!! Sorry, pep talk over! L.

Jul 9, 2010

Nat 30 posts

Topic: General Discussion / Insulin Pumps

I did have some horrid overnight hypos now on split dose and in the heat reduced my evening dose right down but then have the very odd breakfast highs when I go to bed on target.

About the pump people have said that it takes so much more blood testing than without and I seem to be testing all the time don't think I could do any more. I went on the course to become less diabetic if you know what I mean i.e. eating what I want when I want which is sorted but I feel now I don't eat things and go places cause I don't want to upset the good results I've had. Other people have said that they find it uncomfortable and gets cut of at times in the night and on holiday they just wished they didn't have it!

Jul 9, 2010

Leah57 4 posts

Topic: General Discussion / Insulin Pumps

That sounds pretty similar to me Angie, I had a lot of trouble with overnight hypo's and dawn rises etc etc, and the pump's been great.
It's a lot of wok but so worth it, and it makes life much more flexilble.
Nat, what have people said to put you off having a pump, if you don't mind me asking?

Jul 9, 2010

Angie 3 posts

Topic: General Discussion / Insulin Pumps

I started on the pump in January, and I love mine! It's not a magic gadget that suddenly makes everything easy, but it really does allow me to manage my diabetes better. I had problems with hypos and a pretty strong dawn phenomenon that lantus couldn't cope with. The pump allows me to fine tune my basal insulin to match my needs, and I can respond to changes in my routine much faster using the pump. It takes a bit of work, but if you're willing to put the effort in, then the pump is a fantastic tool for helping to control your diabetes. Smile

Jul 8, 2010

Kentbabe 10 posts

Topic: General Discussion / Insulin Pumps

hiya ive heard mixed things about the pump. But i am interested in learning how people have taken to them.

Jul 8, 2010

Kentbabe 10 posts

Topic: General Discussion / Leaking Novopen ?!?!

ive had the same problem with my humalog pen and my leviemer one too. I found that if i left the needle on for a few days it would start to leak a small amount of insulin. I now dont leave a needle on and this has stoped the leakiing. Hope u solve ur problem

Jul 8, 2010

Nat 30 posts

Topic: General Discussion / Insulin Pumps

Hi, I am new to the whole Daphne thing. I have been a Type 1 diabetic for 20 years and was really keen on the insulin pump but many people have put me off lately. How are you getting on with it?

Jul 13, 2010 marke 681 posts	Topic: Questions for HCPs / Night hypo and Morning BG Karl, where did you get that quote from the handbook i.e. what section/page ? I can't find it in the online handbook and so am slightly concerned that there is a 'newer' version being given to graduates that is not online. ( Of course I could just be missing it in the handbook :-) )

Jul 13, 2010 marke 681 posts	Topic: Questions for HCPs / Night hypo and Morning BG bravo, someone else apart from me reads the handbook :-) A very good point. However personally I would still not change my BI without a pattern, my personal experience is I can occasionally get variations in my insulin requirements that go 'back to normal' after a day or so and thus I prefer to be 100% sure I need to change it before I do. Its a personnal choice and I take the point that I am NOT following the official handbook.

Jul 13, 2010 Possum 7 posts	Topic: Questions for HCPs / Graves Disease & Type One-Insulin Dependant Can anyone say if there is a conection between taking Qick acting at dinner (approx 8pm) and 24 hour bolus (approx 9pm to 9.30pm) and having disturbed sleep through the night?...I wake almost every couple of hours - no hypos My BGLs are in on target though out the day (HBA1c is 7)but, I feel tired most of the time & wondered if I change my bolus time or split it will it make any diference?

Jul 12, 2010 Karl 83 posts	Topic: Questions for HCPs / Night hypo and Morning BG You don't need a pattern for a night time Hypo - from the handbook. Continue to monitor for 48 hours to see if there is a pattern (exception is a night-time hypo, in which case BI should be reduced the following evening).

Jul 12, 2010 marke 681 posts	Topic: Questions for HCPs / Night hypo and Morning BG I'm with novarapidboi26, to a degree. I suspect you over did the CP's to recover from the hypo. One of the key things they teach on DAFNE is we generally over do Hypo treatment which causes a see-saw effect in blood sugars. I would not change any insulin doses immediately though, if this was a one off then treat it as such. Especially if there were mitigating circumstances. Its fine to adjust doses to treat a pattern but look back and try to find a pattern otherwise its change for change sake rather than being backed up by logic. Also remember if you are over 'about' 12 then doses and correction doses may have less of an effect than normal. This will vary from person to person so unfortunately the only way to find out is trial and error. If it helps I have the same issue in that if I start the day high I tend to struggle all day, whereas if I start in range I tend to stay in range.

Jul 12, 2010 Nat 30 posts	Topic: Questions for HCPs / Night hypo and Morning BG Yes I agree I think you over treated your hypo. At 4.00 am you could also be hitting the time when the insulin is more resistent. For a 2.3 hypo I would have just taken the 5 tablets or a carton of fruit juice and perhaps one biscuit and that usually would have brought you up by about 6 and the extra 2 biscuits about another 6 so in all about 12. If you don't know what caused you night hypo I would reduce you BI insulin by 20% unless you know for sure it was due to exercise which might have caught up with you.

Jul 12, 2010 Gaz 2 posts	Topic: General Discussion / Leaking Novopen ?!?! yeah, that's done it. cheers.

Jul 12, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Glucose Release Times This question I suppose is for any dieticians out there. Is it possible to work out how fast the glucose contained in food is released using the GI value. This might help me to fine tune the times I take my insulin after eating. (Even though your told to take before) I can always manage to hit my targets at meal times, if i behave, but in between times are always above target. Ideally some kind of calculator that took all the different foods going to be eaten then spat out a rough time to inject...bla bla bla.... Silly ideas I know but it would be ideal for when I have my lunch (2 rolls, bag of crisps, youghurt...etc), glucose is being released after the insulin has peaked.... I crave perfection, one of the side effects of DAFNE....

Jul 12, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Night hypo and Morning BG Hey fifi, I am just a graduate but like to give my opinion..... When you woke up low, the correct action to take is 2CPs of quick acting, then test again if you still feel low. If you need more, take another 2. How many CPs is 5 dextrose tablets and then a further 3 CPs?....... (that may be slow releasing/high GI) That might be why you were high, maybe together with your bodily response of releasing glucose post hypo and an increased resistance to insulin in the morning. Is your background right? I ask this firstly as you went low in the early hours and secondly stayed high after lunch even after correction. Assuming its a slpit dose you might need to adjust your am and pm doses. Less at night, more in the morning. If it was me I would have corrected in the morning and just been vigilant in detecting a hypo, but thats just me. Its all speculation remember, and HCP should give you there opinion.

Jul 12, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Paninis Just had a look at the link section there, its fantastic.... It has all the main takeaways in there, keep adding ppl...

Jul 12, 2010 Alan 49 284 posts	Topic: General Discussion / Exhaustion Athena sounds like a job for your Healthcare Professional Alan

Jul 12, 2010 Lizzie 87 posts	Topic: General Discussion / Exhaustion Have your blood sugars stablised since DAFNE? How are your diet and exercise? What about sleeping? Could it be the recent heatwave draining you? You say you are worrying about work. This additional stress could affect your diabetes and the diabetes could make your stress worse too. If you have annual leave days, I would take them and work on your blood sugars, and try to relax. Keep in close touch with your dr or nurse if you are unsure.

Jul 12, 2010 Ffi010 8 posts	Topic: Questions for HCPs / Night hypo and Morning BG I had a hypo in the night at 4am and I was 2.3! I woke up and treated the hypo with 5 dextrose and 3cp,s. I woke as normal at 8am and I was 22.2! I understand that through the dafne principals that I should not adjust my insulin, but at 22.2 I was worried that I was going to be high throughout the day. I was. I didn't go below 13 the whole day even though I adjusted my dose at lunch when I was 13.8. It wasn't until next morning that I was back to single figures. Is that normal? Did I do the right thing or should I have adjusted it earlier on?? Thank you

Jul 12, 2010 Nat 30 posts	Topic: Carbohydrate Counting / Paninis Yes I had a paninis and I used the rule that as they were thinner that 2 inches was 10g and it worked out!!!

Jul 12, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Paninis My advice would be that 1 inch of baguette is 10 grams of carbs, picked that tip up in the dafne class and it has worked for me so far....... As for paninis probably follows similar rules as above but paninis are smaller and thinner.....

Jul 12, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Exhaustion That sound really unfortunate........ I am no expert but the high before bed and in the morning will probably make you feel more tired.... It shouldnt be lasting all day though if your control is reaonable. Are you hitting targets during the day?? There is the possibility it could be something else but I would put money on that its connected with your blood sugar... Cafeine might help, or not, as it does not really affect me... Good luck...

Jul 10, 2010 Leah57 4 posts	Topic: General Discussion / Insulin Pumps Tell me about it, I've had it for 11 years, I don't know anybody with diabetes, and when I did the Dafne course it was a real eye opener to realise that lots of other people do live with it. Of course, I know other people have it, but talking to people really brought it home for me. Getting a pump depends on your own personal circumstances, but I will say, that since having the pump, I've lost weight, which I put down to better control with my bloods, which in turn has given me more confidence. Feel free to have a moan anytime, like you say, it makes a huge difference having somebody who understands it because they also live with it 24/7. Chin up, and keep smiling!

Jul 9, 2010 Nat 30 posts	Topic: General Discussion / Insulin Pumps I am a mother of 3 and working full time so I certainly do need the flexibility. Thing is even if I do want a pump whether I get one is another thing! I need a pep talk now and again as sometime I do get caught up in my own self pitty and I shouldn't cause as you say I live with it and not around it but it is still only early days and I am trying to lose some weight to so perhaps too much too soon! Thanks for the chat, when you don't have anybody to talk to about things and nobody can understand how it feels to be diabetic unless you are even if you live with someone who has it when they are telling you don't worry you can it and they are tucking into the cupboard full of carbs!!

Jul 9, 2010 Leah57 4 posts	Topic: General Discussion / Insulin Pumps I was testing 4 times a day before I started on the pump, and having to test more was a worry for me, but I reallly didn't have to do that many more. In the early days, it was a case of doing some middle of the night one's to work out my overnight basal rates, beacuse of my overnight hypo's, but it wasn't too traumatic, and I'm back to 2-4 tests a day now. I'm lucky enough to have a great diabetes nursing team, who are fairly chilled out, which really helped. I can't say as I've ever found wearing the pump uncomfortable, and I never even really notice that I'm wearing it, unless the wire snag's on something! Each to their own though, I can see some people wouldn't get on with it. For me, its worth the flexibility I now have. As for not doing things/going places that you want to and not eating things that you want to, try not to think about it too much. You live with diabetes because you have to, but it should never stop you living your life and doing whatever it is you want to do. God, I sound like a counsellor!! Sorry, pep talk over! L.

Jul 9, 2010 Nat 30 posts	Topic: General Discussion / Insulin Pumps I did have some horrid overnight hypos now on split dose and in the heat reduced my evening dose right down but then have the very odd breakfast highs when I go to bed on target. About the pump people have said that it takes so much more blood testing than without and I seem to be testing all the time don't think I could do any more. I went on the course to become less diabetic if you know what I mean i.e. eating what I want when I want which is sorted but I feel now I don't eat things and go places cause I don't want to upset the good results I've had. Other people have said that they find it uncomfortable and gets cut of at times in the night and on holiday they just wished they didn't have it!

Jul 9, 2010 Leah57 4 posts	Topic: General Discussion / Insulin Pumps That sounds pretty similar to me Angie, I had a lot of trouble with overnight hypo's and dawn rises etc etc, and the pump's been great. It's a lot of wok but so worth it, and it makes life much more flexilble. Nat, what have people said to put you off having a pump, if you don't mind me asking?

Jul 9, 2010 Angie 3 posts	Topic: General Discussion / Insulin Pumps I started on the pump in January, and I love mine! It's not a magic gadget that suddenly makes everything easy, but it really does allow me to manage my diabetes better. I had problems with hypos and a pretty strong dawn phenomenon that lantus couldn't cope with. The pump allows me to fine tune my basal insulin to match my needs, and I can respond to changes in my routine much faster using the pump. It takes a bit of work, but if you're willing to put the effort in, then the pump is a fantastic tool for helping to control your diabetes.

Jul 8, 2010 Kentbabe 10 posts	Topic: General Discussion / Insulin Pumps hiya ive heard mixed things about the pump. But i am interested in learning how people have taken to them.

Jul 8, 2010 Kentbabe 10 posts	Topic: General Discussion / Leaking Novopen ?!?! ive had the same problem with my humalog pen and my leviemer one too. I found that if i left the needle on for a few days it would start to leak a small amount of insulin. I now dont leave a needle on and this has stoped the leakiing. Hope u solve ur problem

Jul 8, 2010 Nat 30 posts	Topic: General Discussion / Insulin Pumps Hi, I am new to the whole Daphne thing. I have been a Type 1 diabetic for 20 years and was really keen on the insulin pump but many people have put me off lately. How are you getting on with it?