Recent Posts - DAFNE Online

Jul 13, 2010

Mark2 23 posts

Topic: General Discussion / fiona walkers bg diary

Fiona - to me you don't seem to be taking enough Background insulin. You seem to be on very small doses at unequal times of the day.

Many people with type 1 seem to be on about 20 to 28 units of Background insulin a day (1 or two injections). Of course you may be different, but this certainly looks like the problem. Remember to adjust your doses gradually 2 units at a time.

Jul 13, 2010

novorapidboi26 1,819 posts

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

wow.............lots of jargon there................

Jul 13, 2010

Angie 3 posts

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

A disease isn't necessarily something you catch - it's defined in medical terms as "any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown", which definitely fits diabetes.

I guess I've thought of it as both a disease and a condition somewhat interchangeably, though when I'm having one of those days it does get referred to as "that damn disease!" ;)

Jul 13, 2010

meltow 78 posts

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

Diabetes is a condition
A disease you catch [bacteria or virus], whereas a condition happens, and in the case of diabetes you can't necessarily put your finger on the reason why.

Jul 13, 2010

novorapidboi26 1,819 posts

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

I agree with you marke.............

For me a disease is an outside force entering the body having adverse effects....

A condition is more genetic, or at least comes from inside...... Alzheimers, cancer and so on.....

I thought I would start this thread as I have seen it written as disease many times and totally disagree...

Jul 13, 2010

marke 686 posts

Topic: General Discussion / Clikstar Pens

that doesn't make sense, from a chemist point of view. If they had them on their system then they should have a PIP code. All medicines have a PIP code, either by the manufacturer or 'internal' if its a 'repackaged'.
If the chemist orders it from a supplier they might not have the correct PIP code but the supplier should be able to look up the correct one...
( I work in the IT dept of a pharmaceutical company, so deal with this kind of thing). The PIP codes you give should be enough for any chemist to obtain them, presuming they are correct.

Jul 13, 2010

marke 686 posts

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

no sooner do I post than I think of heart 'disease' which is also referred to as a condition. Anyway I still go with condition myself....

Jul 13, 2010

marke 686 posts

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

for me a disease is an outside 'agent' that you 'catch'. As far as I understand Type 1 is caused by your own body attacking itself and so is a 'condition'. We won't go into causes as this is potential contentious and not completely clear cut. It could be triggered by a 'disease' and then again maybe not....

Jul 13, 2010

Jo Penn 24 posts

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

Mmm I think of it as a condition; but used to think of it as a disease....
A condition is something you can control; but a disease can be life-limiting.....

Jul 13, 2010

novorapidboi26 1,819 posts

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

Diesease or Condition...........

What do you refer to it as........?????????

Jul 13, 2010

NiVZ 82 posts

Topic: General Discussion / Clikstar Pens

Hello,

OK after many a telling off for using Lantus cartridges in a Humapen I've decided to do something about it. I previously used the Autopen but hate these as they are so plasticy, and two of them broke during injections!

So I've been trying to get hold of a Clikstar pen. My chemist has them on their system but they didn't have a PIP code. Called the doctors surgery and they couldn't find them on their system, even with the manufacturers PIP code. They have submitted a handwritten prescription so fingers crossed I'll get one.

If anyone else is interested in these here are the PIP codes I was given - hopefully your doctors surgery can find them using these:

Silver - 354 8559
Blue - 354 8542

NiVZ

Jul 13, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Night hypo and Morning BG

In black and white, but obviously all other reasons for lows must be excluded and the possibility its just a fluke..

If it happens again you can be sure the BI needs tweaked......

Jul 13, 2010

Karl 83 posts

Topic: Questions for HCPs / Night hypo and Morning BG

http://www.dafneonline.co.uk/hbook_topics/36

Jul 13, 2010

marke 686 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 686 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 686 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 13, 2010 Mark2 23 posts	Topic: General Discussion / fiona walkers bg diary Fiona - to me you don't seem to be taking enough Background insulin. You seem to be on very small doses at unequal times of the day. Many people with type 1 seem to be on about 20 to 28 units of Background insulin a day (1 or two injections). Of course you may be different, but this certainly looks like the problem. Remember to adjust your doses gradually 2 units at a time.

Jul 13, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Diabetes............. wow.............lots of jargon there................

Jul 13, 2010 Angie 3 posts	Topic: General Discussion / Diabetes............. A disease isn't necessarily something you catch - it's defined in medical terms as "any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown", which definitely fits diabetes. I guess I've thought of it as both a disease and a condition somewhat interchangeably, though when I'm having one of those days it does get referred to as "that damn disease!" ;)

Jul 13, 2010 meltow 78 posts	Topic: General Discussion / Diabetes............. Diabetes is a condition A disease you catch [bacteria or virus], whereas a condition happens, and in the case of diabetes you can't necessarily put your finger on the reason why.

Jul 13, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Diabetes............. I agree with you marke............. For me a disease is an outside force entering the body having adverse effects.... A condition is more genetic, or at least comes from inside...... Alzheimers, cancer and so on..... I thought I would start this thread as I have seen it written as disease many times and totally disagree...

Jul 13, 2010 marke 686 posts	Topic: General Discussion / Clikstar Pens that doesn't make sense, from a chemist point of view. If they had them on their system then they should have a PIP code. All medicines have a PIP code, either by the manufacturer or 'internal' if its a 'repackaged'. If the chemist orders it from a supplier they might not have the correct PIP code but the supplier should be able to look up the correct one... ( I work in the IT dept of a pharmaceutical company, so deal with this kind of thing). The PIP codes you give should be enough for any chemist to obtain them, presuming they are correct.

Jul 13, 2010 marke 686 posts	Topic: General Discussion / Diabetes............. no sooner do I post than I think of heart 'disease' which is also referred to as a condition. Anyway I still go with condition myself....

Jul 13, 2010 marke 686 posts	Topic: General Discussion / Diabetes............. for me a disease is an outside 'agent' that you 'catch'. As far as I understand Type 1 is caused by your own body attacking itself and so is a 'condition'. We won't go into causes as this is potential contentious and not completely clear cut. It could be triggered by a 'disease' and then again maybe not....

Jul 13, 2010 Jo Penn 24 posts	Topic: General Discussion / Diabetes............. Mmm I think of it as a condition; but used to think of it as a disease.... A condition is something you can control; but a disease can be life-limiting.....

Jul 13, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / Diabetes............. Diesease or Condition........... What do you refer to it as........?????????

Jul 13, 2010 NiVZ 82 posts	Topic: General Discussion / Clikstar Pens Hello, OK after many a telling off for using Lantus cartridges in a Humapen I've decided to do something about it. I previously used the Autopen but hate these as they are so plasticy, and two of them broke during injections! So I've been trying to get hold of a Clikstar pen. My chemist has them on their system but they didn't have a PIP code. Called the doctors surgery and they couldn't find them on their system, even with the manufacturers PIP code. They have submitted a handwritten prescription so fingers crossed I'll get one. If anyone else is interested in these here are the PIP codes I was given - hopefully your doctors surgery can find them using these: Silver - 354 8559 Blue - 354 8542 NiVZ

Jul 13, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Night hypo and Morning BG In black and white, but obviously all other reasons for lows must be excluded and the possibility its just a fluke.. If it happens again you can be sure the BI needs tweaked......

Jul 13, 2010 Karl 83 posts	Topic: Questions for HCPs / Night hypo and Morning BG http://www.dafneonline.co.uk/hbook_topics/36

Jul 13, 2010 marke 686 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 686 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 686 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...