Recent Posts - DAFNE Online

Jul 2, 2010

Kevin Jones 3 posts

splitting the dose is useful if you are eating a large carb meal to help avoid the hypo that can be created by those high units of insulin. on lower or medium carb meals, i think you can put the insulin in at once. by lower or medium carb meals i mean a normal amount of pasta, say half a plate or less. if you have garlic bread like me as well as the pasta, the carb amount COULD possibly be treated as a large amount.

again, trial and error are the best ways to work out the dose you need. the DAFNE carb book and/or the food packaging will guide you most of the way as well as your own personal ratio.

happy eating!

Jul 2, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / chocoholic!!!!!!!!!!!!!!!!!

Oh I agree,

As a DAFNE graduate you can eat as much as you like as long as u cover with insulin.

But as it is for everyone, too much is bad for your teeth, weight, so on and so forth........

Jul 2, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Pizza

Good advice.......

So do most of you agree that when eating low GI foods, like pizza, and i think pasta, but maybe not, you should split the dose before and after or just wait....

That would help me at lunch times as between lunch and dinner is the only time my sugars increase between those two times (about three o clock) down to the mixture of different GI foods, sandwiches, crisps, biscuits and fruit, I know Im a muncher....

Jul 2, 2010

Kevin Jones 3 posts

Topic: General Discussion / chocoholic!!!!!!!!!!!!!!!!!

i eat chocolate every day without fail, i love it. the funny thing thing is i never ate before being diagnosed. but once it became a 'fobidden' food (until my DAFNE training), i wanted it all the time. i dont go mad, about 4 chunks will do just to satisfy my craving and make me feel a bit more like a normal person!

my fav is old jamaica rum and raisen, the smell......

Jul 2, 2010

Kevin Jones 3 posts

Topic: Carbohydrate Counting / Pizza

I dont have much trouble with pizza. i normally use the values from the packaging if available and have learned pretty much how much insulin to put in by trial and error. the thin crust pizza 9" is normally 8 units for a whole pizza and a deep pan can be up to 12 units. Bear in mind my ratio is slightly lower than 1 CP to 1 unit of insulin.

The best advice is as usual. do a test run. take a reading before, eat the pizza, i normally wait about 20 mins for the meal to start digesting, and then inject the insulin. then do another reading about 2 hours later.

if you hypo from putting all the insulin in at once, split the dose and inject half after about 20 mins and then half about 1 and 1/2 hours later. if you still hypo, then the have the number of units too high. make a note of what you used and do another test run (yummy!) when convenient.

remember that thin crust and thick crust differ quite substantionally in their carb values. and if you have one of those 'stuffed crusts' it's even higher. i think they should be avoided at all costs, all that cheese and fat cant be good for you!

once you have worked out the dosage for each type and amount of pizza, eg. thin crust, 9", you can pretty much guess the others and get close.

enjoy the food!

Jul 2, 2010

Jo Penn 24 posts

Topic: Carbohydrate Counting / Picnics (grr)

Thanks Norman.. will try that with the correction doses.

Thanks NovorapidBoi... got to grips with the maths bit quite quickly... just the other bits to tweak.

Jul 1, 2010

marke 686 posts

Topic: Carbohydrate Counting / Vegetables

If you want more information on this you should google 'glycemic index' which is an indication of the rate carbs are converted to sugar. It is not covered on the DAFNE Course,
when I checked why ( people had been asking) it was because it was felt it was too much information to take on board when you are being bombarded with ratios and rules etc.
The feeling is that those interested will look into it themselves. If you disagree with this approach I would recommend posting in the DUAG forum, since they are the interface between graduates and the DAFNE Programme management.

Jul 1, 2010

Tony.P 16 posts

Topic: General Discussion / I want an insulin pump

we have to be passionate about our condition i think. The problem is it was a trial but on the day of the end of the trial they gave us hope that we would keep the pumps, only to be told by phone a few days later that we had not met the criteria so read that as you will.

Jul 1, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / I want an insulin pump

Hey Tony,

Now whats happened to you is shit, you were given an pump, to find it had positive effects, which naturally it will, then taken back off you...

Thats why they should be given to individuals who are always low, or high, or both, through no fault of thier own.

HCPs should have realised that you were able to control your sugars normally.

Its a sad thought but it does all boil down to money and thats the reality.

Anyone saying that money doesnt matter is disillusioned.

Theres cuts left, right and centre in th UK.

Pumps are not pratical in everyday life, surely having one just brings it home even more that you have this crappy condition.

Oh how I love my passionate opinions...

Please join the debate.....

Jul 1, 2010

Tony.P 16 posts

Topic: Questions for HCPs / Washing before testing

Obviously if you can great, but it is not always possible and I don't think it makes a huge difference I have not noticed anyway.

Jul 1, 2010

Tony.P 16 posts

Topic: General Discussion / I want an insulin pump

I think it important to have this debate, i am sure my pump was taken back on purely Financial reasons.

Jul 1, 2010

EMS 15 posts

Topic: Carbohydrate Counting / Vegetables

ok, thanks. I didn't realize that. Still a lot to learn!

Jul 1, 2010

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Washing before testing

I got into that habit too when I was on the course, but not so much now, unless I know I ahve been touching somethin like ink or a bit of fruit I wont bother.

It only affects the reading about + or - 1 mmol/l.

Test it out yourself, before and after washing, then decide wether to make it an issue........

Jul 1, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / I want an insulin pump

Edit*

Only if you cant control the condition after trying everything is it suitable..........

We could go on forever weighing up the good and bad........

Jul 1, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / fiona walkers bg diary

Hey fiona........

My first thoughts are jesus, you are on hardly any insulin, are you just recently diagnosed.

Secondly, It seems that your ratios are fine, assuming 1+1 actually means 1:1.

In the morning however you dont seem to be correcting enough.

On the sunday you were 18.9, so to get down to the magic 5.5, you need to come down 13.4 mmol/l, so if 1 unit brings you down between 2-3 mmol/l then you will need 5 units correction, instead of 3.

Likely more as your BG was quite high and the 2-3 rule usually doesnt apply.

You seem to be doing this every morning, I think if you get that correction right you will be on target the rest of the day.

On the drink side, I myself drink buckfast, by the bottle (75cl). I contacted Buckfast to find out how much sugar was in it, they got back and said 90g of grape sugar per 75cl bottle.

So when I have buckfast, usually after my dinner insulin has peaked, I inject for the wine (12 with my ratio of 1.5:1 at that time).

So I would reccomend injecting 4 units if your having a half flask, if drinking before the peak of dinner insulin, add it on to your dinner dose, if after, just inject before you start.

As I am no HCP and have a different physiology from you, make sure you have some hypo relief at hand later on, incase the alcohol and insulin bring your sugars down fast.

I look forward to hearing your results.

Jul 1, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / DAFNE and Employers

Most employers seem ok with it.......

Fortunately I was unemployed at the time....

Jun 30, 2010

fionawalker3 1 post

Topic: General Discussion / fiona walkers bg diary

bg diary

Jun 30, 2010

Nat 30 posts

Topic: General Discussion / DAFNE and Employers

I completed my course last week. I just handed in the letter which my course administrator sent me and they never mentioned anything. I explained that I was attending not only for my own health but to minimise the need for more hospital trips etc and left it up to them to decide whether they wanted to support me or not and it was all fine!

Jun 30, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / I want an insulin pump

I mean no offence......all I m saying is everyone can't have one just because they can't be arsed injecting.....patterns can be spotted on paper......dafne educators would agree I say......only if u can control the condition after trying everythin is it suitable........

Jun 30, 2010

Katy B 8 posts

Topic: General Discussion / I want an insulin pump

Are you more worried about the cost to the NHS or the cost of your health? your own health is priceless and you should want the best care possible! You do not need to carry around canulars and resovoirs unless you were going on holiday or something. All you need day to day is your pump and testing kit. Sleeping with it doesnt bother me, I leave it loose and it follows me around the bed. Its not even an issue!

* Pumpers report better quality of life compared to using other devices for administering insulin. The improvement in QOL is reported in type 1 and insulin-requiring type 2 diabetes subjects on pumps.

*The use of rapid-acting insulin for basal needs offers relative freedom from a structured meal and exercise regimen previously needed to control blood sugar with slow-acting insulin. The alternative basal insulins, such as the long lasting insulins injected once a day, often release their insulin at a very unpredictable rate.
Many pumpers feel that bolusing insulin from a pump is more convenient and discreet than injection.

*Insulin pumps make it possible to deliver more precise amounts of insulin than can be injected using a syringe. This supports tighter control over blood sugar and Hemoglobin A1c levels, reducing the chance of long-term complications associated with diabetes. This is predicted to result in a long-term cost savings relative to multiple daily injections.

*Many modern "smart" pumps have a "bolus wizard" that calculates how much bolus insulin you need taking into account your expected carbohydrate intake, blood sugar level, and still-active insulin.

*Insulin pumps can provide an accurate record of insulin usage through their history menus. On many insulin pumps, this history can be uploaded to a computer and graphed for trend analysis.

*Neuropathy is a troublesome complication of diabetes resistant to usual treatment. There are reports of alleviation or even total disappearance of resistant neuropathic pain with the use of insulin pumps.

*Recent studies of use of insulin pumps in Type 2 diabetes have shown profound improvements in HbA1c, sexual performance, and neuropathy pain.

If you did some research or were allowed to try one over a week Novorapidboi26 you would relise they do more than just deliver insulin, You can have a standard bolus, extended bolus, combination bolus and a superbolus. You can increase and reduce the basal rate hourly (Novorapidboi26 this would help you and your dawn phenomenon), You can have a tempory basal rate for exercise, illness, stress etc. I not wasting my time arguing with you, and im not here to make anyone even want one. Im here to make it clear to anyone that DOES want one that they are infact a brilliant step forward and not a negative, scary or in anyway difficult to live with. Maybe if you tried one you would realise, but you just keep worrying about the NHS why dont you....

Jun 30, 2010

Tony.P 16 posts

Topic: General Discussion / I want an insulin pump

the amount of insulin used is very well controlled on a pump it has to be said, you don't have to round up or down on your carb's and it does take into account your active inuslin although I found that a bit of a pain at night if I was a bit high it would not give suggested dose so I had to override it, but that is a minor issue. I liked the fact that whilst out and a bout I could just dial up the amount of insulin i needed push button and away you go, very discrete but I also found the canulars would irritate me at times and I did not like inserting them every 2 or three days the little needles in the pens are in my oppinion less uncomfortable.

Jun 30, 2010

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Vegetables

Exactly right.......they are absorbed too slowly for any quick acting insulin to deal with....

Background should deal with it.....

On some occasions if I have had baked beans or sweetcorn I have taken one unit....

Jun 30, 2010

novorapidboi26 1,819 posts

Topic: General Discussion / I want an insulin pump

The downsides of the pump described in the last post surely outweigh the positives......the only positive I an see is the ability to deliver over a longer gradual period......

Jul 2, 2010 Kevin Jones 3 posts	Topic: Carbohydrate Counting / Pizza splitting the dose is useful if you are eating a large carb meal to help avoid the hypo that can be created by those high units of insulin. on lower or medium carb meals, i think you can put the insulin in at once. by lower or medium carb meals i mean a normal amount of pasta, say half a plate or less. if you have garlic bread like me as well as the pasta, the carb amount COULD possibly be treated as a large amount. again, trial and error are the best ways to work out the dose you need. the DAFNE carb book and/or the food packaging will guide you most of the way as well as your own personal ratio. happy eating!

Jul 2, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / chocoholic!!!!!!!!!!!!!!!!! Oh I agree, As a DAFNE graduate you can eat as much as you like as long as u cover with insulin. But as it is for everyone, too much is bad for your teeth, weight, so on and so forth........

Jul 2, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Pizza Good advice....... So do most of you agree that when eating low GI foods, like pizza, and i think pasta, but maybe not, you should split the dose before and after or just wait.... That would help me at lunch times as between lunch and dinner is the only time my sugars increase between those two times (about three o clock) down to the mixture of different GI foods, sandwiches, crisps, biscuits and fruit, I know Im a muncher....

Jul 2, 2010 Kevin Jones 3 posts	Topic: General Discussion / chocoholic!!!!!!!!!!!!!!!!! i eat chocolate every day without fail, i love it. the funny thing thing is i never ate before being diagnosed. but once it became a 'fobidden' food (until my DAFNE training), i wanted it all the time. i dont go mad, about 4 chunks will do just to satisfy my craving and make me feel a bit more like a normal person! my fav is old jamaica rum and raisen, the smell......

Jul 2, 2010 Kevin Jones 3 posts	Topic: Carbohydrate Counting / Pizza I dont have much trouble with pizza. i normally use the values from the packaging if available and have learned pretty much how much insulin to put in by trial and error. the thin crust pizza 9" is normally 8 units for a whole pizza and a deep pan can be up to 12 units. Bear in mind my ratio is slightly lower than 1 CP to 1 unit of insulin. The best advice is as usual. do a test run. take a reading before, eat the pizza, i normally wait about 20 mins for the meal to start digesting, and then inject the insulin. then do another reading about 2 hours later. if you hypo from putting all the insulin in at once, split the dose and inject half after about 20 mins and then half about 1 and 1/2 hours later. if you still hypo, then the have the number of units too high. make a note of what you used and do another test run (yummy!) when convenient. remember that thin crust and thick crust differ quite substantionally in their carb values. and if you have one of those 'stuffed crusts' it's even higher. i think they should be avoided at all costs, all that cheese and fat cant be good for you! once you have worked out the dosage for each type and amount of pizza, eg. thin crust, 9", you can pretty much guess the others and get close. enjoy the food!

Jul 2, 2010 Jo Penn 24 posts	Topic: Carbohydrate Counting / Picnics (grr) Thanks Norman.. will try that with the correction doses. Thanks NovorapidBoi... got to grips with the maths bit quite quickly... just the other bits to tweak.

Jul 1, 2010 marke 686 posts	Topic: Carbohydrate Counting / Vegetables If you want more information on this you should google 'glycemic index' which is an indication of the rate carbs are converted to sugar. It is not covered on the DAFNE Course, when I checked why ( people had been asking) it was because it was felt it was too much information to take on board when you are being bombarded with ratios and rules etc. The feeling is that those interested will look into it themselves. If you disagree with this approach I would recommend posting in the DUAG forum, since they are the interface between graduates and the DAFNE Programme management.

Jul 1, 2010 Tony.P 16 posts	Topic: General Discussion / I want an insulin pump we have to be passionate about our condition i think. The problem is it was a trial but on the day of the end of the trial they gave us hope that we would keep the pumps, only to be told by phone a few days later that we had not met the criteria so read that as you will.

Jul 1, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / I want an insulin pump Hey Tony, Now whats happened to you is shit, you were given an pump, to find it had positive effects, which naturally it will, then taken back off you... Thats why they should be given to individuals who are always low, or high, or both, through no fault of thier own. HCPs should have realised that you were able to control your sugars normally. Its a sad thought but it does all boil down to money and thats the reality. Anyone saying that money doesnt matter is disillusioned. Theres cuts left, right and centre in th UK. Pumps are not pratical in everyday life, surely having one just brings it home even more that you have this crappy condition. Oh how I love my passionate opinions... Please join the debate.....

Jul 1, 2010 Tony.P 16 posts	Topic: Questions for HCPs / Washing before testing Obviously if you can great, but it is not always possible and I don't think it makes a huge difference I have not noticed anyway.

Jul 1, 2010 Tony.P 16 posts	Topic: General Discussion / I want an insulin pump I think it important to have this debate, i am sure my pump was taken back on purely Financial reasons.

Jul 1, 2010 EMS 15 posts	Topic: Carbohydrate Counting / Vegetables ok, thanks. I didn't realize that. Still a lot to learn!

Jul 1, 2010 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Washing before testing I got into that habit too when I was on the course, but not so much now, unless I know I ahve been touching somethin like ink or a bit of fruit I wont bother. It only affects the reading about + or - 1 mmol/l. Test it out yourself, before and after washing, then decide wether to make it an issue........

Jul 1, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / I want an insulin pump Edit* Only if you cant control the condition after trying everything is it suitable.......... We could go on forever weighing up the good and bad........

Jul 1, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / fiona walkers bg diary Hey fiona........ My first thoughts are jesus, you are on hardly any insulin, are you just recently diagnosed. Secondly, It seems that your ratios are fine, assuming 1+1 actually means 1:1. In the morning however you dont seem to be correcting enough. On the sunday you were 18.9, so to get down to the magic 5.5, you need to come down 13.4 mmol/l, so if 1 unit brings you down between 2-3 mmol/l then you will need 5 units correction, instead of 3. Likely more as your BG was quite high and the 2-3 rule usually doesnt apply. You seem to be doing this every morning, I think if you get that correction right you will be on target the rest of the day. On the drink side, I myself drink buckfast, by the bottle (75cl). I contacted Buckfast to find out how much sugar was in it, they got back and said 90g of grape sugar per 75cl bottle. So when I have buckfast, usually after my dinner insulin has peaked, I inject for the wine (12 with my ratio of 1.5:1 at that time). So I would reccomend injecting 4 units if your having a half flask, if drinking before the peak of dinner insulin, add it on to your dinner dose, if after, just inject before you start. As I am no HCP and have a different physiology from you, make sure you have some hypo relief at hand later on, incase the alcohol and insulin bring your sugars down fast. I look forward to hearing your results.

Jul 1, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / DAFNE and Employers Most employers seem ok with it....... Fortunately I was unemployed at the time....

Jun 30, 2010 fionawalker3 1 post	Topic: General Discussion / fiona walkers bg diary bg diary

Jun 30, 2010 Nat 30 posts	Topic: General Discussion / DAFNE and Employers I completed my course last week. I just handed in the letter which my course administrator sent me and they never mentioned anything. I explained that I was attending not only for my own health but to minimise the need for more hospital trips etc and left it up to them to decide whether they wanted to support me or not and it was all fine!

Jun 30, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / I want an insulin pump I mean no offence......all I m saying is everyone can't have one just because they can't be arsed injecting.....patterns can be spotted on paper......dafne educators would agree I say......only if u can control the condition after trying everythin is it suitable........

Jun 30, 2010 Katy B 8 posts	Topic: General Discussion / I want an insulin pump Are you more worried about the cost to the NHS or the cost of your health? your own health is priceless and you should want the best care possible! You do not need to carry around canulars and resovoirs unless you were going on holiday or something. All you need day to day is your pump and testing kit. Sleeping with it doesnt bother me, I leave it loose and it follows me around the bed. Its not even an issue! * Pumpers report better quality of life compared to using other devices for administering insulin. The improvement in QOL is reported in type 1 and insulin-requiring type 2 diabetes subjects on pumps. The use of rapid-acting insulin for basal needs offers relative freedom from a structured meal and exercise regimen previously needed to control blood sugar with slow-acting insulin. The alternative basal insulins, such as the long lasting insulins injected once a day, often release their insulin at a very unpredictable rate. Many pumpers feel that bolusing insulin from a pump is more convenient and discreet than injection. Insulin pumps make it possible to deliver more precise amounts of insulin than can be injected using a syringe. This supports tighter control over blood sugar and Hemoglobin A1c levels, reducing the chance of long-term complications associated with diabetes. This is predicted to result in a long-term cost savings relative to multiple daily injections. Many modern "smart" pumps have a "bolus wizard" that calculates how much bolus insulin you need taking into account your expected carbohydrate intake, blood sugar level, and still-active insulin. Insulin pumps can provide an accurate record of insulin usage through their history menus. On many insulin pumps, this history can be uploaded to a computer and graphed for trend analysis. Neuropathy is a troublesome complication of diabetes resistant to usual treatment. There are reports of alleviation or even total disappearance of resistant neuropathic pain with the use of insulin pumps. Recent studies of use of insulin pumps in Type 2 diabetes have shown profound improvements in HbA1c, sexual performance, and neuropathy pain. If you did some research or were allowed to try one over a week Novorapidboi26 you would relise they do more than just deliver insulin, You can have a standard bolus, extended bolus, combination bolus and a superbolus. You can increase and reduce the basal rate hourly (Novorapidboi26 this would help you and your dawn phenomenon), You can have a tempory basal rate for exercise, illness, stress etc. I not wasting my time arguing with you, and im not here to make anyone even want one. Im here to make it clear to anyone that DOES want one that they are infact a brilliant step forward and not a negative, scary or in anyway difficult to live with. Maybe if you tried one you would realise, but you just keep worrying about the NHS why dont you....

Jun 30, 2010 Tony.P 16 posts	Topic: General Discussion / I want an insulin pump the amount of insulin used is very well controlled on a pump it has to be said, you don't have to round up or down on your carb's and it does take into account your active inuslin although I found that a bit of a pain at night if I was a bit high it would not give suggested dose so I had to override it, but that is a minor issue. I liked the fact that whilst out and a bout I could just dial up the amount of insulin i needed push button and away you go, very discrete but I also found the canulars would irritate me at times and I did not like inserting them every 2 or three days the little needles in the pens are in my oppinion less uncomfortable.

Jun 30, 2010 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Vegetables Exactly right.......they are absorbed too slowly for any quick acting insulin to deal with.... Background should deal with it..... On some occasions if I have had baked beans or sweetcorn I have taken one unit....

Jun 30, 2010 novorapidboi26 1,819 posts	Topic: General Discussion / I want an insulin pump The downsides of the pump described in the last post surely outweigh the positives......the only positive I an see is the ability to deliver over a longer gradual period......