Recent Posts - DAFNE Online

Apr 16, 2010

Alan 49 284 posts

Topic: Carbohydrate Counting / Carb Links section added

Mark

Would it be appropriate to put a link to the Glycaemic Index here?

Apr 15, 2010

marke 686 posts

Topic: Carbohydrate Counting / Am i counting carbs right

Steve, unfortunately no one can tell you the answer to this question since it depends on you. If when you next test your BG its in the correct
range then you have got it right, if its not you got it wrong. There is no golden answer, yes you are following the right basic principle of carb counting but everyone is different and the combination of foods can affect the rate at which you absorb the carbs in food. To be honest I wouldn't see 14 as a large amount of insulin but then my insulin requirements would not be the same as yours.
For me the most important bit of carb counting is making a note of what I eat and what I inject. I use this as the basis for future carb estimating, i.e I learn from my mistakes and yes I DO make mistakes, I'm sure we all do.

Apr 15, 2010

steve o 5 posts

Topic: Carbohydrate Counting / Am i counting carbs right

I just need confirmation that i am counting carbs correctly because it seems i am taking a lot of insulin for what i am eating. For example at dinner i had 2 steak and kidney pies i.e. birds eye individual ones and some roast potatoes and a yoghurt after for that i took 14 units of humalog insulin as i am on a ratio of 1 : 1 it just seems a lot of insulin to take i am taking one unit of insulin for every 10 grams of carbohydrate i am looking at the food packets for the carb content so feel i must be doing things right.

Apr 15, 2010

mcmillan 8 posts

Topic: Carbohydrate Counting / Home Made Meals

We're involved in a lot of home cooking both here and in France. The only "best" solution I have found is to work through a given recipe either doing it myself or watching others, and weighing, measuring or otherwise estimating all the CPs that go into each, then working out how many CPs per tablespoon of the result I serve on to my plate. Then I keep a careful little note in my CP booklet and use that. It seems to work quite well.

Apr 15, 2010

vic demain 87 posts

Topic: Questions for HCPs / Prat.

Hi,
Thanks for the replies.
Karl, I cannot use the ratios at breakfast. I always have 5CP's but if I take more that 3 units QA I will be hypo within 2 hours. Therefore I usually use 0.6:1, not in the book I know but that's what works for me. Guess I should have eaten more but that is a heck of a lot of carbs.
JWo, my BI is something which we have worked hard at, I am lucky in so much as I appear to be sensitive to insulin, so don't need too much. The knock-on effect could have something to do with the fact that I regularly have hypo's and so my reserves may be low. For other meals I normally take 1:1 or slightly above but cannot use this at breakfast.
Pleased to say breakfast result today was 7.0 and I've taken 2 units, so hopefully sorted but fully expect some further repercussions yet.

Many thanks.

Vic.

Apr 14, 2010

JayBee 587 posts

Topic: Questions for HCPs / Prat.

Firstly, I'm not a HCP but I would like to comment.

I've been daft enough to inject BI instead of QA for a meal before. Did lead to unusual results but at least with this sort of thing you have some idea on the possible outcomes thanks to DAFNE. I have to side with Karl's comment considering - as annoying as it is, the most common preventive measure for this sort of situation is to eat to counteract it... however, I am quite surprised by the knock-on effect you've had during the course of today.... how is your BI situation? Do you work by 1 CP to 1 QA meal ratios? Sad

Also, be careful with any adjustments after a hypo (referring to the 4 QA dose at 19.15)... the QA will take you down a lot more than it would for a normal dose. Considering what you've done so far - I would prepare for another hypo if it was me. Sad

Take care and let us know how it gets on. I hope a HCP replies soon to ease your mind.

p.s. You're not a prat - we all make mistakes! ;)

Apr 14, 2010

Karl 83 posts

Topic: Questions for HCPs / Prat.

If you think you did that I would have thought the best measure would be to have the carbs to match. What ratio you on to take 2 for 5 CP's ? .

Apr 14, 2010

vic demain 87 posts

Topic: Questions for HCPs / Prat.

Forget last post, managed to change it.

Apr 14, 2010

vic demain 87 posts

Topic: Questions for HCPs / Prat.

Sorry 19:15 should read 4 units QA not 4 CP's.

Apr 14, 2010

vic demain 87 posts

Topic: Questions for HCPs / Prat.

Meant to take 2 units of QA at breakfast this morning but for some stupid reason ended up taking 12. Tested every hour (4 hypo's) took no insulin with lunch and only early evening did the results start to go up. Still not taken proper amount. Has anyone else been stupid enough to do a similar thing and can pass on experiences or is there an HCP who can offer advice. It's probably covered in the book but not quite with it at the moment to go through it.
Thanks.
Vic.

Apr 14, 2010

JayBee 587 posts

Topic: Carbohydrate Counting / London Cheese Cake

Does anyone have any idea on what the CPs are for the typical "London Cheese Cake"?

They're not the typical "cheese cake" (nor like Nigella Lawson's incorrectly named London Cheesecake) and I've yet to discover another name that they go by - they look like this.

I'm never sure how much to take whenever I treat myself to one so I've been taking a guess of 4 or 5 QA for them which in turn usually comes across as incorrect.

You'd think you'd find the information online but I've yet to find out what they are per 100g which is very frustrating whenever I treat myself to one with my lunch or something from places like Greggs. I cannot seem to find the infomation anywhere online.

So... does anyone know? Many many thanks in advance if you do. I can't be the only one who loves them lol. Smile

Apr 14, 2010

mcmillan 8 posts

Topic: General Discussion / "Balance" letter about injecting in public

A late response to Richard about injecting on planes. I travel internationally a lot, and obviously inject during the flights. Before travelling we should request and carry with us a letter from our diabetic clinic, GP or health authority stating that we are required to carry syringes, insulin and other medical supplies for our diabetic condition. We need to announce this at check in and as we go through security. I have never had a problem, but some airlines and countries may have different policies and practices.... During a long-haul flight I usually measure my blood sugar a bit more often than usual. I try to be discreet about injecting. Sometimes I can do it in my seat or in the back of the aircraft, especially with pen injections. With the BI (I use Lantus with regular syringes) I tend to go to the toilet. You're right - especially these days people in aircraft tend to be a bit more sensitive to anyone behaving "unusually", and whipping out syringes and injecting oneself is probably not "best practice".

As a second late response to the previous emails about the "complaining nurse" - obviously she's got a bit of a problem, that none of us can fix. I also inject when and as I need to, including in restaurants. I try not to make a big deal out of it, but if anyone notices I explain gently but quickly what has happened. It only takes a few seconds and I usually turn away from the table. Most folks are OK with it. However, I did have one colleague faint away at a table in Italy at the sight of a needle !

Apr 14, 2010

mcmillan 8 posts

Topic: General Discussion / Is life expectancy limited for diabetics?

Hi - just to add my own positive experience about this. Diabetes is really quite a "healthy" disease, in that we learn much more about our bodies and how to take care of them than other people. We don't smoke, eat and drink "reasonably", try to exercise and keep our weight down : we also have all these regular check-ups, examine our feet and eyes and take care of personal hygiene. We're so good ! In my own case I definitely take better care of myself since being diagnosed (>20 years ago : I'm now 55). After many years of working blindly, DAFNE 2 years ago was a revelation - it gave me the first feeling of control over my insulin/sugar/CP count. Now I know what to aim for and most importantly to be able to analyse anomalies as they occur, and not get too worried when they happen. After 2 years out after a back injury I'm running, skiing and playing football again - I get just as sore as before ! Just enjoy life, do all the good things you like to do, keep healthy and maintain the regular blood sugar monitoring, and don't get stressed about possible future complications. With best wishes, Paul

Apr 14, 2010

mcmillan 8 posts

Topic: General Discussion / Random question!

Can you work out what was in it ? I.e. - how much "fruit" - e.g., 1-2 tablespoons, with everything lumped together ? Anything else ? Try to write it down, then make a decent guess... I have to do the same when my wife makes a fruit tart when we go back to France - I take the CP count of the pastry, plus the number/weight of apples etc on top, and divide it to estimate the CP in what I will eat... (then I keep this as a note in my CP booklet to remind me for next time...).

Apr 14, 2010

mcmillan 8 posts

Topic: General Discussion / Advice on sugar levels after exercise

Thanks all - this is a question I was going to ask because I have been having the same problem. I run and play soccer 3-4 times a week and was getting frustrated that my BS was high up to 2-3 hours after. Now I have started injecting 1-2 units QA beforehand and it seems to have solved the problem.

Apr 13, 2010

Luggerz 10 posts

Topic: Carbohydrate Counting / Bubble and Squeek

Does anybody have a carb content for Bubble and Squeek as I'm having trouble counting it.

Cheers
Marc

Apr 12, 2010

steve o 5 posts

Topic: General Discussion / Carbs and cals book

I have been trying to buy a copy of the new book called carbs and cals have been on various websites waterstones wh smiths and amazon and they all say book is unavailable although it was released on 31st March i am very confused has any one had any luck getting a copy. I know it is available on the carbs and cals website but is it available any where else?

Apr 10, 2010

Simon Heller 46 posts

Topic: Questions for HCPs / Cold Medicines

Hi Lizzie, the only thing I can think of is that there is some sucrose in these preparations and you just need to be aware of the potential effect they might have on your blood glucose. I think your comments about using a hot water bottle are really sensible. By and large manufacturers will want to cover themselves and their advice needs to be interpreted in this light. Simon

Apr 9, 2010

JayBee 587 posts

Topic: General Discussion / Where you inject matters

That's cool if it works out better for you instead to do that for your hypos. Smile

The highest I seem to go with the 2-2 treatment is about 14 usually... which in turn, I also noticed that I tend to be about the same for when I've hypo'd during the night while I was still working out what my body needed over night.

It certainly is funny how the body works! I have also been very frustrated by the option to not adjust after a hypo for 24 hours because of the discomfort being high can cause - it took me a while to break the age old habit of adjusting at the slightest high... gotta let the BI take it down gradually, not the QA rapidly... -_-;; you're going to be high sometimes but with our BI, all will work out again (as long as other stuff is sorted too of course). One day of being high isn't half as bad as being high for, say, a month - it's the longer periods that do the damage - I hope that helps you feel a bit better about it possibly... Smile

While I think of it, another pointer I picked up on at my last DAFNE from a chap who did regular exercise (football playing mostly though - his BG results were remarkably good but he wasn't long diagnosed which may be an involved factor) - he said that if he had taken too much insulin for a meal, he could tell a hypo was coming before the symptoms hit by testing at the 4th hour of the insulin working - the BG results being lower than what would be considered reasonable. This may be something you could look at as well but I am unsure how reliable it is. I have mostly been applying it when I have doubts about my meal CP which hasn't been too often.

Glad to hear it's working out better for you now anyway... keep up the good work. Smile

Apr 9, 2010

Alan 49 284 posts

Topic: General Discussion / Where you inject matters

Thanks for the feedback - very useful. Regarding the treatment of hypos: I've never found it necessary to have the recommended 2 CPs of medium-acting carbs as well as the 2 fast-acting portions. I used to use hypos as an excuse to 'pig-out' on things ususally forbidden - chocolates etc, but I found that the resuilting BG tests were way too high, so I now keep it to 2CPs - or 3 if it's a bad one. That seems to work for me.
I have to admit that in February I was trying hard to keep my BGs 'withing target'; obviously I was trying too hard and getting lots of 'below 4' tests. I have since (as Marke suggests) reduced my BI by one unit and I've not been so stringent with my QA injections. Consequenlty, my BGs are running a bit on the high side.
I agree with JWo that the DAFNE guidelines are just recommendations - not rules.
Thankfully, the night-time hypos haven't occurred since.

Apr 8, 2010

andrewlc 1 post

Topic: General Discussion / Lantus and Apidra

You definitely can for apidra. I got given cartridges once by mistake instead of solostar pens.

Apr 8, 2010

JayBee 587 posts

Topic: General Discussion / Where you inject matters

Considering quite a few of the low results are over an hour before a meal, it's fair comment to consider the extra CPs - especially when exercise is involved.

I hypo at work for taking lots of calls on a busy phone line while sitting (eg, no 'exercise' that's noted in the guidebook!) so I know it can be very awkward to work out how much to eat to prevent hypos - it's because of my experiences that I'm able to think out side the box and remember that the DAFNE guide book is JUST A GUIDE. On top of this - once you've had a hypo, this can make you prone to them for the next 24 hours which is probably causing a knock on effect generally for Alan's situation.

With this, your taken opportunity for a bit of nick picking with the hypo stuff came across as a bit condescending with me, just so you know marke.

If the concern is with the overnight stuff, I do recommend setting an alarm and doing a 3am night test considering it should be only your BI working at that point... even more so that your dinner tends to be around 7pm-7.30pm when your insulin probably hasn't finished working before 12midnight (I have to count 5 hours for my QA (humalog)... you should keep in mind what your QA working time is as well)... so when you do your test at 11pm, it's unlikely that you're getting a true picture of your BG.

With that, good luck with your pattern finding Alan. I've been there with the over night stuff myself. You'll work it out. Smile

Just to add, I was told the "Dawn Phenomenon" was a rare thing by my DAFNE nurse - not a 'most people' thing... and that it doesn't tend to be a 'one off' occurrence like this example, either.

Apr 8, 2010

marke 686 posts

Topic: General Discussion / Where you inject matters

much as I hate to be a swat the handbook says this . Which is not exactly the same as you seem to have been told regarding hypos. That said I totally agree with everything else you say ;-)

My take Alan is maybe your nighttime BI is too high, you seem to be low most mornings and a fair bit higher the night before. If you don't have any CP's before bed then the BI should keep you roughly the same and you seem to be dropping a lot, especially as most people tend to be higher in the mornings due to the dawn phennomeon. This of course is the view of a fellow DAFNE Grad and not a HCP. I would check with your DAFNE Educators what they think about your readings.

Apr 16, 2010 Alan 49 284 posts	Topic: Carbohydrate Counting / Carb Links section added Mark Would it be appropriate to put a link to the Glycaemic Index here?

Apr 15, 2010 marke 686 posts	Topic: Carbohydrate Counting / Am i counting carbs right Steve, unfortunately no one can tell you the answer to this question since it depends on you. If when you next test your BG its in the correct range then you have got it right, if its not you got it wrong. There is no golden answer, yes you are following the right basic principle of carb counting but everyone is different and the combination of foods can affect the rate at which you absorb the carbs in food. To be honest I wouldn't see 14 as a large amount of insulin but then my insulin requirements would not be the same as yours. For me the most important bit of carb counting is making a note of what I eat and what I inject. I use this as the basis for future carb estimating, i.e I learn from my mistakes and yes I DO make mistakes, I'm sure we all do.

Apr 15, 2010 steve o 5 posts	Topic: Carbohydrate Counting / Am i counting carbs right I just need confirmation that i am counting carbs correctly because it seems i am taking a lot of insulin for what i am eating. For example at dinner i had 2 steak and kidney pies i.e. birds eye individual ones and some roast potatoes and a yoghurt after for that i took 14 units of humalog insulin as i am on a ratio of 1 : 1 it just seems a lot of insulin to take i am taking one unit of insulin for every 10 grams of carbohydrate i am looking at the food packets for the carb content so feel i must be doing things right.

Apr 15, 2010 mcmillan 8 posts	Topic: Carbohydrate Counting / Home Made Meals We're involved in a lot of home cooking both here and in France. The only "best" solution I have found is to work through a given recipe either doing it myself or watching others, and weighing, measuring or otherwise estimating all the CPs that go into each, then working out how many CPs per tablespoon of the result I serve on to my plate. Then I keep a careful little note in my CP booklet and use that. It seems to work quite well.

Apr 15, 2010 vic demain 87 posts	Topic: Questions for HCPs / Prat. Hi, Thanks for the replies. Karl, I cannot use the ratios at breakfast. I always have 5CP's but if I take more that 3 units QA I will be hypo within 2 hours. Therefore I usually use 0.6:1, not in the book I know but that's what works for me. Guess I should have eaten more but that is a heck of a lot of carbs. JWo, my BI is something which we have worked hard at, I am lucky in so much as I appear to be sensitive to insulin, so don't need too much. The knock-on effect could have something to do with the fact that I regularly have hypo's and so my reserves may be low. For other meals I normally take 1:1 or slightly above but cannot use this at breakfast. Pleased to say breakfast result today was 7.0 and I've taken 2 units, so hopefully sorted but fully expect some further repercussions yet. Many thanks. Vic.

Apr 14, 2010 JayBee 587 posts	Topic: Questions for HCPs / Prat. Firstly, I'm not a HCP but I would like to comment. I've been daft enough to inject BI instead of QA for a meal before. Did lead to unusual results but at least with this sort of thing you have some idea on the possible outcomes thanks to DAFNE. I have to side with Karl's comment considering - as annoying as it is, the most common preventive measure for this sort of situation is to eat to counteract it... however, I am quite surprised by the knock-on effect you've had during the course of today.... how is your BI situation? Do you work by 1 CP to 1 QA meal ratios? Also, be careful with any adjustments after a hypo (referring to the 4 QA dose at 19.15)... the QA will take you down a lot more than it would for a normal dose. Considering what you've done so far - I would prepare for another hypo if it was me. Take care and let us know how it gets on. I hope a HCP replies soon to ease your mind. p.s. You're not a prat - we all make mistakes! ;)

Apr 14, 2010 Karl 83 posts	Topic: Questions for HCPs / Prat. If you think you did that I would have thought the best measure would be to have the carbs to match. What ratio you on to take 2 for 5 CP's ? .

Apr 14, 2010 vic demain 87 posts	Topic: Questions for HCPs / Prat. Forget last post, managed to change it.

Apr 14, 2010 vic demain 87 posts	Topic: Questions for HCPs / Prat. Sorry 19:15 should read 4 units QA not 4 CP's.

Apr 14, 2010 vic demain 87 posts	Topic: Questions for HCPs / Prat. Meant to take 2 units of QA at breakfast this morning but for some stupid reason ended up taking 12. Tested every hour (4 hypo's) took no insulin with lunch and only early evening did the results start to go up. Still not taken proper amount. Has anyone else been stupid enough to do a similar thing and can pass on experiences or is there an HCP who can offer advice. It's probably covered in the book but not quite with it at the moment to go through it. Thanks. Vic.

Apr 14, 2010 JayBee 587 posts	Topic: Carbohydrate Counting / London Cheese Cake Does anyone have any idea on what the CPs are for the typical "London Cheese Cake"? They're not the typical "cheese cake" (nor like Nigella Lawson's incorrectly named London Cheesecake) and I've yet to discover another name that they go by - they look like this. I'm never sure how much to take whenever I treat myself to one so I've been taking a guess of 4 or 5 QA for them which in turn usually comes across as incorrect. You'd think you'd find the information online but I've yet to find out what they are per 100g which is very frustrating whenever I treat myself to one with my lunch or something from places like Greggs. I cannot seem to find the infomation anywhere online. So... does anyone know? Many many thanks in advance if you do. I can't be the only one who loves them lol.

Apr 14, 2010 mcmillan 8 posts	Topic: General Discussion / "Balance" letter about injecting in public A late response to Richard about injecting on planes. I travel internationally a lot, and obviously inject during the flights. Before travelling we should request and carry with us a letter from our diabetic clinic, GP or health authority stating that we are required to carry syringes, insulin and other medical supplies for our diabetic condition. We need to announce this at check in and as we go through security. I have never had a problem, but some airlines and countries may have different policies and practices.... During a long-haul flight I usually measure my blood sugar a bit more often than usual. I try to be discreet about injecting. Sometimes I can do it in my seat or in the back of the aircraft, especially with pen injections. With the BI (I use Lantus with regular syringes) I tend to go to the toilet. You're right - especially these days people in aircraft tend to be a bit more sensitive to anyone behaving "unusually", and whipping out syringes and injecting oneself is probably not "best practice". As a second late response to the previous emails about the "complaining nurse" - obviously she's got a bit of a problem, that none of us can fix. I also inject when and as I need to, including in restaurants. I try not to make a big deal out of it, but if anyone notices I explain gently but quickly what has happened. It only takes a few seconds and I usually turn away from the table. Most folks are OK with it. However, I did have one colleague faint away at a table in Italy at the sight of a needle !

Apr 14, 2010 mcmillan 8 posts	Topic: General Discussion / Is life expectancy limited for diabetics? Hi - just to add my own positive experience about this. Diabetes is really quite a "healthy" disease, in that we learn much more about our bodies and how to take care of them than other people. We don't smoke, eat and drink "reasonably", try to exercise and keep our weight down : we also have all these regular check-ups, examine our feet and eyes and take care of personal hygiene. We're so good ! In my own case I definitely take better care of myself since being diagnosed (>20 years ago : I'm now 55). After many years of working blindly, DAFNE 2 years ago was a revelation - it gave me the first feeling of control over my insulin/sugar/CP count. Now I know what to aim for and most importantly to be able to analyse anomalies as they occur, and not get too worried when they happen. After 2 years out after a back injury I'm running, skiing and playing football again - I get just as sore as before ! Just enjoy life, do all the good things you like to do, keep healthy and maintain the regular blood sugar monitoring, and don't get stressed about possible future complications. With best wishes, Paul

Apr 14, 2010 mcmillan 8 posts	Topic: General Discussion / Random question! Can you work out what was in it ? I.e. - how much "fruit" - e.g., 1-2 tablespoons, with everything lumped together ? Anything else ? Try to write it down, then make a decent guess... I have to do the same when my wife makes a fruit tart when we go back to France - I take the CP count of the pastry, plus the number/weight of apples etc on top, and divide it to estimate the CP in what I will eat... (then I keep this as a note in my CP booklet to remind me for next time...).

Apr 14, 2010 mcmillan 8 posts	Topic: General Discussion / Advice on sugar levels after exercise Thanks all - this is a question I was going to ask because I have been having the same problem. I run and play soccer 3-4 times a week and was getting frustrated that my BS was high up to 2-3 hours after. Now I have started injecting 1-2 units QA beforehand and it seems to have solved the problem.

Apr 13, 2010 Luggerz 10 posts	Topic: Carbohydrate Counting / Bubble and Squeek Does anybody have a carb content for Bubble and Squeek as I'm having trouble counting it. Cheers Marc

Apr 12, 2010 steve o 5 posts	Topic: General Discussion / Carbs and cals book I have been trying to buy a copy of the new book called carbs and cals have been on various websites waterstones wh smiths and amazon and they all say book is unavailable although it was released on 31st March i am very confused has any one had any luck getting a copy. I know it is available on the carbs and cals website but is it available any where else?

Apr 10, 2010 Simon Heller 46 posts	Topic: Questions for HCPs / Cold Medicines Hi Lizzie, the only thing I can think of is that there is some sucrose in these preparations and you just need to be aware of the potential effect they might have on your blood glucose. I think your comments about using a hot water bottle are really sensible. By and large manufacturers will want to cover themselves and their advice needs to be interpreted in this light. Simon

Apr 9, 2010 JayBee 587 posts	Topic: General Discussion / Where you inject matters That's cool if it works out better for you instead to do that for your hypos. The highest I seem to go with the 2-2 treatment is about 14 usually... which in turn, I also noticed that I tend to be about the same for when I've hypo'd during the night while I was still working out what my body needed over night. It certainly is funny how the body works! I have also been very frustrated by the option to not adjust after a hypo for 24 hours because of the discomfort being high can cause - it took me a while to break the age old habit of adjusting at the slightest high... gotta let the BI take it down gradually, not the QA rapidly... -_-;; you're going to be high sometimes but with our BI, all will work out again (as long as other stuff is sorted too of course). One day of being high isn't half as bad as being high for, say, a month - it's the longer periods that do the damage - I hope that helps you feel a bit better about it possibly... While I think of it, another pointer I picked up on at my last DAFNE from a chap who did regular exercise (football playing mostly though - his BG results were remarkably good but he wasn't long diagnosed which may be an involved factor) - he said that if he had taken too much insulin for a meal, he could tell a hypo was coming before the symptoms hit by testing at the 4th hour of the insulin working - the BG results being lower than what would be considered reasonable. This may be something you could look at as well but I am unsure how reliable it is. I have mostly been applying it when I have doubts about my meal CP which hasn't been too often. Glad to hear it's working out better for you now anyway... keep up the good work.

Apr 9, 2010 Alan 49 284 posts	Topic: General Discussion / Where you inject matters Thanks for the feedback - very useful. Regarding the treatment of hypos: I've never found it necessary to have the recommended 2 CPs of medium-acting carbs as well as the 2 fast-acting portions. I used to use hypos as an excuse to 'pig-out' on things ususally forbidden - chocolates etc, but I found that the resuilting BG tests were way too high, so I now keep it to 2CPs - or 3 if it's a bad one. That seems to work for me. I have to admit that in February I was trying hard to keep my BGs 'withing target'; obviously I was trying too hard and getting lots of 'below 4' tests. I have since (as Marke suggests) reduced my BI by one unit and I've not been so stringent with my QA injections. Consequenlty, my BGs are running a bit on the high side. I agree with JWo that the DAFNE guidelines are just recommendations - not rules. Thankfully, the night-time hypos haven't occurred since.

Apr 8, 2010 andrewlc 1 post	Topic: General Discussion / Lantus and Apidra You definitely can for apidra. I got given cartridges once by mistake instead of solostar pens.

Apr 8, 2010 JayBee 587 posts	Topic: General Discussion / Where you inject matters Considering quite a few of the low results are over an hour before a meal, it's fair comment to consider the extra CPs - especially when exercise is involved. I hypo at work for taking lots of calls on a busy phone line while sitting (eg, no 'exercise' that's noted in the guidebook!) so I know it can be very awkward to work out how much to eat to prevent hypos - it's because of my experiences that I'm able to think out side the box and remember that the DAFNE guide book is JUST A GUIDE. On top of this - once you've had a hypo, this can make you prone to them for the next 24 hours which is probably causing a knock on effect generally for Alan's situation. With this, your taken opportunity for a bit of nick picking with the hypo stuff came across as a bit condescending with me, just so you know marke. If the concern is with the overnight stuff, I do recommend setting an alarm and doing a 3am night test considering it should be only your BI working at that point... even more so that your dinner tends to be around 7pm-7.30pm when your insulin probably hasn't finished working before 12midnight (I have to count 5 hours for my QA (humalog)... you should keep in mind what your QA working time is as well)... so when you do your test at 11pm, it's unlikely that you're getting a true picture of your BG. With that, good luck with your pattern finding Alan. I've been there with the over night stuff myself. You'll work it out. Just to add, I was told the "Dawn Phenomenon" was a rare thing by my DAFNE nurse - not a 'most people' thing... and that it doesn't tend to be a 'one off' occurrence like this example, either.

Apr 8, 2010 marke 686 posts	Topic: General Discussion / Where you inject matters much as I hate to be a swat the handbook says this . Which is not exactly the same as you seem to have been told regarding hypos. That said I totally agree with everything else you say ;-) My take Alan is maybe your nighttime BI is too high, you seem to be low most mornings and a fair bit higher the night before. If you don't have any CP's before bed then the BI should keep you roughly the same and you seem to be dropping a lot, especially as most people tend to be higher in the mornings due to the dawn phennomeon. This of course is the view of a fellow DAFNE Grad and not a HCP. I would check with your DAFNE Educators what they think about your readings.