Recent Posts

Hi everyone,
This is a really important topic! From recent research and experience, (I am a diabetes nurse) most people need to run at the top end of the DAFNE targets if trying to regain symptoms, for at least 2-3 weeks, and that also means during that time having no hypos whatsoever. This is easy to say but not necessarily easy to achieve, particularly if you're prone to lows overnight.
The theory is that if you've had a lot of hypos, the body 'resets' what it thinks is a hypo, so you may only get symptoms wghen extremely low indeed. This makes you more likely to have a severe hypo, where you need help from another person. It is linked to how long you've had diabetes too, which you can't do much about, and is one of the reasons why not everyone aims for lower HbA1c results immediately after DAFNE courses; you have to take it steady! Ask your health professional direct for advice as sometimes two heads are better than one - and congrats Vic on steadier results, I'm sure that will help you sort things out.
Cheers, Clare

Feb 9, 2010

hankypanky 18 posts

Hi Barry
just thinking to myself about you wearing your pump on leg at night Smile

i always use the clip of the night and hook it over my boxers at the front, like the way th echildren think your wearing a pager, of the day at work i thread the tube under my belt then keep it in my buttoned pocket at the front but hey all of us are different one way or the other lol, likewise to having 25000 - 30000 injections wow we like pin cushions but the pump i mlove and will never ever go back to injections hope your keeping good control and are well Smile

take care
speak soon
Steve H :0

Feb 9, 2010

hankypanky 18 posts

hi EeeBee

well i was having really bad absorbtion with insulin not matter where i injected it , so therefore i woundnt work with hardly any meals so i had another jab to compensate for the one that didnt absorb and with me doing this the one that didnt absorb i thiink it kicked in later on and was havibng hypos regulary, so instead of 4 injections daily i was having about 7-8 daily and my a1c was always high too, i went on a "DAFNE" course and with me having type1 for 14 yrs i was overwhelmed by what i found out and still am to this day (excellent course) would say tha to loads of other type 1's (have you been on this course?) i know that you have to fit a certain criteria though, i was missing food and going hungry alot to avoid the injections, but im still getting used to the pump ( medtronic ) but wow the changing of the pump every 3 -4 days what a relief, see your diabetes nurse if you havent been on a DAFNE course,

Feb 9, 2010

davewybrow 2 posts

Going on to it required a four session training course which was well done, we had the involvement of the Animas rep (Paul) who was useful. The pump is quite complicated i.e. it does a great deal and takes the haphazard guesswork out of calculating how quickly the isulin is used up, how much you have left, what time of the day it is and many other things. It also makes it very easy to correct blood glucose levels that are out of target.

The prime points that PCT's need is either high HbA1c levels (11+) or a history of hypos which cause worry in either their frequency or their timinhg or their unpredictability.

I started on insulin in 1962 at King's College and have lead a very active life, the pump will allow me to continue that - it is waterproof so I can even swim in it if I wish, After approx 54,000 injections since 1962 it has made life VERY much more pleasant and means I can boost quickly and easily if we decide to stop for a snack irrespective of what it is provided I can work out the CHO level (DAPHNE works very well for that!).

My clinic says that currently they have 20% of their patients on pumps and that figure is increasing as courses are run several times a year for small groups.

It is comfortable to wear - like having a pager with me 24/7 and the kids in my school believe it is a pager! It has alarms for anything which you need to be aware of (low level of insulin remaining,blood glucose too high or too low, reminder to test for ketones, reminder about low glucose levels, blockage, too much delivered, low battery etc) and does instant adjustments for sick days with a % adjustment that you decide for as long as you decide.

A great piece of kit and I wish I had sought it a long while ago......... I was reluctant to consider it and am really glad that I did. I would not go back and do feel very supported by the professionals and the company with a 24h helpline if needed. They have also lent me a spare pump "just in case" for holidays but of course I still need to monitor glucose levels and carry both short and long acting insulin pens in case I have to take it off for any reason lenger than 1 hour.

Feb 9, 2010

marke 681 posts

Carolin,
Can you clarify what you are saying, are we talking about Hypo recognition or DAFNE generally. I would have thought all diabetics try to avoid hypos, believe me its not something we particularly enjoy ;^) . We also try to keep within DAFNE targets which is the point of DAFNE. However if we are talking hypo awareness and lack of it then of course avoiding hypo's is a priority.

When you talk about aiming at the upper end of the range, is this connected with trying to restore hypo warnings ? Is there any guidance over how long it might take to regain warning signs. Obviously individuals will vary in both their warning signs and the time it takes to regain them, however a rough indicator on how long the aim of top end DAFNE BG's should be maintained would be useful.

Feb 9, 2010

marke 681 posts

Topic: General Discussion / Exercise and high BG

Hi,
Not sure I like the sound of QA before exercise, especially if it involves the 'area' of injection since exercise speeds up the absorbtion of insulin. This would mean a bigger 'hit' of insulin to take the sugar out of the blood, increasing the risk of Hypo I would have thought.

I would take advice before injecting pre-exercise. I occasionally had high BG's after exercise, however it always went back down on its own
and I would rather be a bit high than having to be picked up off the floor....

Feb 9, 2010

Simon 578 posts

Good news - you now have a drop down next to the ratio selection box with your previously used ratios - hope this makes things easier for you.

Also, you can now specify an injection site - if i've missed any then let me know. You can't currently see any graphs for this or it represented on the diary display (would you want to), however in time these will come too!

Let us know if we can do anything else/differently.

Simon

Feb 9, 2010

Paul G Wales 8 posts

Topic: General Discussion / Ratios tryed them all

Hi ive been trying unsuccessfully to find a ratio that will work for me I started at 1:1and moved up gradaully to 3:1 and im sure it will end up at 3.5 : 1 ,has anyone got any advice, on this a most of the dafne advice i got doesent really help with this ! i have just been prescribed Metformin but wanted to get my ratio sorted before i went ahead with it ! should i start it now and deal with it all in one go ? im just aware of the change one thing at a time thanks paul

Feb 9, 2010

EeeBee 4 posts

Topic: General Discussion / Exercise and high BG

Hi

I've experienced the same after exercise and was informed that its because there isn't enough insulin in your bloodstream to carry the glucose to the muscles hence it remains in the bloodstream = high BG.

Therefore I've been advised by my HCPs that if your BG is high before exercise or you do exercise first thing in the morning before breakfast, then have QA 'correction units' that you would have to bring your BG into target BEFORE exercising. That way you will have enough insulin in your body to not give you a high BG after exercise. However, be careful to check BG after exercise too as depending on how strenuous your exercise is you could risk a hypo.

Also you may want to check this with your HCPs too but hope it helps!

Feb 9, 2010

EeeBee 4 posts

Hi Steve & Barry

How easy was it to be put on a pump? I asked my Diabetic HCPs and they said I couldn't have one because my HBA1c is not terrible and its usually only for people who've had problems controlling their BGs over a long period of time.

However, I've had T1D for 27yrs now and even though my HBA1c is fine I still find my BGs fluctuating daily out of target too often for my liking. I also have snacks and am getting sick of injecting more than 5 times per day, I think I'm having insulin absorption problems if I do my injection anywhere other than my stomach, and hence I am gradually developing lypodystrophy and fat build up round my stomach!

How can I convince them to even consider me for it?? It wouldnt be a PCT budget thing would it?

Thanks

Feb 9, 2010

EeeBee 4 posts

Hi Simon,

I think your suggestion of : 'have a drop-down box which has all of the ratios that you personally have already used, with the option to enter text manually thus adding a new ratio' would be a good option.

the injection site function would be much appreciated especially as i've found last week that by doing my injections in other places rather than my stomach has had a profound effect on my BGs. My calculations have been correct to my CPs (like the previous week and had good BGs) but I've suffered high BGs last week after meals since doing my injections in say my arm or leg.

I'm sure there's an absorbtion problem but since we're all advised not to keep doing injections in one place ie. stomach I'm a bit stuck for solutions. I can't increase my ratios at meal times because I suffer hypos so my ratio of 1:1 must be correct. So, it would be good to visually monitor injection sites and BGs!

Thanks so much

Feb 9, 2010

tsavage1990 11 posts

Topic: General Discussion / First illness since dafne

i'm currently getting really poorly - probably just a bad cold but we'll see - this will be my first spell of illness since doing the course in september (think it was september anyway). fingers crossed i can keep better control of my bloods using dafne, wish me luck
Smile

Feb 9, 2010

Sam 64 posts

Topic: General Discussion / Lantus Lasting 24 hours?

Hi Mark

I had similar experiences and I changed to Levemir which is split between morning and dinner, maybe consider speaking to your diabetic team. I'm now on Humulin I split at 12 midnight and morning I was climbing BGs before bed and through the night, so far so good though. It's good your noticing a pattern.

Sam

Feb 9, 2010

Lena 1 post

Topic: General Discussion / Pregnancy

Hi I am 37 and have been diabetic for 30 years. I have three kids aged 13, 10 and 7. I had no problems getting pregnant at all. My control was very poor before pregnancy but with help from diabetes team it was well controlled during. I did not go to the pre-conception classes but think its a really good idea! Keep practising!

Feb 9, 2010

qprfcmark 3 posts

Topic: General Discussion / Lantus Lasting 24 hours?

Hi, just started on DAFNE after being type 1 for 30 years. Has anyone else found that their BG is going above target at around 18:00 & 22:00? I had a zero CP meal at 18:00 and my BG went from 6.9 to 9.8 at 22:00. This to me indicates the BI Lantus is running out by 15:00 and I'm relying purely on QA Novorapid. My ratio for Novorapid is already 2.5:1 at 12:00 & 18:00. Anyone else experienced this and what is the solution? Regards Mark

Feb 8, 2010

Simon 578 posts

Done - 15 it is! Good luck with the pregnancy Smile

Feb 8, 2010

vic demain 87 posts

Hi Carolin,
Thanks for making contact, it is much appreciated.

Last two days have been much better, only one hypo, results are hovering around 8-10. Aim is to keep things as they are for a couple more days and see where we are.

Keep up the good work.

Vic.

Feb 8, 2010

Carolin 83 posts

Hi,
Just a quick update to the info that's currently in the Handbook (which is due to be re-issued later this year). We now recommend:

1. Keeping your BG within DAFNE targets, i.e. do not allow it to drop below 4.5mmol/l at any time and try to avoid hypos at all costs (be more cautious with corrective QA doses, particularly if you have had a hypo already that day)

2. Aiming to be at the upper end of the target range before meals, i.e. BG around 7.5mmol/l (8mmol/l at bedtime). You should not need to run your BG above DAFNE targets in order to regain hypo warnings.

Hope this helps

Feb 7, 2010

Davidherd 1 post

Topic: General Discussion / BG targets

I have only just completed the DAFNE course and have been on my own for a week so its early days. There seems to be a few red BG`s but on some I am only just over target.

Feb 7, 2010

RachelA 10 posts

Hi SImon - would it be possible to get 15 entries. That would definitely be enough, for all my injections and snacks. Thanks alot - Rachel

Feb 7, 2010

Simon 578 posts