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Nov 27, 2009
marke 643 posts

Topic: Questions for HCPs / Should I split my Levemir?

Alan,
You don't really supply enough BG readings to draw conclusions. However splitting your Levimir dose is usually done because it doesn't last 24 hours NOT because of hypos in the morning. This is more likely caused by your BI being too high, however as I say without more evidence its dangerous to jump to conclusions. I would suggest you speak to your DAFNE Educators or a DAFNE aware Diabetes consultant before making any changes. I had my Levimir dose split before I went on a DAFNE Course and had DAFNE people around to advise me. Although you could split it on your own, I'm not sure its a good idea.
 
Nov 27, 2009
leah 1 post

Topic: General Discussion / Least painful lancet??

Hi, i use the Autolet impression. Its great, far better than any other one i have ever used!! It is designed to be less painful, it has six different settings for the lance and three different force settings, its another alternative to the GucoJect Dual mentioned above. Here is a link for you to have a look at. Hope you find ones that works for you.x

http://www.owenmumford.com/en/range/12/autolet-impression.html
 
Nov 27, 2009
Alan 49 280 posts

Topic: Questions for HCPs / Should I split my Levemir?

I currently take one injection of 17 units of Levemir before bed. My BG before bed last night was 10.9. I didn't take any Humalog to correct this. My BG this morning was 3.8. A similar thing happened the night before: 9.7 before bed and 4.1 first thing. I have noticed this happening more and more recently. Would splitting my Levemir injection sort this out?
 
Nov 26, 2009
susieh 3 posts

Topic: General Discussion / Dawn Phenomenon

Hi

I've been reading all the postings and thinking - hey! that sounds like what happens to me!

My BG has been high in the mornings for months and every effort from DAFNE Educators and DSN's doesn't seem to have any effect. Mine are usually between 11 & 14 most days and then occassionally I get one in single figures.
Saw the DSN on Monday and she suggested a Continuous Glucose Monitoring. I understand this is done for 72 hours so you can see exactly what's going on.
I just wondered if anyone else had had this done and if it had helped to see whether the cause was hypos or 'dawn'?

Su x
 
Nov 25, 2009
Derek Brown 32 posts

Topic: General Discussion / Need a kick up the backside! :(

Hi again

Firstly thanks to everyone who's read and replied to this thread. Every time I read the positive messages your all giving it keeps giving me much needed encouragement which is still quite often.

I went to the DANFE review and got that kick up the backside I've needed.

On a good note my Hba1c is reduced to 8.8 which I thought was rotten until I was told it was 10.9 18 months previous and that an overall 2% reduction is a great thing. The bad thing though is they don't really understand why looking at my readings it should have increased o although it's down I'm still curious why and how.

The not so good news was my blood pressure in not just high but 'very high' and cholesterol is up a good bit and this is driving me to frustration. My GP generally looks after these points and I have already tried around half a dozen statins and blood pressure tablets with no positive result. I don't eat a lot of meat and grill what I do so it's another mystery. Currently back on ramapril for BP because of the benefits to the kidneys.

Picture I got painted was that within 5yrs I will have heart problems and my eyesight will deteriorate if I don't get a quick improvement. A little history needed here. My fathers side all have heart conditions and he himself had a heart attack before he was 40. I'm 32 so hereditary factors, the increased risk with diabetes and the blood pressure make me a time bomb. I'm already 4000+ laser hits between each eye for retinopathy so high BP and yo-yo blood sugars need no explaining.

It's a big fright but I'm determined not to feel depressed or give up with it, that will only give a bigger hill to climb up, but it's not easy. I have already spoke with my manager at work regarding the impact stress could be having on my diabetes control but only to explain my situation, my workload and everything else needs to be constant for me to regain control, my life controls the diabetes not the other way around.

I'm speaking with my DAFNE educators every other day with a quick phone call, no matter how silly it is they always take time to advise or reassure. I'm starting back at basics by checking my BI is correct then ratio's but I'm not having any clear patterns so far with my BI. some mornings it's went up by up to 5 and some it drops as much but no 2 days the same but I'll keep testing slowly and surely to nail it. I have fortnightly appointments with my GP to keep on top of the BP and cholesterol too and am determined I'll win this.

Some days I does feel overwhelming and pointless and begin to hate testing, measuring etc but commonsense and stubbornness over come that.

Derek
 
Nov 25, 2009
susanh 20 posts

Topic: General Discussion / sugars in the 20's who to call in aust.

Hi Russ,
I hope you are feeling a little better this week and have managed to track down your DAFNE educator in Ballarat. As an alternative in Australia, you are welcome to call the Diabetes Australia Diabetes Information and Advice Line (DIAL) on 1300 136 588. The DIAL operators can then put you through to a diabetes nurse educator and/or dietitian (normally between the hours of 9am and 4pm). In Victoria, quite a few of the DNEs and dietitians that take these calls are DAFNE trained, so will be able to give you more specific help when you can't get in contact with your own educator.

Cheers,
Susan (OzDAFNE Project Officer in Australia)
 
Nov 25, 2009
Toni 2 posts

Topic: Carbohydrate Counting / How do you caluculate...

Hi I also agree

I have a 10g carbs=2units

I find that i using electronic scales work very good becuse you can plate up you food on the scales, also you have to bear in mind you may have a little routine on what you eat i.e breakfast toast, or cereal as you buy the same each week, also you may use the same bowl for breakfast cereal which helps. I find that having practice with not cooking a meal and having to guess what was in it and the portion size, have whom ever cooks it to keep a not of the total of each item and packets you can then work out after meal and see if you got it right. Just look out for the pattern try that food frequent and test a little more if a new thing.

Thats what i did the food i found difficult was jacket potato, porridge, take out like chinese due to sauce they put in. Ow and you may find that you dont need same ratio for breakfast, lunch dinner it does depend.

You will be fine its all trial and error. Good luck
 
Nov 24, 2009
Toni 2 posts

Topic: General Discussion / Hi!..... Im New

Hi my name is Toni i have just signed up today.

I attened the dafne course in aug 09 and had my 1st review. I am 22yrs old and had type 1 diabetes for 9yrs.

Any advice would be great, i have been doing some of the dafne thing years before the course so im not that bad at it. I tend to be good at helping other with there diabetes so if anyone needs my help or a chat please let me know won't be a problem.
 
Nov 23, 2009
LizB 22 posts

Topic: General Discussion / Swine Flu

Hi all

Had my vaccine last Friday. Like the others I had a sore arm for a few days - just about gone now. Also had that unpleasant oversensitive or "creepy crawly skin" sensation Friday night and Saturday. Took it easy and had a kip on the sofa on Saturday and was right as rain by Sunday.

Worth it though because people at work do seem to be getting Swine flu.
 
Nov 23, 2009
susieh 3 posts

Topic: General Discussion / Hi!..... Im New

Hi Everyone

I've just signed up to DAFNE online today. Although I did my DAFNE course at Medway about 16 months ago, I only found out about the online stuff today from Jan Campbell - so here I am!
I've already read some things about 'dawn phenomenon', which I think I have a plateful of. It's really helpful knowing I'm not alone with this.
Anyway, I really believe that DAFNE is the way to go. Debs - I was diagnosed 30+ years ago (the dark ages!)and only found out some things last year, so I know how you feel.
Now I need to find loads of time to read all the interesting stuff here.......

Su x
 
Nov 23, 2009
Alan 49 280 posts

Topic: Carbohydrate Counting / Persimmon

Great, thanks Laura. Have you inserted this in the Carb Counter?

Alan
 
Nov 23, 2009
laurals11 11 posts

Topic: Carbohydrate Counting / Persimmon

I guessed as 1.5 CP last week as I wasn't near a pc and that worked for me. Wiki says 18.59g cho per 100g http://en.wikipedia.org/wiki/Persimmon. They were actually called Kaki in Lidl's and Sharon fuit in most supermarkets but I when I first found them they were persimmons.
 
Nov 23, 2009
sphillips 24 posts

Topic: Carbohydrate Counting / How do you caluculate...

HI, I agree with NiVZ, it's often calculating the CP value of the food that's the tricky bit the insulin dose tends to be a bit easier to work out. Having said that as well as working out the ratio for the insulin you would then need to consider adjusting for planned activity and blood glucose at the time of the meal. A calculator type device has already been developed and some DAFNE centres, including Addenbrookes and Sheffield-I think- have worked with DAFNE graduates to try it out, I'm not sure how positive these trials were. I think the first question might be would people find a divice such as this useful?
 
Nov 23, 2009
jigme 9 posts

Topic: General Discussion / recording, meters, software & DAFNE

hi Simon -

ok, well here's my thoughts on what a DAFNE app would need.

each individual record to include the following fields (all optional, except perhaps Date/Time):

  • Date/Time (autofilled with current values, but editable to allow post-dated enties);
  • CP (Carbohydrate Portions eaten)
  • BG (Blood Glucose reading);
  • QA (Quick Acting insulin dose with either the option to add Adjustment dose, or a separate field for Adjustment dose);
  • BI (Background Insulin dose);
  • Notes

I'd suggest that a number-wheel for the numerical entries would probably be quickest, with one decimal place for the BG field (and maybe an option to enable a decimal place for the QA/BI fields, for pump users? for pen users, these would probably just get in the way.)

additional features that would be necessary/helpful are, in no particular order:

  • personal info. to include name, height, weight, insulin types, other medication, etc.
  • ability to view a day's results together (listed in chronological order), and maybe a week's results together (grouped by day) - basically, just like looking at a page in your DAFNE diary.
  • ability to see BGs plotted on a daily graph, perhaps with the ability to overlay several days' results, and with all out-of-range BGs and Adjustment doses highlighted?
  • ability to export results to PC/Mac (as csv, or similar).
  • ability to connect and upload results to your DAFNE online diary.
  • ability to email results to yourself, your HCP, etc.
  • ability to input ratios for mealtimes, and for the appropriate QA field to be automagically calculated and filled (whilst remaining editable) from the CP field's value.

these are just a few things off the top of my head. if anyone sees something that you disagree with, or doesn't see something that should be included, then please comment!

many thanks to Simon and any other interested developers.
 
Nov 22, 2009
Ian Dransfield 2 posts

Topic: General Discussion / Do you have access to the Online Handbook?

Hi Marke

PDF format is fine, it just makes it easier to have a copy on my PDA where it is not possible to connect to the net to read it online

Many thanks

Ian
 
Nov 21, 2009
john day 54 posts

Topic: Questions for HCPs / BG Diary at Clinic

Hi All,

Here is a suggested spec for a basic HCP summary: suggest it’s located on the Diary view page and generates a tabular result.
The process summarises analyses already available on a date by date basis plus few other bits.
To be effective needs Diary entries to be filled fully inc significant comments on ratio changes, CP errors etc .

Needs a User selected high reading level X specified to suit their situation.

The User specifies a start date and no of weeks to be covered by the table.
7 day’s records are averaged and summarized per line of a table with column headings:

Start Date, Avg Daily QA taken, Avg Daily BI taken, Avg Breakfast BG, Avg Lunch BG, Avg Dinner BG, No of rdgs< 3.5, No of rdgs> X, Avg Bkf ratio, Avg Lun ratio, Avg Din ratio, Comments for all 7 days

The Ratios are the tricky one. If the avg ratios per Type are calculated, need to either use the entered ratios or calculate using the CPs and QA data entered (if in a + b format). The former seems easier. I always note ratio changes in Comments, but other info also. Perhaps Ratio handling need a rethink in due course?

For longish diaries it might be good to eventually to offer a separate but similar previous month by month analysis for longer term comparison. But no doubt better to get the basics out for feedback first.

Using my own data, this was easy to see trends and impact of dosage changes made.. as long as these were recorded in Comments! The comment lists gave a review of how I was trying to attack BGs over time. One surprising thing I noted was that although the averages were generally coming down, as was the no of rdgs >12 (doh!), the trend of rdgs <3.5 stayed the same, either 1, 2, or 3. Go figure.

Anyway, interesting to see if you think this can be done without too mush hassle and then see user response. I’m off to a Dafne Review next week and am taking my own manual version along so will see what the hcps think!

Cheers, John

 
Nov 20, 2009
john day 54 posts

Topic: Questions for HCPs / BG Diary at Clinic

Hi marke .. I'll send you some clarification by message. Cheers, John
 
Nov 20, 2009
john day 54 posts

Topic: Site Development / Question: Sharing the online diary

Hi Jennifer & Simon ..

I tried this a few weeks ago and saw the gobbledy gook too but did not think it related to Excel but to some other more esoteric software! The excel meal Estimator form I send to others are .csv.

Anyway, have tried XML output again to be rewarded with 'This XML file does not appear to have any style information associated with it. The document tree is shown below.'

Excel Help advises it does not recognise the search term xml and can't see anything on the menus, so how can I use xml in relation to excel? I did use a homemade excel BG analysis pre Compass and Dafne Online.

Cheers, John







 
Nov 20, 2009
Karen Westwood 38 posts

Topic: General Discussion / Need a kick up the backside! :(

Hi Derek,

By making this first step of asking for support via the forum I think that is a really positive start.

As others have said, we have all been where you are today, and I think that it needs to be yourself that wants to improve not anyone else.

Before DAFNE I had a bit of a health scare and with 2 young children (aged 6 and 9) and being significantly overweight I knew that I had to tighten my control or risk not being here to see my kids grow up. This was the thing that has kept me going since I attended my DAFNE course in July this year. Following on from DAFNE I have managed to get my Hba1c down to 6.7 and have lost almost 5 stone in weight. I feel so much better in myself but I know that you have to be in the right place mentally to achieve what you want.

I think what Mark has said about making sure that you do plenty of tests is absolutely the best thing to do first because you need these results to see any patterns that are forming with your results.

Hopefully your hospital review was helpful too in pointing you in the right direction to get you back on track.

Don't forget to keep us informed of how you are getting on.

Good luck

Karen x
 
Nov 20, 2009
marke 643 posts

Topic: General Discussion / sugars in the 20's who to call in aust.

Russ,
Unfotunately there are not many people signed up from Oz as yet so you may not get a response from them. I am not a HCP but my advice would be don't panic. Your BG's are not ideal but given the way they are going up and down I wouldn't be hugely concerned about Ketones just yet. Your BG's are erratic and without lots of background information it might be hard to identify the exact cause on here. You
really need the help of an expert. I'm not sure how it works in Oz, do you have a Diabetes Consultant or Nurse you see regularly can they help with advice ? Sorry I can't help more. One thing I would say, earlier in the year I had to take Steriods and they cause Insulin Resistance. My BG's were up like yours for a few months and as far as I can tell it has done me no long term damage, well apart from the stupid idea of helping with a diabetes website, but thats another story :^)