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Oct 24, 2009
Sam 64 posts

Topic: General Discussion / Dawn Phenomenon

Hi Guys

Just wondering if any of you suffer from the above. I've been diabetic for over 20 months now my ratios are as follows:

Breakfast 3:1 plus 16u BI Levemir
Lunch 2:1
Dinner 2:1 plus 1000mg metformin and 22u BI Levemir

I attended my DAFNE course mid Sept 09, in that my BI was moved from bed time to dinner time as I was high before bed and high when I woke up in the morning. For 2 days the change seemed to have worked however I have been battling against the rise of BG before bed and when I wake up.

I have recently started taking up swimming and cycling to tighten my control as I want to have a 1:1 ratio eventually!

The last couple of days my BG has been within my targets which I have been really excited about. My problem is now I'm having my dinner around 6ish my insulin taken by 630pm and I'm in bed by 10pm. QA is working as it should because for example last night I went to bed with a BG of 6.1 I woke up this morning at 4.30am thinking I was hypo but to my surprise I was 18.7??? I went back to bed and woke up at 10am with my BG at 17.2....I just don't get it.

I remembered reading a paragraph on this site about the Dawn Phenomenon and googled it, I've pasted the link below. I have my 6 week review next week and will discuss with the Consultant however in the meantime I'd be grateful for anyone's thoughts.

I don't know whether to increase my BI 2 units at dinner time but I feel I'm on plenty insulin as it is and really trying to cut back from a weight perspective.

The article makes sense but I would be interested what everyone else thinks!!

Cheers
Sam x

http://www.diabetes-support.org.uk/joomla/dawn-phenomenon
 
Oct 24, 2009
Simon 578 posts

Topic: Site Development / Searches

Hi Alan,

Sounds like a good idea - will start working on it.

Simon
 
Oct 23, 2009
Karen Westwood 38 posts

Topic: General Discussion / New Job

Hi Clare, You seem to be having a bit of a nightmare at the moment.

I remember being told on our DAFNE course that the lowest ratio should be 1:1 so I think that maybe your best bet would be to try and reduce you BI by a bit more than you have already done. If you are having hypos throughout the day and night it seems that you are having too much BI.

With regards to your days off I would first try and get your BI correct on your working days because obviously having so many hypos is not good for you. If you find your BG is higher on your days off maybe you could increase your BI on these days. From what I understand Levemir changes work pretty much straight away so hopefully you might be able to work out what insulin you need on working and non working days.

Good luck!

Karen x
 
Oct 23, 2009
Tony Quick 1 post

Topic: General Discussion / Hello!!

hi shazz, I have just done DAFNE in exeter and feel the same as you, it was great its too early to see if it works but I've learn so much I can't see it failing. good luck let us know when your hba1c is under the magic 7. regards TQ
 
Oct 23, 2009
Simon 578 posts

Topic: Site Development / Meter Upload Development

Hi NiVZ,

Great stuff - I've sent you a message with another email to try - not sure why this one is being blocked.

Simon
 
Oct 23, 2009
NiVZ 82 posts

Topic: Site Development / Meter Upload Development

Hi Simon,

I've got something ready that can read the dates, times and BG from the UltraEasy meter and display them in a window.

I tried to email it to your dafneonline email address but the .exe attachment keeps getting returned (even when zipped)

Any ideas how I can get it to you?

Cheers,

NiVZ
 
Oct 23, 2009
Tracey Bond 14 posts

Topic: Carbohydrate Counting / any1 know how many cps in a ferra roche

The website 'myfitnesspal.com' allows you to input varying quantities of the chocolates to get an accurate carb value. Now I know exactly what's in them I think I will add them to my Christmas list without any pangs of guilt!!
 
Oct 23, 2009
Matt S 1 post

Topic: General Discussion / Moving overseas

I spent six months in Cambodia last year, and struggled to a) be prescribed enough insulin to last the whole trip, and b) come up with an alternative supply just in case I lost or damaged any. For several years I have questioned how British diabetics have secured supplies overseas, particularly if they move abroad for extended periods.

Any ideas?
 
Oct 23, 2009
Alann 12 posts

Topic: Site Development / Searches

Hi Guys,

First what a wonderful resource the DAFNE online site is!

Can I make a suggestion, a search function for both the handbook and forums would be really useful.

Many thanks

Alan.
 
Oct 22, 2009
Simon 578 posts

Topic: Site Development / Meter Upload Development

I think the best thing to do would be to make entries keyed on the date and time (so that there could only be one for each minute of the day, say). That way we could overwrite/update any duplicate entries to maintain consistency with the database on the meter.

Not sure how COM/Serial ports work so can't advise I'm afraid!

Simon
 
Oct 22, 2009
NiVZ 82 posts

Topic: Site Development / Meter Upload Development

Good news and bad news tonight.

Good news is I managed to read all 500 dates, times and BG's from my UltraEasy meter. Bad news is on the second attempt there was a COM read error at record 217 which knocked everything out by 1 character so this means I'll need to add more error checking when receiving messages (either that or I was trying to read too quickly - might try a slight pause first and see if that helps)

NiVZ
 
Oct 22, 2009
cmturnbull 6 posts

Topic: General Discussion / New Job

Hi All,
Was going to call my DSN but thought I might throw this problem open to the floor in the meantime.
Have just started a new job. Not only do I walk there but it is also a lot more physical than I expected it to be. I am hypoing ALL THE TIME and it is really getting me down. I've set all my ratios to 1:1 and am still hypoing as soon as 2 hours after breafast. Is 0.5:1 ratio possible? It seems so small to me. This is mainly about my breakfast injection, and even after the 1:1 ratio I still have many hypos. I then started to have a fiddle with my background (split levemir), cutting the morning dose by 10-20%. Still more hypos!

And the nighttime too is a bit of a mess. I might (for example) go to sleep at 7-8mmol/l, sleep the whole night through but then wake up hypo. This is a slight improvement from just having 3-4am hypos, but I don't really understand why it would happen (except for maybe the body replenishing stores during the night). It's stressing me out!

Any tips/ideas what is happening?
Also if anyone does a physical job...how do they adjust their insulin on days off?

Thanks,
Clare xx
 
Oct 22, 2009
NiVZ 82 posts

Topic: Site Development / Meter Upload Development

Hi Simon,

I've done a REST interface into Twitter before, and I'm familiar with using Java SOAP GET and SOAP requests over HTTP.

The UltraEasy is coming together nicely. Been trying to add some nice things like automatically figuring out which COM port the meter is on, and retrying initial connect 3 times if meter is not ready. I'll hopefully have something by the end of next week that can connect to the meter and get all it's readings in XML format.

After that I'll be needing you and Marke's help to get the data uploaded.

Do you guys have any ideas about whats best to do with duplicate entries? ie if you upload all your meter readings today, take a few more and then upload the next day

As far as I can tell we'll have 2 choices.

1. Read every reading from the meter every time and discard duplicates (or overwrite exisiting entries) when POSTing. This appears to be what the manufacturers software does and also means I can do a porgress bar.

2. Read the last entry from the web, then read from meter until we reach the last web entry. This would be quicker but means I couldn't do a progress bar because I won't know in advance how many meter readings we'll be using.

Might be useful to setup a test login/diary that we can send data to until we get it sussed.

I'll also need some other UltraEasy users to give it a try.
Cheers,

NiVZ
 
Oct 21, 2009
Tracey Bond 14 posts

Topic: Questions for HCPs / Rising morning BG'S with/without breakfast.

Hi, many thanks for replying. I was thinking along the same lines but I was told on my course that if your Lantus is spot on then it should keep you steady. Maybe I'm just looking for problems when the answer is just some QA to counter the rise.
 
Oct 21, 2009
Nick Sproston 5 posts

Topic: Questions for HCPs / Rising morning BG'S with/without breakfast.

Tracey
I have the same issue and also take lantus am/pm.
I was told that as i do not have breakfast it would be allright for me to take some QA to counter the morning BG rise.
But as you know we are all different so you would have to see if this would be ok for yourself
 
Oct 21, 2009
Tracey Bond 14 posts

Topic: Questions for HCPs / Rising morning BG'S with/without breakfast.

I was hoping that a HCP or other could answer my query. I have split doses of Lantus 7.30 (am and pm)but am finding that my BG at the time of my morning Lantus is rising before breakfast which is ususally 2 or 3 hours later. I understood that even if I decided I didn't want breakfast a correct dose of Lantus twice daily would hold my BG steady.

Please help if you can. Thank you.

Tracey Bond
 
Oct 20, 2009
Simon 578 posts

Topic: Site Development / Meter Upload Development

I think the proprietary protocols are an example of the mercenary nature of drug companies - it's all about making money unfortunately. The software/cables are often paid for somewhere along the line (even if we the end users get them free) so the companies are reluctant to share their protocols/apis with third parties as they could produce rival software which then eats into the companies profits. Also, everyone thinks they are doing things the 'right' way and don't want to change to conform with other products/standards. As mark says, its not the blood glucose meter market that this is affected by, but most of IT.

Anyways, moan over Smile So in theory our BG diary is exposed as a REST API, meaning we can use HTTP methods to create, read, update, and delete (CRUD) data. As long as you are able to get your extracted data into an XML format (which we can develop together) then with a few tweaks our end you should just be able to use HTTP GET and POST to login and input data to the site, meaning you don't have to use a specific programming language.

If there's anything we can do to help in the meantime just give us a shout.

Simon
 
Oct 20, 2009
marke 681 posts

Topic: Site Development / Meter Upload Development

Hi, I have an Ultra Smart as well I'm afraid :-( I like all the geeky features on it, being able to enter more than just BG readings.
The bluetooth meter sounds interesting in principle, however what does it do to the battery life ? Usually bluetooth tends to eat batteries so it might not be a great idea, it would be interesting to hear if anyone has tried one.
Yes it would be good to have a common standard however the rest of the computer industry has never managed it, so why believe that meter companies can do it. I am suprised by the minutes since 2000 approach, the seconds since 1970 is fairly standard on most unix/linux derivatives which I'm guessing these devices run. It would be nice to have published protocols, even better software API's. If its windows software its most likely been written using COM and it would be easy to publish an API for people to use. Although there is unlikely to be much demand for it I guess ;-)
Anyway keep at it, as soon as you have something read we can work out how to interface it to the website so we can upload.
 
Oct 19, 2009
NiVZ 82 posts

Topic: Site Development / Meter Upload Development

Hi marke,

I am really close to having the Ultra Easy completely done, but I started looking at the Ultra Smart as Simon said thats what he was using. Can I be nosey and ask your meter of choice?

Yeah infra-red is a bit old nowadays and probably not the fastest for data transfer. I thought I read somewhere on their site that they had a USB cable, but maybe it's the USB to infra-red.

Have you seen the Wavesense Jazz? It looks retro, but it has Bluetooth connectivity and automatically sends the data to your PC whenever it's on and in range.

It would be great if all the companies could create some sort of standard data format for accessing the data. Even the same companies use different standard. On the Ultra Easy the date is marked as seconds since 01/01/1970. On the Ultra Smart it's minutes since 01/01/2000!!!Don't see why they keep it all secret as it's not like they make any money on it anyway as they all give away their software for free.

As for getting the data uploaded, I'm hoping to format it into XML. Not sure what to do about duplicates, ie if you upload all your data one day then take 4 more readings and upload again. Worry about it once I've pieced what I've got together.

NiVZ
 
Oct 19, 2009
marke 681 posts

Topic: Site Development / Meter Upload Development

Hi, we would be interested ( as Simon has said in the past) in anything you produce. I guess once you can 'extract' the data from the meter we need to get it into a format that can be 'uploaded' to the site. Let us know when you are in a position to do this and we can work on it.
I was also intetrested in the link you posted on the Roche meters. To be honest I gave up on Compass and switched to lifescan because I couldn't put up with their obsession with Infra-red any longer. In my experience I have never used a 'good' infra-red device, its a technology that had its day in the 80's and is long past its useby date. Especially as USB is now such a 'standard', its much better supported and widely used. Roche now have this 'smartpix' device that uses USB to the PC but still uses infra-red to the device :-( I would like to get my hands on a 'smartpix' but they won't send me one without charging and since I don't use a Roche meter, I can't see the point. One day maybe we can do something with Roche, however Lifescan seem much more friendly AND use USB !!
 
Oct 19, 2009
John Roscoe 14 posts

Topic: Carbohydrate Counting / CP value of Stoneless Dates

Thanks Sarah, I can now eat my wife's museli without worrying that I might have estimated the wrong CP value.
Regards
John
 
Oct 19, 2009
john day 54 posts

Topic: Site Development / Meter Upload Development

Hello NiVZ

Thanks for info, I would certainly be interested in uploading from the Aviva in due course.

Had a quick look at Simon Pickering’s info and suspect his comments re Roche are valid and Compass is definitely a bit clunky!

The technical comments don’t mean much to me, but if you do get anything worked out I would be happy to assist with any testing required.

Cheers, John