Recent Posts - DAFNE Online

Aug 19, 2009

Jess 13 posts

Topic: General Discussion / Changes to HbA1c reporting

I do think the new way of reporting will confuse many people. At the moment having the HbA1c as a percentage means that most people know not to relate it directly to finger prick measurements, in mmol/l. However, the new version is in mmol/mol - which is a very different metric to mmol/l, but sounds similar. I would really like to know WHY they have decided to do this, and what they think the benefits are, there must be some surely?

Its a long time since was converting mols to litres (or whatever) but I'd like to find out how we can convert mols of blood to litres of blood (not something I can look up on the periodic table!). Then we can easily convert the new HbA1c to mmol/l which would give us a rouhg idea of what our average BG is in terms we understand.

I have seen tables that roughly corellate the % to mmol/l so they will still stand.

So, unless someone can tell me WHY they are doing this, I'm unconvinced at the moment!

Oh, one thing that you don't see advertised much is the variation between labs. IIRC it is quite high, and I was told (once, in the dark ages) that when you move labs you shouldn't directly compare HbA1cs as their ranges on the test will be slightly different. Anyone know if this is still true.
Or would it??

Aug 19, 2009

Jess 13 posts

Topic: General Discussion / Hypos

That would of course be a good idea, don't know why I didn't think of that, thanks!

There really should be a 5-year refresher course, you do slip into bad habits after that long!

Aug 19, 2009

mandyrobertson9 10 posts

Topic: General Discussion / Hypos

How about reducing your night time background insulin if you've been exercising.

Aug 18, 2009

Jess 13 posts

Topic: General Discussion / Hypos

Its 00:30 and I', 2.8 mmol. Woke up in a sweat (thankfully I guess!). I exercised at 6. with a BG of 7 and a milky way (though they only have the carbs per 100g so I have no idea how many CPs). I was 6.0 before dinner, did 1:1 instead of my usual 1:1.5, and 8.2 before bed. Hooray! I thought.

But no. I really want to go to bed, but I'm desperately trying to wait for my OJ to take effect before I eat a long acting snack as per the handbook I re-read recently. I know if I don't eat a snack I'll be up again in a few hours from experience though.

As I was 8.2 before bed I can't reduce my after exercise insulin further. What should I do in future?

Aug 18, 2009

Jess 13 posts

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

Cheers.

Aug 18, 2009

Karen Westwood 38 posts

Topic: General Discussion / Diabetic Birth Stories

Katy,

So pleased you have managed to speak to your diabetic nurse and hopefully things will settle down for you soon. Enjoy you bedtime snack! and most of all the rest of your pregnancy.

All the best

Karen
x

Aug 18, 2009

marke 681 posts

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

Jess,
I have contacted DAFNE Central about 'verifying' you as a graduate, as soon as I have a result I will let you know.

Aug 18, 2009

Polly 2 posts

Topic: General Discussion / Caravan towing?

Thanks for all that info, very helpful

Aug 17, 2009

Katy Lou 2 posts

Topic: General Discussion / Diabetic Birth Stories

Karen - My nurse agrees with you. She gave me very similar advice so fingers crossed I may have a full night's sleep before the week is out and get to eat biscuits at bedtime. Reading your success story has really helped. Thank you.

Aug 17, 2009

Concha 1 post

Topic: Questions for HCPs / Giving birth without an insulin/glucose drip

Hi,
i can only give you my experience 14 y ago.i was induced because of risk of still birth(placenta not working anymore) at 39 weeks. did no have a drip, but I was encourage to do prick finger test during delivery. straight away after my son was born, was kept under obs.and I was asked to breast fed from start (on delivery bed)and 2 hourly prety tiring!!. all went well.i forgot, i did have normal vaginal delivery..all the best concha

Aug 17, 2009

noatey 1 post

Topic: General Discussion / Caravan towing?

There is full information on driving license catagories and types of caravans and trailors that can be towed on the caravan club website. The main point being that a change came into force in 1997, I believe. I have copied the article and will try and paste it here:

DRIVERS' LICENCES IN A NUTSHELL!
This leaflet is prepared as a Club service. The contents are believed correct at the date of publication but please raise any queries with the Clubâ€™s Information office.
April 2008
TOWED OUTFITS AND RIGID MOTOR CARAVAN OUTFITS
CATEGORY B LICENCE OBTAINED PRIOR TO 1 JANUARY 1997 MAY DRIVE:
a. Towed Outfits any outfit where the combined MAM (Maximum Authorised Mass) does not exceed 8,250kg. (over which weight would have required an additional test pre-1997) However Club recommendations on weight ratio between trailer and towing vehicle remain at 85%.
b. Rigid Motor Caravans without trailer any rigid motor caravan without a trailer where the MAM does not exceed 7,500kg.
c. Rigid Motor Caravan with trailer provided the total MAM of trailer and motor caravan does not exceed 8,250kg no further test is required, but Club recommendations on weight ratio between trailer and towing vehicle remain at 85%.
CATEGORY B LICENCE FIRST OBTAINED ON OR AFTER 1 JANUARY 1997
MAY DRIVE:
a. Towed Outfits driver restricted to a combined MAM of 3,500kg and the trailer MAM must not exceed the unladen weight of the towing vehicle (85% ratio remains strongly recommended). If this MAM is to be exceeded an E Test pass is required. A list of B+E test driving instructorsâ€™ can be found in the Practical Advice section of The Caravan Club Website. The Driving Instructorsâ€™ Association also has a list of qualified driving instructors that can tutor those wishing to take the B+E driving test - visit the Driving Standards Website on www.dsa.gov.uk, or telephone 0845 345 5151.
b. Rigid Motor Caravans without trailer driver restricted to a MAM of 3,500kg until obtaining a pass of the LGV test, after which the driver is qualified to 7,500kg MAM.
c. Rigid Motor Caravan towing trailer provided the trailer does not exceed 750kg and the combined MAM does not exceed 4,250kg no further test is required for this type of outfit. However if the trailer MAM exceeds 750kg then a. applies for a vehicle less than 3,500kg. Otherwise an LGV test plus an E Test is needed.
YOUR DRIVING ENTITLEMENT ON RENEWING AT THE AGE OF 70
On reaching the age of 70, drivers will retain their driving entitlement for Category B and Category B+E (provided Category B+E was held prior to the expiry date of their driving licence). Category B+E entitles drivers to drive a motor vehicle (ie car, van or 4x4) not exceeding 3.5 tonnes Maximum Authorised Mass* (MAM), drawing/towing any weight trailer/caravan within the prescribed maximum towing weight. The maximum towing weight will be specified in the technical data section of the vehicle manufacturerâ€™s handbook. However, Club recommendations on weight ratio between trailer and towing vehicle remain at 85%.
*The terms â€˜Maximum Authorised Massâ€™, â€˜Gross Weightâ€™ and â€˜Permissible Maximum Weightâ€™ all have the same meaning, ie the weight of the vehicle plus the maximum load the vehicle may safely carry.
When drivers of any vehicle over a MAM of 3,500kg reach 70 years of age and their driving licence expires they must pass the D4 Medical Test and pass the required standard eyesight test at 20.5 metres/67 feet with glasses used when driving. This legislation became effective from 1 January 1998.
COURSES/TESTS/EGC/JP/SJS/LICENCE Â© The Caravan Club 2008

Aug 17, 2009

Claire Hough 12 posts

Topic: Carbohydrate Counting / Cherries

Hi Sylvia, I find the supermarket websites really helpful for fresh food carb values as they give the nutritional values for nearly everything they sell. Sainsburys is especially good as you don't need to register your details before you can view the products. Hope that helps

Aug 17, 2009

Sylvia 3 posts

Topic: Carbohydrate Counting / Cherries

Thanks to both Anita and Clare. It's 2 years since I did DAFNE, and they don't appear in my carb counter. I was a bit concerned, as I like them and tend to eat a lot when they're in season!! Sylvia.

Aug 16, 2009

Jess 13 posts

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

Hi Marke, I actually found my handbook! I didn't find it necessary to write anything like dates or names in it though, mores the pity. It says May 2003 on the front though! I've also found some emails from course-mates from March 2004, so I think it was Feb 2004, and I know they only had one course per month at the time. Dont' know if that is enough info for you!

Aug 16, 2009

anitas 2 posts

Topic: Carbohydrate Counting / Cherries

hI i'VE BOUGHT MYSELF A GREAT LITTLE BOOK FROM WATERSTONES CALLED COLLINS GEM CARB COUNTER AND IN THERE IT HAS CHERRIES DOWN AS 10.4 CARBS PER 90G HOPE THIS HELPS
ANITA

Aug 16, 2009

Karen Westwood 38 posts

Topic: General Discussion / Diabetic Birth Stories

Katy,

I wouldn't worry too much about BG of 8 in the morning. This is not extremely high and as along as using a corrective dose at breakfast brings you back in line by lunch time I wouldn't have thought it too much of an issue. As long as your HBA1C results as still within the targets I think you will be OK. It is probably more important that you try not to have night time hypos. Have you tried having a bit of something to eat before bed. Both my pregnancies were pre DAFNE and I didn't have the information available to me then that I have now but I always found that I needed to have my BG a little higher before bed to ensure that I didn't dip too low in the night. I was unfortunate in that I lost all my hypo warning symptoms during both my pregnancies so it was more important for me to keep myself that bit higher at night. This never effected my HBA1C because I was at really good levels during the day. Also I had 2 lovely healthy babies.

With regards to your question about coping with the increased insulin requirements, I think that you will find this much easier with your background DAFNE training. It was very much guess work when I did it but I think using the DAFNE principles it will probably not be too bad. You may find though that you have to use a bigger ratio of insulin to carbohydrate than you are used to as from my expreience the insulin requirements increase quite dramatically. Maybe someone from your DAFNE team maybe able to give you some more information on this.

I reallly hope things work out well for you and I know it is hard for you at the moment but it will all be worth it in the end!!

Take care.

Karen
x

Aug 16, 2009

cmturnbull 6 posts

Topic: Carbohydrate Counting / Cherries

I don't think they have one! I finished DAFNE on Friday and I think because their GI is so low, you'd hypo if you injected for them.
Hope that helps,
Clare

Aug 16, 2009

Jacqueline S... 1 post

Topic: Carbohydrate Counting / Wholemail flatbread

I sometimes get lunch online through my work. I have a "wholemeal flatbread" which looks like a wrap but I cannot find anything in the carbs details about what it should be. I weighed it the other day and it is about 86g. I wonder if anyone has advice about what this actually might be, please? I have tried to get the information from the online company but without success. Thanks.

Aug 16, 2009

Katy Lou 2 posts

Topic: General Discussion / Diabetic Birth Stories

Hi,

I'm 15 weeks pregnant and petrified. Although all the success stories have made me feel reassured. Thank you for sharing. Fingers crossed in 22/23 weeks ill add my own. The fact you went for a second and third baby is brilliant. Very encouraging.

Ive had a lot of morning (all day everyday anytime) sickness which has made life difficult. I thought at 13 weeks it had passed but it has struck back this week.

Being dafne trained im adjusting my BI and QA as and when trends develop. so far I have reduced my BI by 12 units although my day time ratios have increased.

I'm still having 2-3 hypos during the day which i can recognize and react to. My concern is night time. I'm going to bed with a BG of 5.9, dipping to 3.3 in the night treating it but having a morning BG of 8.7. Ive tried treating the 3.3 with less CPs - down to 3grams last night but still waking at 8.7. I've tried less BI but i still get the 8ish reading in the morning. I'm waiting to hear back from the nurse.

I don't know what to do and fear all the extra glucose is going straight to the baby. Any ideas? Having been in control prior to conceiving i'm finding the changes a real challenge.

i know from the course I will start to need more insulin at around 26 weeks - can anyone say what happened for them and how they coped.

Is there any literature out there to refer to for support? The Dafne guide doesn't really deal with what happens in pregnancy.

Jess - i find each day a struggle at the moment but keeping the diary really helps and guides me to what changes i need to make. I find being regimented, eating similar meals and injecting same time each day helps show a pattern. Cutting out alcohol and exercise for a few days might help as both can affect your BG levels. Sometimes there is no reason for a rogue result.Don't be too hard on yourself, its difficult getting it right. Are there any refresher courses you could sign up to? I think they are running some at my local hospital once every 3 months or so. Good luck.

Aug 16, 2009

Val 1 post

Topic: Questions for HCPs / Giving birth without an insulin/glucose drip

Hi
I'm new here and been DAFNEING for 2Â½ years. Had my babies before DAFNE (now 9 and 6 - time does fly).

Do you plan to try and go full term naturallly or will you be induced at 38 weeks? I was encouraged to go for being induced at 38 weeks as I was told after this time the placenta can stop working without warning, with obvious results. Maybe the advice is diff now? I'd be interested to hear?

Induction just didn't work for us, my stubborn son wasn't budging (he's the same now if comfortable, you can't shift him!) so I had a c.section. Which was fine, no complaints, up and about the same day, then a planned one for number two.

First time I went into hosp with a birth plan all written out and then ended up never even opeining it as the induction just wasn't working. I came to the conclusion that my son was safer out than in so went for the c.section and don't regret it. So what I'm saying in a round about way is don't get too hung up on the delivery, focus on the outcome.

The bit that did frustrate me about both deliveries was the assumption that I would have a baby with a hypo and that they insisted on bottle feeding both at birth. I wanted to BF and hated the fact that despite excellent control during pregnancy, and that I think most babies blood sugar is low on delivery, they stuck a bottle in his mouth, it felt like they were covering themselves. Second baby I tried to insist this didn't happen and they said they had never seen anyone manually express milk in the recovery room (I expressed some to add to the bottle as they still wanted to give one). If you want to breastfeed (and do its lovely!!) this is an area I would try and clarify with your health carers rather than being pushed into giving bottles.

Also make sure you take plenty of food in with you and ask NOT to be put on the diabetic menu. Second baby I was asked to go in the night before so they could control my blood sugars, went really low in the middle of the night (which I had never done before!) and all they could find for me to eat was a sandwich 2 days over its shelf life!!!

Best wishes

Val

Aug 15, 2009

marke 681 posts

Topic: Questions for HCPs / Can anyone put numbers (%) on ideal split between above target, on target and below target BGs?

As ever I will start by saying I am NOT a HCP just a run of the mill DAFNE Graduate.

So, what should you be aiming for, perfection ! Will you ever acheive it ? Very probably no, but it doesn't hurt to try :-) I don't believe a view has been formed because I don't think one can. We are all different and the answer will differ slightly for each of us. Keeping your BG's within target range reduces your risks of complications, the key here is 'reduces'. Life doesn't come with an guarantees and especially not if you have Diabetes. You could keep your BG's perfect and still suffer complications and vice-versa, again because we are ALL different our risk factors will vary. It's just life !
So at least you are seeing an improvement, making progress, thats something to be happy about ! So well done.
By the way we are glad that you are finding the graphs useful :-)

Aug 15, 2009

marke 681 posts

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

John,
I'm really sorry but we cannot give you access to the handbook at the moment. I appreciate you don't get to choose what Diabetes Education course you do and it sounds a bit 'them' and 'us', but we are only allowed to provide access to validated DAFNE Graduates.
Why is this ? Well amonst other things, there is concern that non DAFNE people will try to use information in the handbook without the backup of a DAFNE Educator and do themselves harm. I know there are some that do not agree with this and think eveyone should be treated as though they are capable of managing without DAFNE Educators. Unfortunately this is not a risk DAFNE Central or DAFNEOnline are prepared to take.
In addition DAFNE Central are concerned about 'variations' on DAFNE like BIANCA. The point of DAFNE is it is rigidly based on the original german version and has a very tight management scheme of the DAFNE Educators. All DAFNE courses should be pretty much identical in course content regardless of where they are run, the educators are also all trained the same and are audited every year. This means the course meets all the NHS criteral for Diabetes Education and is consistent.
Unfortunately PCT variations do NOT have this kind of control or management and are often cut down versions of DAFNE. This may mean what are considered vitial elements are missed out. I appreicate this doesn't help you and I would like to be able to help, however we have to stick to the rules laid down by DAFNE Central since we work so closely with them. If the situation changes we will let you know.

Aug 15, 2009

marke 681 posts

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

Jess,
If you can remember who your dAFNE educator was or when you did the course we might be able to cross reference it with DAFNE
Central and give you access i.e change your account status to graduate. Why do we need to do this, see my response to John below.

Aug 15, 2009

shirley 9 posts

Topic: Questions for HCPs / post menopause

does anyone have any experience with 'hot sweats' due to post menopausal symptoms? I can not seem to make my mind up if the BG results I have are due to post menopause or hypos. Any advisce will help!!!

Aug 15, 2009

Sylvia 3 posts

Topic: Carbohydrate Counting / Cherries

Can anyone tell me the carb value of fresh cherries?

Aug 19, 2009 Jess 13 posts	Topic: General Discussion / Changes to HbA1c reporting I do think the new way of reporting will confuse many people. At the moment having the HbA1c as a percentage means that most people know not to relate it directly to finger prick measurements, in mmol/l. However, the new version is in mmol/mol - which is a very different metric to mmol/l, but sounds similar. I would really like to know WHY they have decided to do this, and what they think the benefits are, there must be some surely? Its a long time since was converting mols to litres (or whatever) but I'd like to find out how we can convert mols of blood to litres of blood (not something I can look up on the periodic table!). Then we can easily convert the new HbA1c to mmol/l which would give us a rouhg idea of what our average BG is in terms we understand. I have seen tables that roughly corellate the % to mmol/l so they will still stand. So, unless someone can tell me WHY they are doing this, I'm unconvinced at the moment! Oh, one thing that you don't see advertised much is the variation between labs. IIRC it is quite high, and I was told (once, in the dark ages) that when you move labs you shouldn't directly compare HbA1cs as their ranges on the test will be slightly different. Anyone know if this is still true. Or would it??

Aug 19, 2009 Jess 13 posts	Topic: General Discussion / Hypos That would of course be a good idea, don't know why I didn't think of that, thanks! There really should be a 5-year refresher course, you do slip into bad habits after that long!

Aug 19, 2009 mandyrobertson9 10 posts	Topic: General Discussion / Hypos How about reducing your night time background insulin if you've been exercising.

Aug 18, 2009 Jess 13 posts	Topic: General Discussion / Hypos Its 00:30 and I', 2.8 mmol. Woke up in a sweat (thankfully I guess!). I exercised at 6. with a BG of 7 and a milky way (though they only have the carbs per 100g so I have no idea how many CPs). I was 6.0 before dinner, did 1:1 instead of my usual 1:1.5, and 8.2 before bed. Hooray! I thought. But no. I really want to go to bed, but I'm desperately trying to wait for my OJ to take effect before I eat a long acting snack as per the handbook I re-read recently. I know if I don't eat a snack I'll be up again in a few hours from experience though. As I was 8.2 before bed I can't reduce my after exercise insulin further. What should I do in future?

Aug 18, 2009 Jess 13 posts	Topic: General Discussion / Do you have access to the Online Handbook? Cheers.

Aug 18, 2009 Karen Westwood 38 posts	Topic: General Discussion / Diabetic Birth Stories Katy, So pleased you have managed to speak to your diabetic nurse and hopefully things will settle down for you soon. Enjoy you bedtime snack! and most of all the rest of your pregnancy. All the best Karen x

Aug 18, 2009 marke 681 posts	Topic: General Discussion / Do you have access to the Online Handbook? Jess, I have contacted DAFNE Central about 'verifying' you as a graduate, as soon as I have a result I will let you know.

Aug 18, 2009 Polly 2 posts	Topic: General Discussion / Caravan towing? Thanks for all that info, very helpful

Aug 17, 2009 Katy Lou 2 posts	Topic: General Discussion / Diabetic Birth Stories Karen - My nurse agrees with you. She gave me very similar advice so fingers crossed I may have a full night's sleep before the week is out and get to eat biscuits at bedtime. Reading your success story has really helped. Thank you.

Aug 17, 2009 Concha 1 post	Topic: Questions for HCPs / Giving birth without an insulin/glucose drip Hi, i can only give you my experience 14 y ago.i was induced because of risk of still birth(placenta not working anymore) at 39 weeks. did no have a drip, but I was encourage to do prick finger test during delivery. straight away after my son was born, was kept under obs.and I was asked to breast fed from start (on delivery bed)and 2 hourly prety tiring!!. all went well.i forgot, i did have normal vaginal delivery..all the best concha

Aug 17, 2009 noatey 1 post	Topic: General Discussion / Caravan towing? There is full information on driving license catagories and types of caravans and trailors that can be towed on the caravan club website. The main point being that a change came into force in 1997, I believe. I have copied the article and will try and paste it here: DRIVERS' LICENCES IN A NUTSHELL! This leaflet is prepared as a Club service. The contents are believed correct at the date of publication but please raise any queries with the Clubâ€™s Information office. April 2008 TOWED OUTFITS AND RIGID MOTOR CARAVAN OUTFITS CATEGORY B LICENCE OBTAINED PRIOR TO 1 JANUARY 1997 MAY DRIVE: a. Towed Outfits any outfit where the combined MAM (Maximum Authorised Mass) does not exceed 8,250kg. (over which weight would have required an additional test pre-1997) However Club recommendations on weight ratio between trailer and towing vehicle remain at 85%. b. Rigid Motor Caravans without trailer any rigid motor caravan without a trailer where the MAM does not exceed 7,500kg. c. Rigid Motor Caravan with trailer provided the total MAM of trailer and motor caravan does not exceed 8,250kg no further test is required, but Club recommendations on weight ratio between trailer and towing vehicle remain at 85%. CATEGORY B LICENCE FIRST OBTAINED ON OR AFTER 1 JANUARY 1997 MAY DRIVE: a. Towed Outfits driver restricted to a combined MAM of 3,500kg and the trailer MAM must not exceed the unladen weight of the towing vehicle (85% ratio remains strongly recommended). If this MAM is to be exceeded an E Test pass is required. A list of B+E test driving instructorsâ€™ can be found in the Practical Advice section of The Caravan Club Website. The Driving Instructorsâ€™ Association also has a list of qualified driving instructors that can tutor those wishing to take the B+E driving test - visit the Driving Standards Website on www.dsa.gov.uk, or telephone 0845 345 5151. b. Rigid Motor Caravans without trailer driver restricted to a MAM of 3,500kg until obtaining a pass of the LGV test, after which the driver is qualified to 7,500kg MAM. c. Rigid Motor Caravan towing trailer provided the trailer does not exceed 750kg and the combined MAM does not exceed 4,250kg no further test is required for this type of outfit. However if the trailer MAM exceeds 750kg then a. applies for a vehicle less than 3,500kg. Otherwise an LGV test plus an E Test is needed. YOUR DRIVING ENTITLEMENT ON RENEWING AT THE AGE OF 70 On reaching the age of 70, drivers will retain their driving entitlement for Category B and Category B+E (provided Category B+E was held prior to the expiry date of their driving licence). Category B+E entitles drivers to drive a motor vehicle (ie car, van or 4x4) not exceeding 3.5 tonnes Maximum Authorised Mass* (MAM), drawing/towing any weight trailer/caravan within the prescribed maximum towing weight. The maximum towing weight will be specified in the technical data section of the vehicle manufacturerâ€™s handbook. However, Club recommendations on weight ratio between trailer and towing vehicle remain at 85%. *The terms â€˜Maximum Authorised Massâ€™, â€˜Gross Weightâ€™ and â€˜Permissible Maximum Weightâ€™ all have the same meaning, ie the weight of the vehicle plus the maximum load the vehicle may safely carry. When drivers of any vehicle over a MAM of 3,500kg reach 70 years of age and their driving licence expires they must pass the D4 Medical Test and pass the required standard eyesight test at 20.5 metres/67 feet with glasses used when driving. This legislation became effective from 1 January 1998. COURSES/TESTS/EGC/JP/SJS/LICENCE Â© The Caravan Club 2008

Aug 17, 2009 Claire Hough 12 posts	Topic: Carbohydrate Counting / Cherries Hi Sylvia, I find the supermarket websites really helpful for fresh food carb values as they give the nutritional values for nearly everything they sell. Sainsburys is especially good as you don't need to register your details before you can view the products. Hope that helps

Aug 17, 2009 Sylvia 3 posts	Topic: Carbohydrate Counting / Cherries Thanks to both Anita and Clare. It's 2 years since I did DAFNE, and they don't appear in my carb counter. I was a bit concerned, as I like them and tend to eat a lot when they're in season!! Sylvia.

Aug 16, 2009 Jess 13 posts	Topic: General Discussion / Do you have access to the Online Handbook? Hi Marke, I actually found my handbook! I didn't find it necessary to write anything like dates or names in it though, mores the pity. It says May 2003 on the front though! I've also found some emails from course-mates from March 2004, so I think it was Feb 2004, and I know they only had one course per month at the time. Dont' know if that is enough info for you!

Aug 16, 2009 anitas 2 posts	Topic: Carbohydrate Counting / Cherries hI i'VE BOUGHT MYSELF A GREAT LITTLE BOOK FROM WATERSTONES CALLED COLLINS GEM CARB COUNTER AND IN THERE IT HAS CHERRIES DOWN AS 10.4 CARBS PER 90G HOPE THIS HELPS ANITA

Aug 16, 2009 Karen Westwood 38 posts	Topic: General Discussion / Diabetic Birth Stories Katy, I wouldn't worry too much about BG of 8 in the morning. This is not extremely high and as along as using a corrective dose at breakfast brings you back in line by lunch time I wouldn't have thought it too much of an issue. As long as your HBA1C results as still within the targets I think you will be OK. It is probably more important that you try not to have night time hypos. Have you tried having a bit of something to eat before bed. Both my pregnancies were pre DAFNE and I didn't have the information available to me then that I have now but I always found that I needed to have my BG a little higher before bed to ensure that I didn't dip too low in the night. I was unfortunate in that I lost all my hypo warning symptoms during both my pregnancies so it was more important for me to keep myself that bit higher at night. This never effected my HBA1C because I was at really good levels during the day. Also I had 2 lovely healthy babies. With regards to your question about coping with the increased insulin requirements, I think that you will find this much easier with your background DAFNE training. It was very much guess work when I did it but I think using the DAFNE principles it will probably not be too bad. You may find though that you have to use a bigger ratio of insulin to carbohydrate than you are used to as from my expreience the insulin requirements increase quite dramatically. Maybe someone from your DAFNE team maybe able to give you some more information on this. I reallly hope things work out well for you and I know it is hard for you at the moment but it will all be worth it in the end!! Take care. Karen x

Aug 16, 2009 cmturnbull 6 posts	Topic: Carbohydrate Counting / Cherries I don't think they have one! I finished DAFNE on Friday and I think because their GI is so low, you'd hypo if you injected for them. Hope that helps, Clare

Aug 16, 2009 Jacqueline S... 1 post	Topic: Carbohydrate Counting / Wholemail flatbread I sometimes get lunch online through my work. I have a "wholemeal flatbread" which looks like a wrap but I cannot find anything in the carbs details about what it should be. I weighed it the other day and it is about 86g. I wonder if anyone has advice about what this actually might be, please? I have tried to get the information from the online company but without success. Thanks.

Aug 16, 2009 Katy Lou 2 posts	Topic: General Discussion / Diabetic Birth Stories Hi, I'm 15 weeks pregnant and petrified. Although all the success stories have made me feel reassured. Thank you for sharing. Fingers crossed in 22/23 weeks ill add my own. The fact you went for a second and third baby is brilliant. Very encouraging. Ive had a lot of morning (all day everyday anytime) sickness which has made life difficult. I thought at 13 weeks it had passed but it has struck back this week. Being dafne trained im adjusting my BI and QA as and when trends develop. so far I have reduced my BI by 12 units although my day time ratios have increased. I'm still having 2-3 hypos during the day which i can recognize and react to. My concern is night time. I'm going to bed with a BG of 5.9, dipping to 3.3 in the night treating it but having a morning BG of 8.7. Ive tried treating the 3.3 with less CPs - down to 3grams last night but still waking at 8.7. I've tried less BI but i still get the 8ish reading in the morning. I'm waiting to hear back from the nurse. I don't know what to do and fear all the extra glucose is going straight to the baby. Any ideas? Having been in control prior to conceiving i'm finding the changes a real challenge. i know from the course I will start to need more insulin at around 26 weeks - can anyone say what happened for them and how they coped. Is there any literature out there to refer to for support? The Dafne guide doesn't really deal with what happens in pregnancy. Jess - i find each day a struggle at the moment but keeping the diary really helps and guides me to what changes i need to make. I find being regimented, eating similar meals and injecting same time each day helps show a pattern. Cutting out alcohol and exercise for a few days might help as both can affect your BG levels. Sometimes there is no reason for a rogue result.Don't be too hard on yourself, its difficult getting it right. Are there any refresher courses you could sign up to? I think they are running some at my local hospital once every 3 months or so. Good luck.

Aug 16, 2009 Val 1 post	Topic: Questions for HCPs / Giving birth without an insulin/glucose drip Hi I'm new here and been DAFNEING for 2Â½ years. Had my babies before DAFNE (now 9 and 6 - time does fly). Do you plan to try and go full term naturallly or will you be induced at 38 weeks? I was encouraged to go for being induced at 38 weeks as I was told after this time the placenta can stop working without warning, with obvious results. Maybe the advice is diff now? I'd be interested to hear? Induction just didn't work for us, my stubborn son wasn't budging (he's the same now if comfortable, you can't shift him!) so I had a c.section. Which was fine, no complaints, up and about the same day, then a planned one for number two. First time I went into hosp with a birth plan all written out and then ended up never even opeining it as the induction just wasn't working. I came to the conclusion that my son was safer out than in so went for the c.section and don't regret it. So what I'm saying in a round about way is don't get too hung up on the delivery, focus on the outcome. The bit that did frustrate me about both deliveries was the assumption that I would have a baby with a hypo and that they insisted on bottle feeding both at birth. I wanted to BF and hated the fact that despite excellent control during pregnancy, and that I think most babies blood sugar is low on delivery, they stuck a bottle in his mouth, it felt like they were covering themselves. Second baby I tried to insist this didn't happen and they said they had never seen anyone manually express milk in the recovery room (I expressed some to add to the bottle as they still wanted to give one). If you want to breastfeed (and do its lovely!!) this is an area I would try and clarify with your health carers rather than being pushed into giving bottles. Also make sure you take plenty of food in with you and ask NOT to be put on the diabetic menu. Second baby I was asked to go in the night before so they could control my blood sugars, went really low in the middle of the night (which I had never done before!) and all they could find for me to eat was a sandwich 2 days over its shelf life!!! Best wishes Val

Aug 15, 2009 marke 681 posts	Topic: Questions for HCPs / Can anyone put numbers (%) on ideal split between above target, on target and below target BGs? As ever I will start by saying I am NOT a HCP just a run of the mill DAFNE Graduate. So, what should you be aiming for, perfection ! Will you ever acheive it ? Very probably no, but it doesn't hurt to try :-) I don't believe a view has been formed because I don't think one can. We are all different and the answer will differ slightly for each of us. Keeping your BG's within target range reduces your risks of complications, the key here is 'reduces'. Life doesn't come with an guarantees and especially not if you have Diabetes. You could keep your BG's perfect and still suffer complications and vice-versa, again because we are ALL different our risk factors will vary. It's just life ! So at least you are seeing an improvement, making progress, thats something to be happy about ! So well done. By the way we are glad that you are finding the graphs useful :-)

Aug 15, 2009 marke 681 posts	Topic: General Discussion / Do you have access to the Online Handbook? John, I'm really sorry but we cannot give you access to the handbook at the moment. I appreciate you don't get to choose what Diabetes Education course you do and it sounds a bit 'them' and 'us', but we are only allowed to provide access to validated DAFNE Graduates. Why is this ? Well amonst other things, there is concern that non DAFNE people will try to use information in the handbook without the backup of a DAFNE Educator and do themselves harm. I know there are some that do not agree with this and think eveyone should be treated as though they are capable of managing without DAFNE Educators. Unfortunately this is not a risk DAFNE Central or DAFNEOnline are prepared to take. In addition DAFNE Central are concerned about 'variations' on DAFNE like BIANCA. The point of DAFNE is it is rigidly based on the original german version and has a very tight management scheme of the DAFNE Educators. All DAFNE courses should be pretty much identical in course content regardless of where they are run, the educators are also all trained the same and are audited every year. This means the course meets all the NHS criteral for Diabetes Education and is consistent. Unfortunately PCT variations do NOT have this kind of control or management and are often cut down versions of DAFNE. This may mean what are considered vitial elements are missed out. I appreicate this doesn't help you and I would like to be able to help, however we have to stick to the rules laid down by DAFNE Central since we work so closely with them. If the situation changes we will let you know.

Aug 15, 2009 marke 681 posts	Topic: General Discussion / Do you have access to the Online Handbook? Jess, If you can remember who your dAFNE educator was or when you did the course we might be able to cross reference it with DAFNE Central and give you access i.e change your account status to graduate. Why do we need to do this, see my response to John below.

Aug 15, 2009 shirley 9 posts	Topic: Questions for HCPs / post menopause does anyone have any experience with 'hot sweats' due to post menopausal symptoms? I can not seem to make my mind up if the BG results I have are due to post menopause or hypos. Any advisce will help!!!

Aug 15, 2009 Sylvia 3 posts	Topic: Carbohydrate Counting / Cherries Can anyone tell me the carb value of fresh cherries?