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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 Club’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 instructors’ can be found in the Practical Advice section of The Caravan Club Website. The Driving Instructors’ 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 manufacturer’s handbook. However, Club recommendations on weight ratio between trailer and towing vehicle remain at 85%.
*The terms ‘Maximum Authorised Mass’, ‘Gross Weight’ and ‘Permissible Maximum Weight’ 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 © 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 2½ 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 686 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 686 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 686 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 14, 2009
John Mannion 1 post

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

I am in a similar position in that I am really keen to look at the the course handbook. I have recently completed the BIANCA course at my local hospital (North Hampshire). I would also like to know how to gain access to the handbook.

Thanks


John
 
Aug 14, 2009
Jess 13 posts

Topic: General Discussion / Introductions

Hello,

I'm Jess, I was diagnosed in 1993 at the wonderful Stoke Mandeville Diabetes Centre. I did DAFNE a loooong time ago at the QMC (Nottingham). So long ago I can't tell you the year, but I know there were only about 4 DAFNE centres. I left Nottingham 4-5 years ago, sadly.

I have just been referred to the pre-conception clinic, and its the first time I've been back under the care of a hospital for years, its good to be back. Frimley don't do DAFNE but say they do somethign similar so I hope they can help me back on track and low enough to conceive.
 
Aug 14, 2009
Janys 5 posts

Topic: General Discussion / Applying DAFNE when hiking

Bob, Thank you for this information, and I think I might try something similar next time. The reductions I tried were OKish but the Lantus reduction was too drastic giving high BGs during the morning. I think next time I will use a mixture of insulin reductions and extra carbs.

I also found that the Lantus reduction was really difficult when our schedule changed and we walked less that planned, so in that sense it was not too flexible. Also I found that for as much as 3 weeks after the holiday I needed to take quite a lot more insulin than I had in the first place (some sort of knock on perhaps).

It sounds as if your walking is a lot more extreme than mine but I probably use as much energy over a day in my own way, so I think your information will be a help to me next time I go away and I can find a level that works for me.

Enjoy your next walk.
 
Aug 14, 2009
Jess 13 posts

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

Hello! I did DAFNE a long time ago at the QMC, back when there were only about 4 centres in the whole country! I'd really like access to the diary, but I have moved house about 3 times since and am no longer in contact with the QMC team. Have you got any advice on how I can access this?
 
Aug 14, 2009
Jess 13 posts

Topic: General Discussion / Diabetic Birth Stories

Hi everyone, I've just joined. I did DAFNE probably about 7 years ago when it was still quite new, I'm glad there is finally an online site!

I've just had my first appointment with the pre-pregnancy diabetes clinic and am trying to get my HbA1c down. Its proving very hard. I don't know if I've forgotten some of the training as it was so long ago, but I'm struggling.

Any tips/support gratfeully received. I am very very nervous about the birth as I am needle-phobic and don't deal with drips very well. I'm sure I'll have other things to worry about but right now that is what is freaking me out.
 
Aug 14, 2009
lucy 3 posts

Topic: General Discussion / Diabetic Birth Stories

Thanks Karen & Fiona, it really helps to hear how others in the same situation got on!
Hi Daisy I bet your HbA1c will come down just by following dafne guidelines & eating healthily, thats what happened for me. Good luck with getting pregnant! Lucy
 
Aug 14, 2009
Karen Westwood 38 posts

Topic: General Discussion / Diabetic Birth Stories

Hi Lucy.

I am type 1 and have had two successful pregnancies . My first pregnancy was induced and I was on a insulin/glucose drip during labour. I also had an epidural so my main problem was that I couldn't walk about during labour I just had to basically lie in my bed attached to 3 different drips. This was over nine years ago so whether things have changed since then I don't know. My baby was born natually at 10lbs 4oz and was absolutely fine after the birth. He was given blood tests for a few hours after the birth to ensure that his blood glucose levels were ok. Just myself left feeling rather uncomfortable (as you can imagine!).

During my second pregnancy I went into labour myself at 36 weeks. As my baby was breach and labour was progressing quite quickly I was taken into theatre for a c-section. I did not have any insulin or glucose drip for this labour. My baby was born already weighing 6lbs 13oz so I was quite grateful that I had not gone any longer as I think he would have been at least the same size as my first. He too was given blood tests to check his glucose levels and thankfully he was absolutely fine and didn't even need to go into special care. In my own experience I actually felt much better in myself after my c-section but then I think everyones experieces will be totally different.

It amazed me how my requirements for insulin reduced back to my pre-pregnancy levels immediately my babies were born.

I really hope that everything goes well for your birth. Don't forget to leave a message on here to let us know how you went on. That's if you can find the time once baby arrives!
 
Aug 14, 2009
Claire Hough 12 posts

Topic: Site Development / Online BG Diaries

Thanks Simon, that's great! Having lots of random hypos for some reason this week so have put that option to good use already!!