Recent Posts - DAFNE Online

Jul 11, 2009

Jennifer 11 posts

I get new Dafne diaries when I attend clinic. Also after our course we were sent them in excel form so we could record our results and send to fellow graduates or Dafne leaders for advice.

Jul 11, 2009

Jennifer 11 posts

Topic: DAFNE Online Mobile / Mobile site released

Great, will be really handy for when i'm out & about to record BG levels & carb counting. I use Sony Ericsson k660i and it seems to be working fine for me. Thanks a lot!

Jul 10, 2009

Daniel Pizarro 1 post

Topic: DAFNE Online Mobile / Mobile site released

I thought about developing this myself a year ago when I did dafne - thanks so much for getting this up and running - for me this will change my life and is probably one of the best uses of technology ever. Whoever created it is a legend. I have not even used the mobile device but I am so excited to do so particularly as I am so bad at recording my results in the dafne book. It almost makes diabetes cool! Cannot wait to get started on my blackeberry. The carb counter is soooooooooooooooo good as I always struggle to keep control when out in restuarents and now can just pull out my phone and get the amount of carb for everything I am eating without pulling out the DAFNE book.

Cheers to all involved

Jul 9, 2009

Simon 578 posts

Topic: General Discussion / More forums ?

Hi Aifric,

If you browse the General forum you'll see that other users have raised general Diabetes related issues here, would this meet your needs, or would you prefer to have a more specific forum geared towards health issues?

Our development, as always, is guided by you - the users.

Thanks,

Simon

Jul 9, 2009

Simon 578 posts

Topic: DAFNE Online Mobile / Rationale - Please read

I also have an iPhone and the mobile version of the site, whilst cut down, displays pretty well on it. If you let us know what features you'd specifically like to access (currently you can search CP lists, view the forums and enter new BG results) via the mobile site then we can work on that, or a native iPhone app.

Thanks,

Simon

Jul 9, 2009

Aifric 2 posts

Topic: DAFNE Online Mobile / Rationale - Please read

I have an iPhone and i use a programme called Islet that i downloaded. Its good and easy enough to use.
The only problem is that you cant really see patterns - the graphs suck and when you "email" the data to yourself, it comes in an unreadable mess.
I'd love to see and iPhone application that you could enter the info in and it would sync easily with an application on your desktop....
Maybe....

Jul 9, 2009

Aifric 2 posts

Topic: General Discussion / More forums ?

Any chance we could get a forum for how diabetes in general affects everyday health issues. ??
I'd love to see a forum where maybe i can chat to other women who have had babies and how they fared with pregnancies etc....

Jul 8, 2009

PJ 1 post

Topic: General Discussion / "Balance" letter about injecting in public

I'd say it's a matter of personal choice and about judging the situation. Of course, as diabetics we are not ashamed by the neccessary paraphenalia that goes along with our condition, and we have the same rights as everyone else to exercise free will. I would definitely make a fuss if I was told to take my injections elsewhere, not because I think toilets are disgusting or unhygenic particularly, but because it's taken me several years to get to the point of self confidence about being diabetic, that I will now do everything in public if I feel like it.
I only take it somewhere private when I feel I can't be bothered with the staring and the curiosity. I'm a quiet, shy sort of person and I don't really want to have to explain to everyone who wants to know, what it is I'm doing.

I think it's about judging the situation in terms of eating at a resteraunt. Of course it's pretty easy to inject discreetly and then pop to the loo to make sure your bloods are ok and you don't need top-ups or something, I might be a little embarrassed about getting out my blood meter and slapping it on the table in front of everyone just because it would appear rather attention seeking. And in my experience it's the blood prick that seems to jar with people the most anyway. Perhaps whipping out a brightly coloured Novopen at a business lunch for new clients might be a little insensitive. But I can't imagine anyone seriously objecting. It's quite obvious that insuin pens and meters are medical and legal and all above board.

It's totally personal preference. I don't think anyone should be forced to inject in a corner, that seems humiliating and unfair. And the nurse who wrote the letter might be more understanding if she did have to inject, if the person who upset her had a habit of announcing her injection and turned it into a regular, gawp fest then I might understand her annoyance. But I'm sure most diabetics simply want it over with asap and discretion is something we're all practising anyway. People who don't like it can always look away or mind their own business.

To be honest I've sat on enough buses smeared with bogeys, fast food grease, cigarette butts and discarded gum and despaired at the way people treat public spaces. I will practise discretion but I will not hide.

PJ

Jul 4, 2009

Alzibiff 21 posts

Topic: DAFNE Graduate Group (DGG) / DAFNE Collaborative Report

Thank you for that write up Marke. I found the "dawn phenomenon" bit of interest and eagerly await DAFNE guidance for pump users now that I have switched to one of those after 42 years of injections. As said - very much appreciated.

Alan

Jul 3, 2009

marke 686 posts

Topic: Site Development / On line carb counter

ok, I have just spent a lovely hour or so correcting the online carb counter so that it now matches version 8 of the book. i also corrected some duplicates that somehow crept in. If anyone spots any other errors please let us know !

Jul 3, 2009

marke 686 posts

Topic: DAFNE Graduate Group (DGG) / DAFNE Collaborative Report

Disclaimer: I am not a Health Care Professional, I have no medical training and as such everything is my laymanâ€™s interpretation of what was said. It is merely a personal interpretation and should not be treated as fact.

What is the DAFNE Collaborative ? It is a conference day where everyone involved with DAFNE in the UK gets together for presentations and updates regarding the DAFNE program. There were 152 delegates in total at the meeting, representing 63 of the 72 DAFNE centres in the UK and Southern Ireland (only 9 centres were not represented) along with reps from Australia DAFNE and New Zealand DAFNE and representatives from Diabetes UK. The DAFNE Online team were invited to attend to publicise the web site. It also gave us an opportunity to attend the day as a whole and see and understand what is involved in the day.

The day started with DAFNE Online having a projector and laptop set-up in the â€˜coffeeâ€™ area just outside the main meeting room. This area also had posters from DAFNE centres detailing outcomes from local services / national audits and also centre QA audit outcomes from 2007-2008. A number of DAFNE Educators were handed leaflets about the web site and were given a demo. A couple signed up for the site there and then. The biggest surprise came when both the New Zealand and Australian representatives of DAFNE in their country asked if they could sign-up to DAFNE online ! We of course said yes and hopefully in the not too distant future you will start to see postings in the forums from DAFNE Graduates in those countries.

The meeting then started in the main meeting room and so focus moved to listening to presentations from various speakers that are described below.

First up was a presentation on the changes to the reporting of HBA1c. This has already started to happen as from the 1st June 2009, HBA1c will be reported in two ways. The original percentage figure and a new mmol/mol value. Why ? Well before june 1st there were a number of different ways of reporting HBA1c around the world. This lead to issues when converting from one set of units to another, all conversions introduce minor variations and thus could introduce inaccuracies in an data used. Therefore the IFCC (International Federation of Clinical Chemistry) have managed to get agreement for a new measure of HBA1c, which is a measure of mmolâ€™s of glycosolated haemoglobin to molâ€™s of haemoglobin. This results in a value rather than a percentage, for example 6.5% in the old measure is 48 mmol/mol in the new measure. The change wonâ€™t be immediate in that the old measure will continue to be reported along with the new measure until 1st June 2011, so you have two years to get your head around it all ! It is also not a totally global standard as yet, but it is hoped that it will become one in the not too distant future. Another point relating to HBA1c that was made is one that all DAFNE graduates should know, there is NO fixed range of values that you should have to be inside since all Diabetics are different. Your new HBA1c target values should be agreed by you and your Diabetes Care Team, not taken from some fixed standard range. Things that could vary your target range are diabetes complications, renal problems, liver problems, abnormal haemoglobin or abnormal red blood cell turnover, both of which make it hard to measure HBA1c.

The next presentation was regarding Psychotherapy research and what works. It was said there were similarities between DAFNE and Psychotherapy with respect to the social interaction factor of both. The key thing that has been found about Psychotherapy approaches is they are all as good as each other, itâ€™s the doing thatâ€™s more important than the approach. It was suggested that this is also true of Diabetes Structured Education, that is we should focus on what works from all types of education not which one is better. The various characteristics of the therapist ( or DAFNE educator) were then detailed with their effect on the outcome of the treatment. Age, gender and ethnicity have no effect. More patient involvement results in a better outcome. Qualification and professional background have no effect. Competence and empathy result in better outcomes as does user feedback. The various characteristics that effect the outcome for the patient ( or DAFNE Graduate) were then detailed. These were realistic expectations, pre-therapy function, trouble with relationships, verbal intelligence, motivation and support. Finally the â€˜serviceâ€™ ( or course characteristics) were detailed with their effect on the outcome. More sessions resulted in a better outcome but at a slower rate, that is after a certain number of sessions the benefits tail-off. It was suggested that 8-16 sessions give the best overall outcome for most people. Follow-up and maintenance after the sessions was also important on the outcome. Supervision of the therapist( or educator) i.e discussion of cases with a superior gave better outcomes.
There was then a coffee break and a few more HCPâ€™s were signed up to the DAFNE Online website with a number of others taking leaflets and promising to sign up soon.

The next two speakers give a presentation relating to background insulin and its capability to last over 24 hours and probably more interestingly the misconceptions surrounding the Somogyi effect or rebound Hyperglycemia. It has been suggested that many high blood sugars in the morning are caused by night-time hypos. The presenters contended that this is generally NOT the case, the night time hypos only result in a relatively small rise in blood sugar. So if this is not the cause then what is ? It was suggested that the cause is a form of the Dawn Phenomenon where the body releases hormones. The factors that cause this rise are length of sleep, duration that a person has had diabetes and horizontal posture. The biggest issue with this hormone release is it occurs from 5am onwards. This means using an increase of background insulin the night before is not a good way to treat it, since a hypo would occur in the hours before the increase in hormones. The only effective way to treat it is by injecting fast acting insulin, which is a bit of an issue since most people are not awake at 5am. One method would be the use of insulin pumps, but since these are still not widely available to all Diabetics there is no easy solution.

The next presentation was an update on developments in the DAFNE research program, volunteer DAFNE Centres were asked for to undertake two Pilot Studies. The first was on the use of pumps verses multiple injections with the DAFNE approach. The second was a DAFNE Course run over 5 weeks rather than 5 consecutive days. At this stage studies would only be trials to look into these potential approaches.

The final presentation of the morning was an update on the psychosocical study being made of DAFNE.
Details of this presentation will be added later once we have permission to produce it online, since it is research work it needs to be cleared for publication first.

It was then lunch time and the overwhelming urge in a room of 100+ DAFNE educators to pull out a set of scales was very hard to resist !

After lunch 2 workshops were attended by all attendees, there were 8 different workshops and hopefully we will have write-ups from them appearing on the site at a later stage. After the workshops a brief summary of each workshop was given to all attendees and the meeting was closed.

Jul 3, 2009

marke 686 posts

Topic: Carbohydrate Counting / Useful link for looking up CPs

Ian, I have spoken to DAFNE Central and they suggest they can provide them if necessary however they would prefer you to get them from your DAFNE Educator. Why ? Because like all parts of the NHS they are under resourced and over worked. I do have the order form that I can send you to obtain copies from DAFNE Central, if this is your only option email admin at dafneonline.co.uk and we will send them to you.

Jul 3, 2009

NiVZ 82 posts

Topic: General Discussion / Diaries

Hi Phil,

Sounds good. Can you send in to nivz78 [at] yahoo.co.uk

I'll send you a copy of what I've done if you want. Might be interesting to 'splice' them together ;o)

NiVZ

Jul 3, 2009

Phil Kane 4 posts

Topic: General Discussion / Diaries

I could send you a copy of same for you to look at if interested.
Philip

Jul 3, 2009

ianmac 3 posts

Topic: General Discussion / DAFNE in peril at the Wirral

if the powers in charge thought about it they would see that in the long run the DAFNE course may save a lot of money as well as helping Type 1 diabetics.
I learnt so much on the course and found out lots of things i was doing wrong
Its better having plenty of time to discuss and learn things rather than 5 minutes with your doctor who is under pressure to get through patients quickly
To me its should be compulsory like in Germany
i am using less insulin which is a saving and if my control is better i hopefully will require less treatmeny on the NHS.

Jul 3, 2009

ianmac 3 posts

Topic: Carbohydrate Counting / Useful link for looking up CPs

Thanks wanted a spare one to leave at work as canteen menu varies

Jul 3, 2009

NiVZ 82 posts

Topic: General Discussion / Diaries

I've also made my own spreadsheet in Excel which exactly copies the layout of the DAFNE diaries, and prints them to fill A4 sheets (like the overheads used on the DAFNE course). I added a button to make it do graphs as well (need to enable Macros).

@Phil - Yours sounds pretty good too with averages, etc

NiVZ

Jul 3, 2009

Phil Kane 4 posts

Topic: General Discussion / Diaries

I have devised a excel worksheet which caculates daily levels, weekly and monthly averages and this is turn is very easy to keep updated as it is a locked cell format. I use this instread of the dairy and I can automatically see just by looking at the screen to where the ups are downs are. The only disadvantage is you need a PC to update this sheet daily.
Phil Kane

Jul 3, 2009

Phil Kane 4 posts

Topic: General Discussion / Introductions

Hi Anne Marie. The Second Irish registered DAFNE user who is now on this site. The one thing I find amazing is the lack of support this site gets from the Health people in the various teaching hospitals in Ireland.You would think that in order for things to grow you need to participate after you finish the last day of the course and walk out into a different way of thinking. I know everybody has a honeymoon period where for a few weeks or months every test is recorded along with each CP but once the pattern gets set, old habits set back in. Keep the faith.
Phll

Jul 2, 2009

Claire Hough 12 posts

Topic: Carbohydrate Counting / Useful link for looking up CPs

Yes it is! My lovely friend Becky (who is also registered on here) ordered me a spare one and some diaries I think for a small price like 70p each. I will ask her to come on and pass on the details. Claire

Jul 2, 2009

Anne-Marie 4 posts

Topic: General Discussion / Introductions

Thanks guys. Its great to have a forum to thrash these things out in. I'm keeping the chin up and know that, given the improvement (albeit imperfect) I have seen so far, then well controlled bgs are not too far away....

Jul 2, 2009

Alzibiff 21 posts

Topic: General Discussion / Introductions

"Remember we are all different!" ...... that comment reminds me of the Monty Python "Life of Brian" film - same line shouted out to the multitude followed by a reply from everyone "Yes - we're all different" ..... and then a singular "I'm not!".

Me - yes - taking a while but little by little, confident that I will get there in the end - trouble is, there's always an explanation from the HPs as to why things were not as you expected ... "Well ... that walk will have lowered the BG by more than that...", "mmm - injection site may have been the reason for that", "Ahhhh - the pint of beer could have accounted for that ..."

Keep at it!

Alan

Jul 2, 2009

marke 686 posts

Topic: General Discussion / Introductions

Welcome Ann-Marie, with regard to your sugar levels not being quite as you would like them just keep the faith. Many people seem to think they are failures because they can't get everything under control immediately after the course. This is NOT the case, it takes time and you just need to keep focusing on the positives. Focus on what you have achieved so far and be patient, I'm sure there are many others on this forum that have had the same experience. For some people it takes longer than others and I have heard of people taking 12 months to finally get fully on top of their BG's. Remember we are all different !

Jul 2, 2009

marke 686 posts

Topic: Site Development / On line carb counter

ok, ok, I admit I got it wrong :-) I will get it corrected ASAP, sorry.

Jul 2, 2009

marke 686 posts

Topic: Carbohydrate Counting / Useful link for looking up CPs

Ian, I have put your question to the nice ladies at DAFNE Central. i will update you when I have a reply. In the mean time you can always use the online version, it should be identical to the paper version.

Jul 11, 2009 Jennifer 11 posts	Topic: General Discussion / Diaries I get new Dafne diaries when I attend clinic. Also after our course we were sent them in excel form so we could record our results and send to fellow graduates or Dafne leaders for advice.

Jul 11, 2009 Jennifer 11 posts	Topic: DAFNE Online Mobile / Mobile site released Great, will be really handy for when i'm out & about to record BG levels & carb counting. I use Sony Ericsson k660i and it seems to be working fine for me. Thanks a lot!

Jul 10, 2009 Daniel Pizarro 1 post	Topic: DAFNE Online Mobile / Mobile site released I thought about developing this myself a year ago when I did dafne - thanks so much for getting this up and running - for me this will change my life and is probably one of the best uses of technology ever. Whoever created it is a legend. I have not even used the mobile device but I am so excited to do so particularly as I am so bad at recording my results in the dafne book. It almost makes diabetes cool! Cannot wait to get started on my blackeberry. The carb counter is soooooooooooooooo good as I always struggle to keep control when out in restuarents and now can just pull out my phone and get the amount of carb for everything I am eating without pulling out the DAFNE book. Cheers to all involved

Jul 9, 2009 Simon 578 posts	Topic: General Discussion / More forums ? Hi Aifric, If you browse the General forum you'll see that other users have raised general Diabetes related issues here, would this meet your needs, or would you prefer to have a more specific forum geared towards health issues? Our development, as always, is guided by you - the users. Thanks, Simon

Jul 9, 2009 Simon 578 posts	Topic: DAFNE Online Mobile / Rationale - Please read I also have an iPhone and the mobile version of the site, whilst cut down, displays pretty well on it. If you let us know what features you'd specifically like to access (currently you can search CP lists, view the forums and enter new BG results) via the mobile site then we can work on that, or a native iPhone app. Thanks, Simon

Jul 9, 2009 Aifric 2 posts	Topic: DAFNE Online Mobile / Rationale - Please read I have an iPhone and i use a programme called Islet that i downloaded. Its good and easy enough to use. The only problem is that you cant really see patterns - the graphs suck and when you "email" the data to yourself, it comes in an unreadable mess. I'd love to see and iPhone application that you could enter the info in and it would sync easily with an application on your desktop.... Maybe....

Jul 9, 2009 Aifric 2 posts	Topic: General Discussion / More forums ? Any chance we could get a forum for how diabetes in general affects everyday health issues. ?? I'd love to see a forum where maybe i can chat to other women who have had babies and how they fared with pregnancies etc....

Jul 8, 2009 PJ 1 post	Topic: General Discussion / "Balance" letter about injecting in public I'd say it's a matter of personal choice and about judging the situation. Of course, as diabetics we are not ashamed by the neccessary paraphenalia that goes along with our condition, and we have the same rights as everyone else to exercise free will. I would definitely make a fuss if I was told to take my injections elsewhere, not because I think toilets are disgusting or unhygenic particularly, but because it's taken me several years to get to the point of self confidence about being diabetic, that I will now do everything in public if I feel like it. I only take it somewhere private when I feel I can't be bothered with the staring and the curiosity. I'm a quiet, shy sort of person and I don't really want to have to explain to everyone who wants to know, what it is I'm doing. I think it's about judging the situation in terms of eating at a resteraunt. Of course it's pretty easy to inject discreetly and then pop to the loo to make sure your bloods are ok and you don't need top-ups or something, I might be a little embarrassed about getting out my blood meter and slapping it on the table in front of everyone just because it would appear rather attention seeking. And in my experience it's the blood prick that seems to jar with people the most anyway. Perhaps whipping out a brightly coloured Novopen at a business lunch for new clients might be a little insensitive. But I can't imagine anyone seriously objecting. It's quite obvious that insuin pens and meters are medical and legal and all above board. It's totally personal preference. I don't think anyone should be forced to inject in a corner, that seems humiliating and unfair. And the nurse who wrote the letter might be more understanding if she did have to inject, if the person who upset her had a habit of announcing her injection and turned it into a regular, gawp fest then I might understand her annoyance. But I'm sure most diabetics simply want it over with asap and discretion is something we're all practising anyway. People who don't like it can always look away or mind their own business. To be honest I've sat on enough buses smeared with bogeys, fast food grease, cigarette butts and discarded gum and despaired at the way people treat public spaces. I will practise discretion but I will not hide. PJ

Jul 4, 2009 Alzibiff 21 posts	Topic: DAFNE Graduate Group (DGG) / DAFNE Collaborative Report Thank you for that write up Marke. I found the "dawn phenomenon" bit of interest and eagerly await DAFNE guidance for pump users now that I have switched to one of those after 42 years of injections. As said - very much appreciated. Alan

Jul 3, 2009 marke 686 posts	Topic: Site Development / On line carb counter ok, I have just spent a lovely hour or so correcting the online carb counter so that it now matches version 8 of the book. i also corrected some duplicates that somehow crept in. If anyone spots any other errors please let us know !

Jul 3, 2009 marke 686 posts	Topic: DAFNE Graduate Group (DGG) / DAFNE Collaborative Report Disclaimer: I am not a Health Care Professional, I have no medical training and as such everything is my laymanâ€™s interpretation of what was said. It is merely a personal interpretation and should not be treated as fact. What is the DAFNE Collaborative ? It is a conference day where everyone involved with DAFNE in the UK gets together for presentations and updates regarding the DAFNE program. There were 152 delegates in total at the meeting, representing 63 of the 72 DAFNE centres in the UK and Southern Ireland (only 9 centres were not represented) along with reps from Australia DAFNE and New Zealand DAFNE and representatives from Diabetes UK. The DAFNE Online team were invited to attend to publicise the web site. It also gave us an opportunity to attend the day as a whole and see and understand what is involved in the day. The day started with DAFNE Online having a projector and laptop set-up in the â€˜coffeeâ€™ area just outside the main meeting room. This area also had posters from DAFNE centres detailing outcomes from local services / national audits and also centre QA audit outcomes from 2007-2008. A number of DAFNE Educators were handed leaflets about the web site and were given a demo. A couple signed up for the site there and then. The biggest surprise came when both the New Zealand and Australian representatives of DAFNE in their country asked if they could sign-up to DAFNE online ! We of course said yes and hopefully in the not too distant future you will start to see postings in the forums from DAFNE Graduates in those countries. The meeting then started in the main meeting room and so focus moved to listening to presentations from various speakers that are described below. First up was a presentation on the changes to the reporting of HBA1c. This has already started to happen as from the 1st June 2009, HBA1c will be reported in two ways. The original percentage figure and a new mmol/mol value. Why ? Well before june 1st there were a number of different ways of reporting HBA1c around the world. This lead to issues when converting from one set of units to another, all conversions introduce minor variations and thus could introduce inaccuracies in an data used. Therefore the IFCC (International Federation of Clinical Chemistry) have managed to get agreement for a new measure of HBA1c, which is a measure of mmolâ€™s of glycosolated haemoglobin to molâ€™s of haemoglobin. This results in a value rather than a percentage, for example 6.5% in the old measure is 48 mmol/mol in the new measure. The change wonâ€™t be immediate in that the old measure will continue to be reported along with the new measure until 1st June 2011, so you have two years to get your head around it all ! It is also not a totally global standard as yet, but it is hoped that it will become one in the not too distant future. Another point relating to HBA1c that was made is one that all DAFNE graduates should know, there is NO fixed range of values that you should have to be inside since all Diabetics are different. Your new HBA1c target values should be agreed by you and your Diabetes Care Team, not taken from some fixed standard range. Things that could vary your target range are diabetes complications, renal problems, liver problems, abnormal haemoglobin or abnormal red blood cell turnover, both of which make it hard to measure HBA1c. The next presentation was regarding Psychotherapy research and what works. It was said there were similarities between DAFNE and Psychotherapy with respect to the social interaction factor of both. The key thing that has been found about Psychotherapy approaches is they are all as good as each other, itâ€™s the doing thatâ€™s more important than the approach. It was suggested that this is also true of Diabetes Structured Education, that is we should focus on what works from all types of education not which one is better. The various characteristics of the therapist ( or DAFNE educator) were then detailed with their effect on the outcome of the treatment. Age, gender and ethnicity have no effect. More patient involvement results in a better outcome. Qualification and professional background have no effect. Competence and empathy result in better outcomes as does user feedback. The various characteristics that effect the outcome for the patient ( or DAFNE Graduate) were then detailed. These were realistic expectations, pre-therapy function, trouble with relationships, verbal intelligence, motivation and support. Finally the â€˜serviceâ€™ ( or course characteristics) were detailed with their effect on the outcome. More sessions resulted in a better outcome but at a slower rate, that is after a certain number of sessions the benefits tail-off. It was suggested that 8-16 sessions give the best overall outcome for most people. Follow-up and maintenance after the sessions was also important on the outcome. Supervision of the therapist( or educator) i.e discussion of cases with a superior gave better outcomes. There was then a coffee break and a few more HCPâ€™s were signed up to the DAFNE Online website with a number of others taking leaflets and promising to sign up soon. The next two speakers give a presentation relating to background insulin and its capability to last over 24 hours and probably more interestingly the misconceptions surrounding the Somogyi effect or rebound Hyperglycemia. It has been suggested that many high blood sugars in the morning are caused by night-time hypos. The presenters contended that this is generally NOT the case, the night time hypos only result in a relatively small rise in blood sugar. So if this is not the cause then what is ? It was suggested that the cause is a form of the Dawn Phenomenon where the body releases hormones. The factors that cause this rise are length of sleep, duration that a person has had diabetes and horizontal posture. The biggest issue with this hormone release is it occurs from 5am onwards. This means using an increase of background insulin the night before is not a good way to treat it, since a hypo would occur in the hours before the increase in hormones. The only effective way to treat it is by injecting fast acting insulin, which is a bit of an issue since most people are not awake at 5am. One method would be the use of insulin pumps, but since these are still not widely available to all Diabetics there is no easy solution. The next presentation was an update on developments in the DAFNE research program, volunteer DAFNE Centres were asked for to undertake two Pilot Studies. The first was on the use of pumps verses multiple injections with the DAFNE approach. The second was a DAFNE Course run over 5 weeks rather than 5 consecutive days. At this stage studies would only be trials to look into these potential approaches. The final presentation of the morning was an update on the psychosocical study being made of DAFNE. Details of this presentation will be added later once we have permission to produce it online, since it is research work it needs to be cleared for publication first. It was then lunch time and the overwhelming urge in a room of 100+ DAFNE educators to pull out a set of scales was very hard to resist ! After lunch 2 workshops were attended by all attendees, there were 8 different workshops and hopefully we will have write-ups from them appearing on the site at a later stage. After the workshops a brief summary of each workshop was given to all attendees and the meeting was closed.

Jul 3, 2009 marke 686 posts	Topic: Carbohydrate Counting / Useful link for looking up CPs Ian, I have spoken to DAFNE Central and they suggest they can provide them if necessary however they would prefer you to get them from your DAFNE Educator. Why ? Because like all parts of the NHS they are under resourced and over worked. I do have the order form that I can send you to obtain copies from DAFNE Central, if this is your only option email admin at dafneonline.co.uk and we will send them to you.

Jul 3, 2009 NiVZ 82 posts	Topic: General Discussion / Diaries Hi Phil, Sounds good. Can you send in to nivz78 [at] yahoo.co.uk I'll send you a copy of what I've done if you want. Might be interesting to 'splice' them together ;o) NiVZ

Jul 3, 2009 Phil Kane 4 posts	Topic: General Discussion / Diaries I could send you a copy of same for you to look at if interested. Philip

Jul 3, 2009 ianmac 3 posts	Topic: General Discussion / DAFNE in peril at the Wirral if the powers in charge thought about it they would see that in the long run the DAFNE course may save a lot of money as well as helping Type 1 diabetics. I learnt so much on the course and found out lots of things i was doing wrong Its better having plenty of time to discuss and learn things rather than 5 minutes with your doctor who is under pressure to get through patients quickly To me its should be compulsory like in Germany i am using less insulin which is a saving and if my control is better i hopefully will require less treatmeny on the NHS.

Jul 3, 2009 ianmac 3 posts	Topic: Carbohydrate Counting / Useful link for looking up CPs Thanks wanted a spare one to leave at work as canteen menu varies

Jul 3, 2009 NiVZ 82 posts	Topic: General Discussion / Diaries I've also made my own spreadsheet in Excel which exactly copies the layout of the DAFNE diaries, and prints them to fill A4 sheets (like the overheads used on the DAFNE course). I added a button to make it do graphs as well (need to enable Macros). @Phil - Yours sounds pretty good too with averages, etc NiVZ

Jul 3, 2009 Phil Kane 4 posts	Topic: General Discussion / Diaries I have devised a excel worksheet which caculates daily levels, weekly and monthly averages and this is turn is very easy to keep updated as it is a locked cell format. I use this instread of the dairy and I can automatically see just by looking at the screen to where the ups are downs are. The only disadvantage is you need a PC to update this sheet daily. Phil Kane

Jul 3, 2009 Phil Kane 4 posts	Topic: General Discussion / Introductions Hi Anne Marie. The Second Irish registered DAFNE user who is now on this site. The one thing I find amazing is the lack of support this site gets from the Health people in the various teaching hospitals in Ireland.You would think that in order for things to grow you need to participate after you finish the last day of the course and walk out into a different way of thinking. I know everybody has a honeymoon period where for a few weeks or months every test is recorded along with each CP but once the pattern gets set, old habits set back in. Keep the faith. Phll

Jul 2, 2009 Claire Hough 12 posts	Topic: Carbohydrate Counting / Useful link for looking up CPs Yes it is! My lovely friend Becky (who is also registered on here) ordered me a spare one and some diaries I think for a small price like 70p each. I will ask her to come on and pass on the details. Claire

Jul 2, 2009 Anne-Marie 4 posts	Topic: General Discussion / Introductions Thanks guys. Its great to have a forum to thrash these things out in. I'm keeping the chin up and know that, given the improvement (albeit imperfect) I have seen so far, then well controlled bgs are not too far away....

Jul 2, 2009 Alzibiff 21 posts	Topic: General Discussion / Introductions "Remember we are all different!" ...... that comment reminds me of the Monty Python "Life of Brian" film - same line shouted out to the multitude followed by a reply from everyone "Yes - we're all different" ..... and then a singular "I'm not!". Me - yes - taking a while but little by little, confident that I will get there in the end - trouble is, there's always an explanation from the HPs as to why things were not as you expected ... "Well ... that walk will have lowered the BG by more than that...", "mmm - injection site may have been the reason for that", "Ahhhh - the pint of beer could have accounted for that ..." Keep at it! Alan

Jul 2, 2009 marke 686 posts	Topic: General Discussion / Introductions Welcome Ann-Marie, with regard to your sugar levels not being quite as you would like them just keep the faith. Many people seem to think they are failures because they can't get everything under control immediately after the course. This is NOT the case, it takes time and you just need to keep focusing on the positives. Focus on what you have achieved so far and be patient, I'm sure there are many others on this forum that have had the same experience. For some people it takes longer than others and I have heard of people taking 12 months to finally get fully on top of their BG's. Remember we are all different !

Jul 2, 2009 marke 686 posts	Topic: Site Development / On line carb counter ok, ok, I admit I got it wrong :-) I will get it corrected ASAP, sorry.

Jul 2, 2009 marke 686 posts	Topic: Carbohydrate Counting / Useful link for looking up CPs Ian, I have put your question to the nice ladies at DAFNE Central. i will update you when I have a reply. In the mean time you can always use the online version, it should be identical to the paper version.