Recent Posts - DAFNE Online

Apr 28, 2009

Claire Hough 12 posts

Topic: General Discussion / DAFNE in peril at the Wirral

Hi guys, I have emailed them as well - will let you know if I get a response.

Can't believe they're going to withdraw funding - why would they do that? DAFNE is brilliant and every type 1 should go on it!

Apr 27, 2009

Crispo 5 posts

Topic: Site Development / Online BG Diaries

Hi Simon,

Many thanks for the update mate. Loving the online diary action!!!

Cheers,
Paul

Apr 25, 2009

Simon Heller 46 posts

Topic: Questions for HCPs / How to attend a DAFNE Clinic after moving house

There are some GPs who know a lot about diabetes (although few who are DAFNE trained) and who could support DAFNE graduates but I agree with marke, that the remark that 'young and healthy' people don't need to see a specialist doesn't suggest that this GP is one of them. I think there are relatively few DAFNE clinics on the South coast but Salisbury is not too far away and Gill Thompson, national clinical director of the DAFNE collaborative may give you a list. I think you have a right to politely but firmly insist that you seek specialist support, particularly as you recognise the need to optimise your glycaemic control prior to becoming pregnant. Any GP will realise that this alone needs specialist support.

Apr 25, 2009

Simon 578 posts

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

Well it seems the rest of Balance readers share our shock and dismay at this nurses views on injecting in public. 2 pages of this months letters section are devoted to people's reactions to the letter mentioned at the top of this post, and I am pleased to say that not one of them supports the point of view expressed by this nurse.

Apr 25, 2009

Simon 578 posts

Topic: General Discussion / "Diabetes set off course" Balance letter

It seems that we share the views of the vast majority of the balance-reading population. This months letters section, for the most part, highlights the strengths of the DAFNE course, and how much of a positive impact it has had on people's lives - both during and after the week itself.

Very encouraging!

Apr 24, 2009

Simon 578 posts

Topic: Site Development / Online BG Diaries

Hi Paul,

I've just added this functionality for you now - you can now add negative corrections to QA, BI and CP field.

Thanks,

Simon

Apr 23, 2009

marke 681 posts

Topic: Questions for HCPs / How to attend a DAFNE Clinic after moving house

moving diabetes care to primary care pah ! Whoops better be careful what I say, I might upset somw HCP's ;-) I'm not a HCP in case you hadn't guessed that already but I totally agree that the approach that you are 'young and healthly' so don't need to see a specialist is rubbish. you won't stay healthly without help, although the 'young' bit I'm afraid you can't do anything about.
It would be nice if you could link up with another DAFNE centre, however there aren't any on our list, DAFNE Central would know better and hopefully someone from there will answer. You don't say where in Hampshire, its a big county. There is a Centre in Salisbury and there
are ones in London that may be not too far if you are in North Hampshire. At the very least I think you should be seen by a Diabetes Care team at your local hospital. There is definitely one in Southampton because I was under there before I moved.
You can always email us using the contact link at the bottom of pages on the website with your address and we can pass this on to DAFNE
Central to see if they can help.

Apr 23, 2009

natv25 2 posts

Topic: Questions for HCPs / How to attend a DAFNE Clinic after moving house

I have recently moved from London (where I atended a DAFNE course at the Central Middlesex Hospital in Jan 07)to Hampshire and have registered with a Doctor here. I gave my DAFNE notes to the DR which included a recommendation that I attend the DAFNE clinics at a nearby hsopital. My doctor told me that because I was "young and Healthy" I did not need to see a specialist. I am not happy with this response.

Before moving to the area my HbA1c was 7.9% and I am hoping to start a family with in the next 2 years. I know my HbA1c needs to be lower and therfore want to attend a clinic regularly.

Does anyone know any way I can attend a DAFNe clinic? Can I contact the hospital myslef or I do I need to be referred by my Doctor?

Apr 23, 2009

Crispo 5 posts

Topic: Site Development / Online BG Diaries

Hi Simon,

Would it also be possible to enter minus vaues into the QA field for times when a unit of insulin is dropped i.e. 4-1 for when exercise is planned or a hypo was experienced earlier before that meal?

Thanks,
Paul

Apr 21, 2009

Carl 5 posts

Topic: Site Development / Online BG Diaries

Simon,

Thanks very much for doing this. AWESOME job! Smile

Carl

Apr 21, 2009

Simon Heller 46 posts

Topic: Questions for HCPs / Type 2 & DAFNE

Another comment from an HCP. I have managed to slip a couple of people with Type 2 diabetes into a DAFNE course and both enjoyed it and have used it to maintain tight glucose control and their weight. The issue is that DAFNE is teaching the skills of insulin replacement and dose adjustment with a philosophy of eating freely. In Type 2 diabetes, control of BP and cholesterol are equally important and don't get big coverage on a DAFNE course. I agree with suggestions above that where the need is for skills in insulin adjustment and someone with Type 2 diabetes is up for taking 5 injections for insulin (relatively unusual) then they can use DAFNE skills to control both blood glucose and weight. However Gill is right that there has never been a trial to prove that people with Type 2 diabetes can do as well as people with Type 1 so there is a nervousness among HCPs in referring them.

Apr 21, 2009

digth 19 posts

Topic: Questions for HCPs / Type 2 & DAFNE

Hi Lizzie

sorry that you have been offended by my posting.

There was absolutely no deliberate thought in the use of 'disrupted'

Type 1 and Type 2 diabetes are essentially different conditions with essentially different treatment pathways, in general Type 2 care pathways involve lifestyle management.

This merely reflected the feedback from DAFNE Educators and applied to different needs of individuals with Type 2 diabetes not covered in the DAFNE curriculum, which was developed for people with Type 1 diabetes and in no way was intended to be interpreted that people with insulin resistance behave inappropriately.

The term disrupted refers to these differing lifestyle requirements and medical needs of the individual(s) with Type 2 diabetes which results in some areas of the DAFNE curriculum being inappropriate for the individual with Type 2 diabetes and the educator having to more spend time ensuring that the different needs of all individual are met.

Apr 20, 2009

marke 681 posts

Topic: DAFNE Online Mobile / Mobile site released

works fine on a HTC TYTN II using Internet explorer !

Apr 20, 2009

Simon 578 posts

Topic: Site Development / Online BG Diaries

Prompted by Carl's (and others) request, there is now an 'XML Export' link displayed above your BG diary, next to it you'll find a link to a nicely formatted printable view of your currently displayed results (I used this recently to take my recent results to a review appointment).

Let us know if there is any other functionality you'd like to see in the online diaries.

Thanks,

Simon

Apr 20, 2009

Zandrew 4 posts

Topic: Carbohydrate Counting / Useful link for looking up CPs

Thanks! It looks really useful. I'm running a DAFNE course in May and will promote the new tool! It would be great to build up the database with more entries....

Apr 20, 2009

Lizzie 87 posts

Topic: Questions for HCPs / Type 2 & DAFNE

Digth - what is you and your colleagues' feelings about type 1 insulin resistant diabetics like me who also have high insulin requirements? I went on a DAFNE course last year which was the best thing I have ever done for my diabetes. I do not feel I "disrupted" the learning of other group members - could you please clarify what you mean by using that word? To me it implies some degree of deliberate thought, in the sense of a child disrupting other childrens learning by misbehaving. I must say I am a little hurt by your use of that word as I would never want to disrupt anyone and I do not feel that I did.

Apr 18, 2009

Simon 578 posts

Topic: DAFNE Online Mobile / Mobile site released

Hi,

We have released a first draft of mobile capabilities for the site. Currently the mobile capabilities are fairly limited' you can login and logout from the site, and when logged in you can browse the Carbohydrate Portion lists as well as search for a specific food item.

As there are many different mobile devices on the market, all with slightly different web browsing functions, we need you to test out the site on your own mobile devices and provide feedback on how the site looks and functions on them.

To get started, point your mobile web browser at www.dafneonline.co.uk - it should automatically detect that you are visiting from a mobile device and show you the mobile login screen. If, however the normal site home page is displayed, let us know what device you are using here, so we can research how to implement the mobile functions for your particular device.

You can log in to the mobile site with your usual username and password, and browse/search the CP lists by 'clicking' on the appropriate links.

As always, we value your feedback so please let us know, either on this or other posts, or via email what you think of the mobile site, as well as which other parts of the main site you would like to see 'going mobile'

Thanks,

Simon

Apr 18, 2009

Becky 7 posts

Topic: General Discussion / DAFNE in peril at the Wirral

Thanks for the e-mail addresses. I'll get something sent to them this weekend.

Apr 17, 2009

marke 681 posts

Topic: General Discussion / DAFNE in peril at the Wirral

Becky, sounds like you ARE upset by this decison. In which case what you need to do as someone who comes under the PCTâ€™s catchment area is to email them on the address below and ask for an explanation as to why they are withdrawing funding for DAFNE and pointing out all the benefits. Also get anyone else who you know to do the same. If any of you are prepared to email the local paper about it as well even better.

The address on the PCTâ€™s website to email is [email protected]

If you donâ€™t get any response from that address, email [email protected]

This is the Patient Advice and Liaison Service and its their job to help you with complaints and contact the right people.

The more people that complain the better the chances they may be 'encouraged' to change their decision.

Apr 17, 2009

Becky 7 posts

Topic: General Discussion / DAFNE in peril at the Wirral

Hi! I did DAFNE at Arrowe Park & I know of a few others that have done it there also. I am totally disgusted with the decision to withdraw DAFNE from Arrowe Park & feel as if the PCT are letting me & other DAFNE trained type 1's down. My HbA1c has come right down from around 9% to 6.8% & my general health has improved as a result. I had the "it'll never happen to me" attitude towards my diabetes & complications before I did DAFNE. Now, I am a better diabetic, a more educated diabetic & perhaps most importantly a heathier diabetic. Does Wirral PCT want type 1's to be ill & suffer with more complications? I believe that my life has been saved by DAFNE. Do the people in charge of the purse strings at Wirral PCT want it on their conscience if diabetics in their care suffer??

Apr 17, 2009

marke 681 posts

Topic: Carbohydrate Counting / Useful link for looking up CPs

The search function is now implemented in the carb counting pages and the ability to add your own items now works properly ! No one told us it didn't and unfortunately in our test environment it DID work. Anyway it all works now, you may have to enable javascript to get it to work though. If you don't know what this means, chances are it WILL work for you.

Apr 17, 2009

Marie T-C 2 posts

Topic: General Discussion / "Diabetes set off course" Balance letter

Just an idea....would it be possible to ask DAFNE education centres to promote course attendees to contact Diabetes UK with their views of DAFNE? Personally, I have nothing but praise for DAFNE. I am still undecided as to whether to persue using a pump (I fit the NICE criteria) but was told by my diabetes centre that if I do follow that path I would need to apply DAFNE to my day to day life anyway. I have only followed DAFNE since Oct '08 and have already improved my diabetes. I think there should be a regular feature in Balance about DAFNE and 'Insulin Pumps' - I really feel knowledge is power - it is then down to the individual if they decide to contact their diabetes care team for specific information.

Apr 17, 2009

Marie T-C 2 posts

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

Absolutley agree with everyone. I too used to go to toilets to inject, that is until I had my DAFNE training. After talking to everyone else in the group I gained the confidence (after 30 years of diabetes - from the age of 11) to test and inject in public. I am discreet - usually injecting in tummy and even my family don't realise I have injected. Whether the toilets are hygenic or not is irrelevant, why should we have to leave the dinner table/friends/topic of conversation to enable us to take medication - particularly if splitting quick acting injections after courses. Would anyone expect someone suffering from asthma to go to the toilets to use an inhaler?!

Apr 8, 2009

rams4eva 1 post

Topic: DAFNE Online Mobile / Rationale - Please read

I would be happy to test on my motorola rokr

Apr 7, 2009

digth 19 posts

Topic: Questions for HCPs / BG Parameters

Please see below response from Prof. Stephanie Amiel from King's College Hopsital London.

The targets for diabetes control IN PREGNANCY are tighter than for non-pregnancy and include targets for post meal glucose values. There is much uncertainly about the importance of the transient rise in blood glucose that occurs after meals for risk of diabetes complications but there is good evidence that controlling them in pregnancy has benefit for the baby. Therefore, in pregnancy only, we focus on post-meal glucose also. At King's we use targets that were shown to benefit babies of mothers with gestational diabetes, which is more like type 2 and where the risk of hypoglycaemia is much less - 3.5-5.5 pre-meal and 4 â€“ 7 one hour after eating (very important NOT to correct if slightly higher than this post meal as hypo will occur â€“ use post prandial values only to make future adjustments to premeal doses over next few days) â€“ these targets can be very difficult for Type 1 where we sometimes relax to 90 min post meal testing!

But pre-conception there are no real data. We just know that having high averages (ie HbA1c) when booking for pregnancy (and the studies are old so booking tended to be at 12 â€“ 16 weeks!) increases risk of poor pregnancy outcome.

We ask our patients to focus on getting HbA1c less than 7% if possible before conception and I then suggest DAFNE targets for pre-meal and conventional 90 min targets of 4.5 â€“ 8. Sometimes this does mean abandoning some of the gains of DAFNE in that some people need to reduce CHO content of meals and even introduce between meal snacks to achieve this without hypo by next meal. To avoid weight gain, shifting calories from the meal to the snack, where this is necessary, is advised. It is fortunate that pregnancy only lasts 9 months!!

Apr 28, 2009 Claire Hough 12 posts	Topic: General Discussion / DAFNE in peril at the Wirral Hi guys, I have emailed them as well - will let you know if I get a response. Can't believe they're going to withdraw funding - why would they do that? DAFNE is brilliant and every type 1 should go on it!

Apr 27, 2009 Crispo 5 posts	Topic: Site Development / Online BG Diaries Hi Simon, Many thanks for the update mate. Loving the online diary action!!! Cheers, Paul

Apr 25, 2009 Simon Heller 46 posts	Topic: Questions for HCPs / How to attend a DAFNE Clinic after moving house There are some GPs who know a lot about diabetes (although few who are DAFNE trained) and who could support DAFNE graduates but I agree with marke, that the remark that 'young and healthy' people don't need to see a specialist doesn't suggest that this GP is one of them. I think there are relatively few DAFNE clinics on the South coast but Salisbury is not too far away and Gill Thompson, national clinical director of the DAFNE collaborative may give you a list. I think you have a right to politely but firmly insist that you seek specialist support, particularly as you recognise the need to optimise your glycaemic control prior to becoming pregnant. Any GP will realise that this alone needs specialist support.

Apr 25, 2009 Simon 578 posts	Topic: General Discussion / "Balance" letter about injecting in public Well it seems the rest of Balance readers share our shock and dismay at this nurses views on injecting in public. 2 pages of this months letters section are devoted to people's reactions to the letter mentioned at the top of this post, and I am pleased to say that not one of them supports the point of view expressed by this nurse.

Apr 25, 2009 Simon 578 posts	Topic: General Discussion / "Diabetes set off course" Balance letter It seems that we share the views of the vast majority of the balance-reading population. This months letters section, for the most part, highlights the strengths of the DAFNE course, and how much of a positive impact it has had on people's lives - both during and after the week itself. Very encouraging!

Apr 24, 2009 Simon 578 posts	Topic: Site Development / Online BG Diaries Hi Paul, I've just added this functionality for you now - you can now add negative corrections to QA, BI and CP field. Thanks, Simon

Apr 23, 2009 marke 681 posts	Topic: Questions for HCPs / How to attend a DAFNE Clinic after moving house moving diabetes care to primary care pah ! Whoops better be careful what I say, I might upset somw HCP's ;-) I'm not a HCP in case you hadn't guessed that already but I totally agree that the approach that you are 'young and healthly' so don't need to see a specialist is rubbish. you won't stay healthly without help, although the 'young' bit I'm afraid you can't do anything about. It would be nice if you could link up with another DAFNE centre, however there aren't any on our list, DAFNE Central would know better and hopefully someone from there will answer. You don't say where in Hampshire, its a big county. There is a Centre in Salisbury and there are ones in London that may be not too far if you are in North Hampshire. At the very least I think you should be seen by a Diabetes Care team at your local hospital. There is definitely one in Southampton because I was under there before I moved. You can always email us using the contact link at the bottom of pages on the website with your address and we can pass this on to DAFNE Central to see if they can help.

Apr 23, 2009 natv25 2 posts	Topic: Questions for HCPs / How to attend a DAFNE Clinic after moving house I have recently moved from London (where I atended a DAFNE course at the Central Middlesex Hospital in Jan 07)to Hampshire and have registered with a Doctor here. I gave my DAFNE notes to the DR which included a recommendation that I attend the DAFNE clinics at a nearby hsopital. My doctor told me that because I was "young and Healthy" I did not need to see a specialist. I am not happy with this response. Before moving to the area my HbA1c was 7.9% and I am hoping to start a family with in the next 2 years. I know my HbA1c needs to be lower and therfore want to attend a clinic regularly. Does anyone know any way I can attend a DAFNe clinic? Can I contact the hospital myslef or I do I need to be referred by my Doctor?

Apr 23, 2009 Crispo 5 posts	Topic: Site Development / Online BG Diaries Hi Simon, Would it also be possible to enter minus vaues into the QA field for times when a unit of insulin is dropped i.e. 4-1 for when exercise is planned or a hypo was experienced earlier before that meal? Thanks, Paul

Apr 21, 2009 Carl 5 posts	Topic: Site Development / Online BG Diaries Simon, Thanks very much for doing this. AWESOME job! Carl

Apr 21, 2009 Simon Heller 46 posts	Topic: Questions for HCPs / Type 2 & DAFNE Another comment from an HCP. I have managed to slip a couple of people with Type 2 diabetes into a DAFNE course and both enjoyed it and have used it to maintain tight glucose control and their weight. The issue is that DAFNE is teaching the skills of insulin replacement and dose adjustment with a philosophy of eating freely. In Type 2 diabetes, control of BP and cholesterol are equally important and don't get big coverage on a DAFNE course. I agree with suggestions above that where the need is for skills in insulin adjustment and someone with Type 2 diabetes is up for taking 5 injections for insulin (relatively unusual) then they can use DAFNE skills to control both blood glucose and weight. However Gill is right that there has never been a trial to prove that people with Type 2 diabetes can do as well as people with Type 1 so there is a nervousness among HCPs in referring them.

Apr 21, 2009 digth 19 posts	Topic: Questions for HCPs / Type 2 & DAFNE Hi Lizzie sorry that you have been offended by my posting. There was absolutely no deliberate thought in the use of 'disrupted' Type 1 and Type 2 diabetes are essentially different conditions with essentially different treatment pathways, in general Type 2 care pathways involve lifestyle management. This merely reflected the feedback from DAFNE Educators and applied to different needs of individuals with Type 2 diabetes not covered in the DAFNE curriculum, which was developed for people with Type 1 diabetes and in no way was intended to be interpreted that people with insulin resistance behave inappropriately. The term disrupted refers to these differing lifestyle requirements and medical needs of the individual(s) with Type 2 diabetes which results in some areas of the DAFNE curriculum being inappropriate for the individual with Type 2 diabetes and the educator having to more spend time ensuring that the different needs of all individual are met.

Apr 20, 2009 marke 681 posts	Topic: DAFNE Online Mobile / Mobile site released works fine on a HTC TYTN II using Internet explorer !

Apr 20, 2009 Simon 578 posts	Topic: Site Development / Online BG Diaries Prompted by Carl's (and others) request, there is now an 'XML Export' link displayed above your BG diary, next to it you'll find a link to a nicely formatted printable view of your currently displayed results (I used this recently to take my recent results to a review appointment). Let us know if there is any other functionality you'd like to see in the online diaries. Thanks, Simon

Apr 20, 2009 Zandrew 4 posts	Topic: Carbohydrate Counting / Useful link for looking up CPs Thanks! It looks really useful. I'm running a DAFNE course in May and will promote the new tool! It would be great to build up the database with more entries....

Apr 20, 2009 Lizzie 87 posts	Topic: Questions for HCPs / Type 2 & DAFNE Digth - what is you and your colleagues' feelings about type 1 insulin resistant diabetics like me who also have high insulin requirements? I went on a DAFNE course last year which was the best thing I have ever done for my diabetes. I do not feel I "disrupted" the learning of other group members - could you please clarify what you mean by using that word? To me it implies some degree of deliberate thought, in the sense of a child disrupting other childrens learning by misbehaving. I must say I am a little hurt by your use of that word as I would never want to disrupt anyone and I do not feel that I did.

Apr 18, 2009 Simon 578 posts	Topic: DAFNE Online Mobile / Mobile site released Hi, We have released a first draft of mobile capabilities for the site. Currently the mobile capabilities are fairly limited' you can login and logout from the site, and when logged in you can browse the Carbohydrate Portion lists as well as search for a specific food item. As there are many different mobile devices on the market, all with slightly different web browsing functions, we need you to test out the site on your own mobile devices and provide feedback on how the site looks and functions on them. To get started, point your mobile web browser at www.dafneonline.co.uk - it should automatically detect that you are visiting from a mobile device and show you the mobile login screen. If, however the normal site home page is displayed, let us know what device you are using here, so we can research how to implement the mobile functions for your particular device. You can log in to the mobile site with your usual username and password, and browse/search the CP lists by 'clicking' on the appropriate links. As always, we value your feedback so please let us know, either on this or other posts, or via email what you think of the mobile site, as well as which other parts of the main site you would like to see 'going mobile' Thanks, Simon

Apr 18, 2009 Becky 7 posts	Topic: General Discussion / DAFNE in peril at the Wirral Thanks for the e-mail addresses. I'll get something sent to them this weekend.

Apr 17, 2009 marke 681 posts	Topic: General Discussion / DAFNE in peril at the Wirral Becky, sounds like you ARE upset by this decison. In which case what you need to do as someone who comes under the PCTâ€™s catchment area is to email them on the address below and ask for an explanation as to why they are withdrawing funding for DAFNE and pointing out all the benefits. Also get anyone else who you know to do the same. If any of you are prepared to email the local paper about it as well even better. The address on the PCTâ€™s website to email is [email protected] If you donâ€™t get any response from that address, email [email protected] This is the Patient Advice and Liaison Service and its their job to help you with complaints and contact the right people. The more people that complain the better the chances they may be 'encouraged' to change their decision.

Apr 17, 2009 Becky 7 posts	Topic: General Discussion / DAFNE in peril at the Wirral Hi! I did DAFNE at Arrowe Park & I know of a few others that have done it there also. I am totally disgusted with the decision to withdraw DAFNE from Arrowe Park & feel as if the PCT are letting me & other DAFNE trained type 1's down. My HbA1c has come right down from around 9% to 6.8% & my general health has improved as a result. I had the "it'll never happen to me" attitude towards my diabetes & complications before I did DAFNE. Now, I am a better diabetic, a more educated diabetic & perhaps most importantly a heathier diabetic. Does Wirral PCT want type 1's to be ill & suffer with more complications? I believe that my life has been saved by DAFNE. Do the people in charge of the purse strings at Wirral PCT want it on their conscience if diabetics in their care suffer??

Apr 17, 2009 marke 681 posts	Topic: Carbohydrate Counting / Useful link for looking up CPs The search function is now implemented in the carb counting pages and the ability to add your own items now works properly ! No one told us it didn't and unfortunately in our test environment it DID work. Anyway it all works now, you may have to enable javascript to get it to work though. If you don't know what this means, chances are it WILL work for you.

Apr 17, 2009 Marie T-C 2 posts	Topic: General Discussion / "Diabetes set off course" Balance letter Just an idea....would it be possible to ask DAFNE education centres to promote course attendees to contact Diabetes UK with their views of DAFNE? Personally, I have nothing but praise for DAFNE. I am still undecided as to whether to persue using a pump (I fit the NICE criteria) but was told by my diabetes centre that if I do follow that path I would need to apply DAFNE to my day to day life anyway. I have only followed DAFNE since Oct '08 and have already improved my diabetes. I think there should be a regular feature in Balance about DAFNE and 'Insulin Pumps' - I really feel knowledge is power - it is then down to the individual if they decide to contact their diabetes care team for specific information.

Apr 17, 2009 Marie T-C 2 posts	Topic: General Discussion / "Balance" letter about injecting in public Absolutley agree with everyone. I too used to go to toilets to inject, that is until I had my DAFNE training. After talking to everyone else in the group I gained the confidence (after 30 years of diabetes - from the age of 11) to test and inject in public. I am discreet - usually injecting in tummy and even my family don't realise I have injected. Whether the toilets are hygenic or not is irrelevant, why should we have to leave the dinner table/friends/topic of conversation to enable us to take medication - particularly if splitting quick acting injections after courses. Would anyone expect someone suffering from asthma to go to the toilets to use an inhaler?!

Apr 8, 2009 rams4eva 1 post	Topic: DAFNE Online Mobile / Rationale - Please read I would be happy to test on my motorola rokr

Apr 7, 2009 digth 19 posts	Topic: Questions for HCPs / BG Parameters Please see below response from Prof. Stephanie Amiel from King's College Hopsital London. The targets for diabetes control IN PREGNANCY are tighter than for non-pregnancy and include targets for post meal glucose values. There is much uncertainly about the importance of the transient rise in blood glucose that occurs after meals for risk of diabetes complications but there is good evidence that controlling them in pregnancy has benefit for the baby. Therefore, in pregnancy only, we focus on post-meal glucose also. At King's we use targets that were shown to benefit babies of mothers with gestational diabetes, which is more like type 2 and where the risk of hypoglycaemia is much less - 3.5-5.5 pre-meal and 4 â€“ 7 one hour after eating (very important NOT to correct if slightly higher than this post meal as hypo will occur â€“ use post prandial values only to make future adjustments to premeal doses over next few days) â€“ these targets can be very difficult for Type 1 where we sometimes relax to 90 min post meal testing! But pre-conception there are no real data. We just know that having high averages (ie HbA1c) when booking for pregnancy (and the studies are old so booking tended to be at 12 â€“ 16 weeks!) increases risk of poor pregnancy outcome. We ask our patients to focus on getting HbA1c less than 7% if possible before conception and I then suggest DAFNE targets for pre-meal and conventional 90 min targets of 4.5 â€“ 8. Sometimes this does mean abandoning some of the gains of DAFNE in that some people need to reduce CHO content of meals and even introduce between meal snacks to achieve this without hypo by next meal. To avoid weight gain, shifting calories from the meal to the snack, where this is necessary, is advised. It is fortunate that pregnancy only lasts 9 months!!