Recent Posts - DAFNE Online

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 686 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 686 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 686 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 7, 2009

digth 19 posts

Topic: Questions for HCPs / Liver Function Tests - Related to Insulin?

Please see reposnse form Prof. Stephanie Amiel, from King's College Hospital, London:

We do know that insulin resistance, common in Type 2 diabetes and not unknown in non-diabetes or Type 1, can be associated with abnormalities of liver function. Also note that the â€œnormal rangeâ€ is calculated statistically and 5-10% of people will always be outside it!

I donâ€™t think the type of insulin or the length of insulin treatment is likely to be relevant. The patient may have a degree of insulin resistance â€“ or another cause of the change.

The change is not huge. It would be best to see if it changes over time. It may just go away with repeat testing and would only be of concern I think if it steadily increases. In which case, I would advise assessment for other causes of abnormal liver function!

Apr 5, 2009

marke 686 posts

Topic: DAFNE Online Mobile / Mobile Feature Requests

At the moment its planned to be a WAP/cut down version of the site. An app would not be suitable because to update it you would still need to connect to the site. So a better solution is to just provide a mobile version of the site. However I take on board your comments re carb counting and the handbook, should we get time to do it.

Apr 2, 2009

Lizzie 87 posts

Topic: DAFNE Online Mobile / Mobile Feature Requests

The CP list would be helpful for me so I could find out how many carbs in stuff without dragging a book around. I know the books are small but still, it's another thing to carry and it has got a bit dogeared so I am wary of carrying it too much now.

I don't know if its asking too much but please could we have some key points from the handbook too? For example recently I was ill with ketones and would really have appreciated being able to check the sick day rules since I don't have internet access at home. But I know there may be some argument as to which are the important bits and it is too much to have the whole thing.

Will this be in the form of an application or will it be a mobile internet/wap site?

Apr 2, 2009

Lizzie 87 posts

Topic: DAFNE Online Mobile / Rationale - Please read

I have a Sony Ericsson K850i.

Apr 2, 2009

marke 686 posts

Topic: General Discussion / DAFNE in peril at the Wirral

I have received word today from DAFNE central that the PCT for Arrowe Park, Wirral are withdrawing all funding for DAFNE and
forcing the HCP's/Trainers to cancel the courses they have already arranged. This PCT is obviosuly VERY short-sighted and lacking in common sense !

Do any registered users know of anyone who is actually in this PCT's area. We would like to get complaints sent to the PCT about
this policy, but they really need to come from people who are actually in the PCT's area. With new government policies on choice
and openness in the NHS, the PCT should listen to all complaints and act upon them.

Its important for both DAFNE and us, as people who have benefitted from it, to give as many people as possible to also benefit from it. To do this we need to pressure any PCT that wants to make short-term decisions based on presumably short term cash flows, to reconsider.

Please post here if you know of anyone in this PCT's area who could help.

Apr 2, 2009

digth 19 posts

Topic: Questions for HCPs / Liver Function Tests - Related to Insulin?

Hi See below response from Prof Simon Heller from Sheffield below.

I am unaware of any evidence that slightly raised lever enzymes are due to Humalog therapy. It is absolutely untrue that AST is a bi-product of insulin. There are a number of important causes of raised liver enzymes including excess alcohol consumption, viral infections causing liver inflammation (hepatitis), some type of medication (but not insulin) and excess fatty deposits in the liver. If liver enzymes don't settle, further tests may be necessary and possible referral to a specialist

Apr 2, 2009

digth 19 posts

Topic: Questions for HCPs / BG Parameters

Please see response below from Carolin Taylor, DSN and DAFNE Educator from Sheffield and Chair of the DAFNE Educator Group.

In Sheffield we recommend BG targets before & during pregnancy of:

Less than 6mmol/l before meals (but no lower than 4mmol/l)

Less than 8mmol/l 1hour after meals / at bedtime

This obviously does mean introducing BG tests after meals (not normally recommended for routine DAFNE); in practice we find that ladies frequently need higher QA:CP ratios in order to hit the target 1hr after meals and in many cases they also need to take their QA up to 1/2hr prior to eating to get the peak effect of the QA at the appropriate time. Consequently, BI may need to be reduced to prevent hypos between meals, or possibly low-GI snacks could be required.

I hope this helps.

Apr 2, 2009

digth 19 posts

Topic: Questions for HCPs / Dieting

Hi

the national DAFNE programme does not produce diet sheets; additional dietary advice beyond the DAFNE course are dealt with on a local level. I would recommend that you speak with your local dietitian about your needs.

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 686 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 686 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 686 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 7, 2009 digth 19 posts	Topic: Questions for HCPs / Liver Function Tests - Related to Insulin? Please see reposnse form Prof. Stephanie Amiel, from King's College Hospital, London: We do know that insulin resistance, common in Type 2 diabetes and not unknown in non-diabetes or Type 1, can be associated with abnormalities of liver function. Also note that the â€œnormal rangeâ€ is calculated statistically and 5-10% of people will always be outside it! I donâ€™t think the type of insulin or the length of insulin treatment is likely to be relevant. The patient may have a degree of insulin resistance â€“ or another cause of the change. The change is not huge. It would be best to see if it changes over time. It may just go away with repeat testing and would only be of concern I think if it steadily increases. In which case, I would advise assessment for other causes of abnormal liver function!

Apr 5, 2009 marke 686 posts	Topic: DAFNE Online Mobile / Mobile Feature Requests At the moment its planned to be a WAP/cut down version of the site. An app would not be suitable because to update it you would still need to connect to the site. So a better solution is to just provide a mobile version of the site. However I take on board your comments re carb counting and the handbook, should we get time to do it.

Apr 2, 2009 Lizzie 87 posts	Topic: DAFNE Online Mobile / Mobile Feature Requests The CP list would be helpful for me so I could find out how many carbs in stuff without dragging a book around. I know the books are small but still, it's another thing to carry and it has got a bit dogeared so I am wary of carrying it too much now. I don't know if its asking too much but please could we have some key points from the handbook too? For example recently I was ill with ketones and would really have appreciated being able to check the sick day rules since I don't have internet access at home. But I know there may be some argument as to which are the important bits and it is too much to have the whole thing. Will this be in the form of an application or will it be a mobile internet/wap site?

Apr 2, 2009 Lizzie 87 posts	Topic: DAFNE Online Mobile / Rationale - Please read I have a Sony Ericsson K850i.

Apr 2, 2009 marke 686 posts	Topic: General Discussion / DAFNE in peril at the Wirral I have received word today from DAFNE central that the PCT for Arrowe Park, Wirral are withdrawing all funding for DAFNE and forcing the HCP's/Trainers to cancel the courses they have already arranged. This PCT is obviosuly VERY short-sighted and lacking in common sense ! Do any registered users know of anyone who is actually in this PCT's area. We would like to get complaints sent to the PCT about this policy, but they really need to come from people who are actually in the PCT's area. With new government policies on choice and openness in the NHS, the PCT should listen to all complaints and act upon them. Its important for both DAFNE and us, as people who have benefitted from it, to give as many people as possible to also benefit from it. To do this we need to pressure any PCT that wants to make short-term decisions based on presumably short term cash flows, to reconsider. Please post here if you know of anyone in this PCT's area who could help.

Apr 2, 2009 digth 19 posts	Topic: Questions for HCPs / Liver Function Tests - Related to Insulin? Hi See below response from Prof Simon Heller from Sheffield below. I am unaware of any evidence that slightly raised lever enzymes are due to Humalog therapy. It is absolutely untrue that AST is a bi-product of insulin. There are a number of important causes of raised liver enzymes including excess alcohol consumption, viral infections causing liver inflammation (hepatitis), some type of medication (but not insulin) and excess fatty deposits in the liver. If liver enzymes don't settle, further tests may be necessary and possible referral to a specialist

Apr 2, 2009 digth 19 posts	Topic: Questions for HCPs / BG Parameters Please see response below from Carolin Taylor, DSN and DAFNE Educator from Sheffield and Chair of the DAFNE Educator Group. In Sheffield we recommend BG targets before & during pregnancy of: Less than 6mmol/l before meals (but no lower than 4mmol/l) Less than 8mmol/l 1hour after meals / at bedtime This obviously does mean introducing BG tests after meals (not normally recommended for routine DAFNE); in practice we find that ladies frequently need higher QA:CP ratios in order to hit the target 1hr after meals and in many cases they also need to take their QA up to 1/2hr prior to eating to get the peak effect of the QA at the appropriate time. Consequently, BI may need to be reduced to prevent hypos between meals, or possibly low-GI snacks could be required. I hope this helps.

Apr 2, 2009 digth 19 posts	Topic: Questions for HCPs / Dieting Hi the national DAFNE programme does not produce diet sheets; additional dietary advice beyond the DAFNE course are dealt with on a local level. I would recommend that you speak with your local dietitian about your needs.