Recent Posts - DAFNE Online

Apr 24, 2016

Peter 109 posts

Topic: General Discussion / My NHS Trust does not offer DAFNE

Paul,
The latest NICE guidelines for Type 1 Diabetes clearly state the need for Structured Education, with DAFNE specifically mentioned as an example of the type of course which should be offered:

Offer all adults with type 1 diabetes a structured education programme of proven benefit, for example the DAFNE (dose-adjustment for normal eating) programme. Offer this programme 6â€“12 months after diagnosis.

Full details of the guidance can be found here: https://www.nice.org.uk/guidance/ng17/chapter/1-Recommendations#education-and-information-2

I'd suggest that you take this to both your GP (as they hold the funds through the CCG) and your hospital team and ask both of them how they are going to meet the NICE guidance in your case. The other possibility is to make a Freedom of information request to the CCG asking how they intend to meet the new NICE guidance. The DAFNE Graduate Group. of which I am chairman, has been using this approach in cases where a DAFNE Center is threatening to withdraw. The questions could be used with your CCG, and they are obliged to provide answers within 20 working days. The direct approach to the providers will probably be quicker, but let me know if you'd like a copy of the questionnaire and details of how to make a FOI request.

Good luck.
Peter

Apr 22, 2016

JayBee 587 posts

Topic: General Discussion / My NHS Trust does not offer DAFNE

Find your nearest DAFNE course

Hope this helps spread some light on possibilities if your team can arrange a referral at all. Sad

I hope they can if they can't arrange to be a centre themselves.

Best wishes!

Apr 22, 2016

skillz 1 post

Topic: Carbohydrate Counting / 12 inch pizza carb

Bear in mind that the absorption of the carbs from pizza can be delayed if it's particularly cheesy/fatty.

Apr 20, 2016

paulfromskeg... 1 post

Topic: General Discussion / My NHS Trust does not offer DAFNE

Hi,

I was recently (December 2015) Diagnosed Type 1, and have had great support from the hospital and DSN. I have recently had a 3 hour introduction to carb counting which I found useful, but I have been told that my NHS trust does not offer DAFNE. As NICE seem to recommend DAFNE for all T1 diabetics, do I have the right to have them refer me to a neighbouring trust so that I can attend the course - Obviously travel and accommodation will be at my own expense, but I will cover that...

Any advice would be appreciated as I understand that this course will benefit me going forward.

Many thanks

Paul

Apr 19, 2016

franklin123 5 posts

Topic: General Discussion / Insulin pump problems

Thanks to u both ..helen and Andrew for your advice. Very useful. Regards.

Apr 19, 2016

Alan 49 284 posts

Topic: Questions for HCPs / blood glucose monitoring diaries

Mall
I have created a Word document for the detail pages and another for the cover. You then need to get some A5 paper for the detail pages and some A5 photographic paper for the covers (because it's stiffer). Obviously you need a printer that will print on A5 stationery. It all works for me, but I can understand if you think it's not worth the effort and expense, but once you've got stationery you're sorted.

Apr 19, 2016

HelenP 218 posts

Topic: General Discussion / Insulin pump problems

Hi Franklin...I also have an Animas Vibe (have had for over 4 years). I think you ought to try out the various cannula options available. I tried most and have settled on Unomedical Animas 17mm long cannula and with 60 cm of tubing from pump to "comfort set". I found the sets you insert yourself to be more reliable than the ones that are designed for those who are needle phobic. I can not find a number that coincides with your 30. My ref: 100-006-51.

I also found that placing the set above the waist line to the right or left of the belly button means that they are dislodged less frequently. I still lose one every couple of months though. The Animas "go-to person" here suggested I tape the tubing about 5cm from the set so that if it is pulled out by catching the tubing then the tape acts as a brake. I decided it was not worth it as you had to take the tape off every time you had a shower or took the pump off for any reason. As Andrew says it may be exacerbated by hair.

Good luck. Helen

Apr 19, 2016

Mall 1 post

Topic: Questions for HCPs / blood glucose monitoring diaries

It would be handy if we could just download one and print it off.

Apr 18, 2016

AMcD 38 posts

Topic: General Discussion / Insulin pump problems

Franklin. .. I should have mentioned that the cannula patch has better adhesion in areas of the body with the least hair... may or may not be a factor. Andy

Apr 18, 2016

franklin123 5 posts

Topic: General Discussion / Insulin pump problems

Thanks for your reply andy. I am going to have a word with the dsn. It's happened again today!!! Will keep you posted.

Apr 17, 2016

AMcD 38 posts

Topic: General Discussion / Insulin pump problems

Hi franklin. I am using a pump for 11 months. I use a medtronic minimed device so it's not the same pump or cannula components. However, I had a similar experience using the first cannula device that I started on which I think was called a quickset unit. After having the same problem as yourself on more than one occasion i changed cannula set to a minimed mio and it hasn't happened since. I'm not sure about your pump and the options for alternative cannulas? There are normally different cannula devices available as we all have different shapes and lifestyles. I would suggest contacting your health care team at the hospital and explain the problem if it is a recurring issue rather than a one off.... you might let us know how you get on? Hope this helps... Andy

Apr 16, 2016

franklin123 5 posts

Topic: General Discussion / Insulin pump problems

Hi all. I'm just wondering if anyone else has had a similar experience. I have had the animas vibe pump for 6 weeks now. In the last week my cannula has become dislodged twice resulting in obvious highs. Was only aware of problem when could smell insulin very strong. I am using the cannula device .inset 30.
Many thanks for any feedback.

Apr 15, 2016

Garry 328 posts

Topic: Carbohydrate Counting / 12 inch pizza carb

Welcome to the Forum danski. Smile

If that is the data given on the pack we must assume that that 245g CHO is correct. I'm not surprised.
Can't help with insulin dose without helpful, relevant information, as that's entirely down to your physiology.
I have a great deal of trouble with pizza. I'm always gobsmacked by my BGs after pizza. So I'm probably not the best to help. I try to avoid.
But if your mealtime (Dinner?) ratio is 1:1 take 24u Quick Acting - FOR THE WHOLE PIZZA. If it is 1.5:1 take 37u. If 2:1 take 49u !!!....................see what I mean...loaded with carbohydrate.
Whatever you decide though, make sure you document what you do, as that will help a great deal the next time you decide to eat it.
Matching insulin, a 1/3rd of your pizza might be OK. That would be 1:1 8u, 1.5:1 12u or 2:1 16u.
Stick with it. You'll soon get the hang of it.
Regards
Garry

Apr 15, 2016

danski 1 post

Topic: Carbohydrate Counting / 12 inch pizza carb

hello anyone can help me i dont know how much insulin to take for a 12 inch pizza it say 24.5 cp !!HELP!!


Apr 24, 2016 Peter 109 posts	Topic: General Discussion / My NHS Trust does not offer DAFNE Paul, The latest NICE guidelines for Type 1 Diabetes clearly state the need for Structured Education, with DAFNE specifically mentioned as an example of the type of course which should be offered: Offer all adults with type 1 diabetes a structured education programme of proven benefit, for example the DAFNE (dose-adjustment for normal eating) programme. Offer this programme 6â€“12 months after diagnosis. Full details of the guidance can be found here: https://www.nice.org.uk/guidance/ng17/chapter/1-Recommendations#education-and-information-2 I'd suggest that you take this to both your GP (as they hold the funds through the CCG) and your hospital team and ask both of them how they are going to meet the NICE guidance in your case. The other possibility is to make a Freedom of information request to the CCG asking how they intend to meet the new NICE guidance. The DAFNE Graduate Group. of which I am chairman, has been using this approach in cases where a DAFNE Center is threatening to withdraw. The questions could be used with your CCG, and they are obliged to provide answers within 20 working days. The direct approach to the providers will probably be quicker, but let me know if you'd like a copy of the questionnaire and details of how to make a FOI request. Good luck. Peter

Apr 22, 2016 JayBee 587 posts	Topic: General Discussion / My NHS Trust does not offer DAFNE Find your nearest DAFNE course Hope this helps spread some light on possibilities if your team can arrange a referral at all. I hope they can if they can't arrange to be a centre themselves. Best wishes!

Apr 22, 2016 skillz 1 post	Topic: Carbohydrate Counting / 12 inch pizza carb Bear in mind that the absorption of the carbs from pizza can be delayed if it's particularly cheesy/fatty.

Apr 20, 2016 paulfromskeg... 1 post	Topic: General Discussion / My NHS Trust does not offer DAFNE Hi, I was recently (December 2015) Diagnosed Type 1, and have had great support from the hospital and DSN. I have recently had a 3 hour introduction to carb counting which I found useful, but I have been told that my NHS trust does not offer DAFNE. As NICE seem to recommend DAFNE for all T1 diabetics, do I have the right to have them refer me to a neighbouring trust so that I can attend the course - Obviously travel and accommodation will be at my own expense, but I will cover that... Any advice would be appreciated as I understand that this course will benefit me going forward. Many thanks Paul

Apr 19, 2016 franklin123 5 posts	Topic: General Discussion / Insulin pump problems Thanks to u both ..helen and Andrew for your advice. Very useful. Regards.

Apr 19, 2016 Alan 49 284 posts	Topic: Questions for HCPs / blood glucose monitoring diaries Mall I have created a Word document for the detail pages and another for the cover. You then need to get some A5 paper for the detail pages and some A5 photographic paper for the covers (because it's stiffer). Obviously you need a printer that will print on A5 stationery. It all works for me, but I can understand if you think it's not worth the effort and expense, but once you've got stationery you're sorted.

Apr 19, 2016 HelenP 218 posts	Topic: General Discussion / Insulin pump problems Hi Franklin...I also have an Animas Vibe (have had for over 4 years). I think you ought to try out the various cannula options available. I tried most and have settled on Unomedical Animas 17mm long cannula and with 60 cm of tubing from pump to "comfort set". I found the sets you insert yourself to be more reliable than the ones that are designed for those who are needle phobic. I can not find a number that coincides with your 30. My ref: 100-006-51. I also found that placing the set above the waist line to the right or left of the belly button means that they are dislodged less frequently. I still lose one every couple of months though. The Animas "go-to person" here suggested I tape the tubing about 5cm from the set so that if it is pulled out by catching the tubing then the tape acts as a brake. I decided it was not worth it as you had to take the tape off every time you had a shower or took the pump off for any reason. As Andrew says it may be exacerbated by hair. Good luck. Helen

Apr 19, 2016 Mall 1 post	Topic: Questions for HCPs / blood glucose monitoring diaries It would be handy if we could just download one and print it off.

Apr 18, 2016 AMcD 38 posts	Topic: General Discussion / Insulin pump problems Franklin. .. I should have mentioned that the cannula patch has better adhesion in areas of the body with the least hair... may or may not be a factor. Andy

Apr 18, 2016 franklin123 5 posts	Topic: General Discussion / Insulin pump problems Thanks for your reply andy. I am going to have a word with the dsn. It's happened again today!!! Will keep you posted.

Apr 17, 2016 AMcD 38 posts	Topic: General Discussion / Insulin pump problems Hi franklin. I am using a pump for 11 months. I use a medtronic minimed device so it's not the same pump or cannula components. However, I had a similar experience using the first cannula device that I started on which I think was called a quickset unit. After having the same problem as yourself on more than one occasion i changed cannula set to a minimed mio and it hasn't happened since. I'm not sure about your pump and the options for alternative cannulas? There are normally different cannula devices available as we all have different shapes and lifestyles. I would suggest contacting your health care team at the hospital and explain the problem if it is a recurring issue rather than a one off.... you might let us know how you get on? Hope this helps... Andy

Apr 16, 2016 franklin123 5 posts	Topic: General Discussion / Insulin pump problems Hi all. I'm just wondering if anyone else has had a similar experience. I have had the animas vibe pump for 6 weeks now. In the last week my cannula has become dislodged twice resulting in obvious highs. Was only aware of problem when could smell insulin very strong. I am using the cannula device .inset 30. Many thanks for any feedback.

Apr 15, 2016 Garry 328 posts	Topic: Carbohydrate Counting / 12 inch pizza carb Welcome to the Forum danski. If that is the data given on the pack we must assume that that 245g CHO is correct. I'm not surprised. Can't help with insulin dose without helpful, relevant information, as that's entirely down to your physiology. I have a great deal of trouble with pizza. I'm always gobsmacked by my BGs after pizza. So I'm probably not the best to help. I try to avoid. But if your mealtime (Dinner?) ratio is 1:1 take 24u Quick Acting - FOR THE WHOLE PIZZA. If it is 1.5:1 take 37u. If 2:1 take 49u !!!....................see what I mean...loaded with carbohydrate. Whatever you decide though, make sure you document what you do, as that will help a great deal the next time you decide to eat it. Matching insulin, a 1/3rd of your pizza might be OK. That would be 1:1 8u, 1.5:1 12u or 2:1 16u. Stick with it. You'll soon get the hang of it. Regards Garry

Apr 15, 2016 danski 1 post	Topic: Carbohydrate Counting / 12 inch pizza carb hello anyone can help me i dont know how much insulin to take for a 12 inch pizza it say 24.5 cp !!HELP!!