Recent Posts - DAFNE Online

Feb 13, 2016

yogababe 4 posts

How much should I reduce my background insulin after having drunk alcohol?
A half bottle of dry white wine, for example, will drop my BG lower but I;m not sure how much I should cut my evening levemir does by - 50%?

Feb 12, 2016

HelenP 218 posts

Topic: General Discussion / Pump death?

Here we have two systems of health care. If you can afford it you are expected to pay for private health care. If you can not afford it, or choose not to on philosophical grounds, you use the public system. I have private health cover and the fund was happy to purchase the first pump at my private endocrinologist's request. My health fund has refused to replace it as it is "fully functioning". It will be 4 years old 8/3/16.
If you do not have private cover you have to negotiate the public system. I believe they do supply pumps to children.. I believe that adults join a health fund, wait the determined amount of time and then request a pump. It costs me just about $AUD 2 400 a year for private health care.

We will see. Helen

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: General Discussion / Pump death?

So do you get funding then...?.....here in the UK younger an upgrade every 4 year I think...is it similar over there?.....

Hopefully it won't beong till you get a new one....the 640g is my next move I think...need to wait a year though...no cgm though...

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / ratio calculator

I use to use a freestyle meter that calculated the dose fore you once you had your ratios, you then program the ratio in, you test your blood then in put the carbs and it gives you the dose...

InsulinX it was called...

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / ratio calculator

If your doing physical activity that isn't a daily occurrence then you should reduce basal, unfortunately working out what a higher ratio means in terms of final dose has to be done manually... Going from 1:1 to 1.5:1 isn't that difficult, a 60g meal at 6 units would be 9 units instead....once you test the new ratio to work good, you can move on..its wise to keep a written record when your working out ratios...do you record it..

Feb 12, 2016

HelenP 218 posts

Topic: General Discussion / Pump death?

Hi Novorapidboi,

I am on an Animas pump and the clip is removable. In fact you have to remove the clip to download the data. Over the past nearly 4 years the clip has broken about a half dozen times. I can buy replacement clips but over the past couple of downloading data episodes I noticed the clip was getting harder to take off and replace. The last time I was unable to replace it. I think that as i used to wear it on my R hip (as I found that the most comfortable and easy to access point) I have gradually distorted the slide in point for the clip. I am reluctant to tackle it with a screwdriver (seems the most obvious tool) and prise it open a tad as I think I will further damage the slide in point, or open it too much!. Still bungee jumping but has not made it to the toilet yet! It is summer here and the "belt" I purchased with a special pocket that is made of a stretchy (non breathable) fabric can become very sweaty over a day and ends up looking like a piece of rope tied around my waist.. It is also less convenient when out to dive under clothing to retrieve the pump for boluses etc. Sitting at the back was great but is no longer an option.
I plan to change brands to Medtronic, when I do upgrade. I have been told that I can realistically expect the pump to last 5 years without problems or I can purchase a new one myself ($(AUD) 10 000) if my health fund will not come to the party. I also plan to go to CGM (Minimed 640G system) so I would be up for significant costs. Helen

Feb 12, 2016

Kordula B 6 posts

Topic: Questions for HCPs / ratio calculator

indeed - YOU: "high at lunch then up your breakfast ratio"
ME: from 1 : 1 to 1.5 : 1
hence it would be SOOOO good to have the calculator which helps me for the ONE MEAL at a time, calculate quickly how much 1.5 : 1 means for that pot of mango sticks, the half slice rye bread - it is time consuming enough collecting all the label info. ...!
Have a good weekend
- for breakfast tomorrow I will use 1 :1 because I shall cycle to the wood, fell some trees (bow saws for volunteers) and help make a bonfire - then we can cook spuds and vegeburgers in the cinders.
If I used 1.5 : 1 ratio I would end up hypo at 12.

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / ratio calculator

Wow, very technical lol...

Your Bi should hold you steady, once that's right you can look at your QA, using DAFNE principles, high at lunch then up your breakfast ratio, high at dinner up your lunch and so on... Only do one meal at a time

Feb 12, 2016

Kordula B 6 posts

Topic: Questions for HCPs / ratio calculator

you are right - having a carb-free day is used for that. - I take 7.5 IU a.m - any more and I end up hypo around 3 o'clock; this is why having a different ratio at different times of the day is another way of keeping within limits despite the diurnal rhythm of various hormones involved in BG levels and regulation:
Corticosteroid levels are generally lower at night and higher during the day - especially the morning
. cortisol promotes lipid and protein breakdown and synthesis of of glucose from amino acids ( protein) Uptake of glucose by muscle and adipose tissue decreases.

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / Bendroflumethiazide effect

Your HCP advice should always be used however I believe if your unsure about whether the issue is with BI or QA you should always get the BI right first, then the QA, your evening QA won't sort out the morning reading as its out your system in 4/5 hours...

Feb 12, 2016

john day 54 posts

Topic: Questions for HCPs / Bendroflumethiazide effect

Thanks for your comment, novo. I see where you are coming from and see the logic.

After posting here I contacted my diabetes nurse who suggested the 'standard' upping my evening ratio from 1.5 to 2 to get the bedtime and possibly breakfast rdgs reasonable again and then look at the levemir as you suggest.

She did/could not comment specifically re the medication though.

We will see ... Thanks again

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / ratio calculator

You have just described a basal test where you go meal free to establish of you BI insulin is holding you steady...

Those results suggest not, so its time to up your background.... What are you on and when?

Feb 12, 2016

Kordula B 6 posts

Topic: Questions for HCPs / ratio calculator

yes - even without food!
example - had a test requiring no food for 7 hours -
so no breakfast - just BI - BG 6.8 mmol - 0 QA
at 11 o'clock BG 11.5 mmol !! ( needed correcting QAI)

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / ratio calculator

Well, everyone is different and that's what the DAFNE approach allows you to do, work it out, once you know it, then you can remember it....I was on 3:1 in the morning when injecting....are you high at lunch then...?...

Feb 12, 2016

Kordula B 6 posts

Topic: Questions for HCPs / ratio calculator

novorapidboi26 said:
ratio calcualtor?

never heard of it, are you looking for something to calculate your dose by simply adding a carb value..?

CALCULATE
if your ratio is 1 : 2 - you take 2 IU insulin for each CP

if your ratio is 1.5 : 1 you take 1.5 IU insulin for each CP

Seems I need to make my own - I take more insulin a.m. ( dawn phenomenon ) and trying out ratios - so a little card would help ( I AM LAZY / busy )
rest of the day 1 : 1 - so that is easier

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / Travel to Sri Lanka

i have no experience with such long journeys but I would be looking to try and keep your timings the same, at least until you get to your destination..........at least with the basal....

if you wont be getting your meals at the normal times then that's OK, that's the beauty of novoarapid/humalog....

you just need to make sure you are still getting the full coverage of Lantus.....

once you get there you can decide how to adjust the Lantus timing so it fits in with the new time zone......this will likely mean you either going without the Lantus for a short period or giving yourself a dose earlier and therefore doubling up on the dose............so you would need to either compensate with a little extra novorapid if you are taking your Lantus later or take less mealtime insulin if your taking your Lantus early....

i hope that makes sense, im getting confused myself reading back....ha ha....

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / Bendroflumethiazide effect

it sounds like the tablet may be effecting your BG throughout the whole day, which could be expected as any oral medication is designed to last over a given time period, as opposed to one that releases its ingredients quickly and is out your system quickly, like carbs in a way....

i would experiment with an increase to your basal/BI, that means you don't need to complicate your carb count and insulin/carb ratios...

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: Questions for HCPs / ratio calculator

ratio calcualtor?

never heard of it, are you looking for something to calculate your dose by simply adding a carb value..?

Feb 12, 2016

novorapidboi26 1,816 posts

Topic: General Discussion / Pump death?

what pump are you on?

is the clip removable?

i ask because my medtronic veo has a belt clip but it comes off, and it breaks at least once every 6 - 9 months.....they happily send a new one, but you could buy one too......

is our situation different...?

Feb 12, 2016

Kordula B 6 posts

Topic: Questions for HCPs / ratio calculator

please where can I find the ratio calculator sheet - thought it was in the hand book but isn't?

Feb 10, 2016

Geoff55 2 posts

Topic: General Discussion / Newby and not sure if I'm getting it right

Thanks
Not really feeling ill
It's a dental thing
Had a spot on day to day though
Just makes it more confusing

Feb 10, 2016

lucy1gus2 13 posts

Topic: Questions for HCPs / Travel to Sri Lanka

Am on a night flight with no doubt a late evening meal and arriving at destination at lunchtime.Time difference is about 5 hours and flight time is 10 hours.
What adjustments do I need to make? Normally Lantus am & pm and quick acting for mealtimes.
I am leaning towards no Lantus at night but what about morning ? Do I run high until I reach destination and back to normal ?
Any assistance appreciated
Thanks

Feb 10, 2016

Phil Maskell 194 posts

Topic: General Discussion / Newby and not sure if I'm getting it right

If you're ill and needing Antibiotics I would expect erratic BG, illness mess me up, normally run high with infection, but then over compensate and hypo.

Hope after the Antibiotics things level out.

Phil

Feb 10, 2016

Geoff55 2 posts

Topic: General Discussion / Newby and not sure if I'm getting it right

I'll be honest struggled at times with the course and since been having erratic levels
Been on Antibiotics twice could this be the reason?
Diagnosed December 2014 LADA
Course attended January 2016 Rolling Eyes

Feb 9, 2016

Victoria Kee... 1 post

Topic: General Discussion / Glucose results

My diary during DAFNE course Very Happy

Pleased with my results during DAFNE. Starting to pay off, glucose dropping into target.

Feb 13, 2016 yogababe 4 posts	Topic: Carbohydrate Counting / Alcohol How much should I reduce my background insulin after having drunk alcohol? A half bottle of dry white wine, for example, will drop my BG lower but I;m not sure how much I should cut my evening levemir does by - 50%?

Feb 12, 2016 HelenP 218 posts	Topic: General Discussion / Pump death? Here we have two systems of health care. If you can afford it you are expected to pay for private health care. If you can not afford it, or choose not to on philosophical grounds, you use the public system. I have private health cover and the fund was happy to purchase the first pump at my private endocrinologist's request. My health fund has refused to replace it as it is "fully functioning". It will be 4 years old 8/3/16. If you do not have private cover you have to negotiate the public system. I believe they do supply pumps to children.. I believe that adults join a health fund, wait the determined amount of time and then request a pump. It costs me just about $AUD 2 400 a year for private health care. We will see. Helen

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: General Discussion / Pump death? So do you get funding then...?.....here in the UK younger an upgrade every 4 year I think...is it similar over there?..... Hopefully it won't beong till you get a new one....the 640g is my next move I think...need to wait a year though...no cgm though...

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / ratio calculator I use to use a freestyle meter that calculated the dose fore you once you had your ratios, you then program the ratio in, you test your blood then in put the carbs and it gives you the dose... InsulinX it was called...

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / ratio calculator If your doing physical activity that isn't a daily occurrence then you should reduce basal, unfortunately working out what a higher ratio means in terms of final dose has to be done manually... Going from 1:1 to 1.5:1 isn't that difficult, a 60g meal at 6 units would be 9 units instead....once you test the new ratio to work good, you can move on..its wise to keep a written record when your working out ratios...do you record it..

Feb 12, 2016 HelenP 218 posts	Topic: General Discussion / Pump death? Hi Novorapidboi, I am on an Animas pump and the clip is removable. In fact you have to remove the clip to download the data. Over the past nearly 4 years the clip has broken about a half dozen times. I can buy replacement clips but over the past couple of downloading data episodes I noticed the clip was getting harder to take off and replace. The last time I was unable to replace it. I think that as i used to wear it on my R hip (as I found that the most comfortable and easy to access point) I have gradually distorted the slide in point for the clip. I am reluctant to tackle it with a screwdriver (seems the most obvious tool) and prise it open a tad as I think I will further damage the slide in point, or open it too much!. Still bungee jumping but has not made it to the toilet yet! It is summer here and the "belt" I purchased with a special pocket that is made of a stretchy (non breathable) fabric can become very sweaty over a day and ends up looking like a piece of rope tied around my waist.. It is also less convenient when out to dive under clothing to retrieve the pump for boluses etc. Sitting at the back was great but is no longer an option. I plan to change brands to Medtronic, when I do upgrade. I have been told that I can realistically expect the pump to last 5 years without problems or I can purchase a new one myself ($(AUD) 10 000) if my health fund will not come to the party. I also plan to go to CGM (Minimed 640G system) so I would be up for significant costs. Helen

Feb 12, 2016 Kordula B 6 posts	Topic: Questions for HCPs / ratio calculator indeed - YOU: "high at lunch then up your breakfast ratio" ME: from 1 : 1 to 1.5 : 1 hence it would be SOOOO good to have the calculator which helps me for the ONE MEAL at a time, calculate quickly how much 1.5 : 1 means for that pot of mango sticks, the half slice rye bread - it is time consuming enough collecting all the label info. ...! Have a good weekend - for breakfast tomorrow I will use 1 :1 because I shall cycle to the wood, fell some trees (bow saws for volunteers) and help make a bonfire - then we can cook spuds and vegeburgers in the cinders. If I used 1.5 : 1 ratio I would end up hypo at 12.

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / ratio calculator Wow, very technical lol... Your Bi should hold you steady, once that's right you can look at your QA, using DAFNE principles, high at lunch then up your breakfast ratio, high at dinner up your lunch and so on... Only do one meal at a time

Feb 12, 2016 Kordula B 6 posts	Topic: Questions for HCPs / ratio calculator you are right - having a carb-free day is used for that. - I take 7.5 IU a.m - any more and I end up hypo around 3 o'clock; this is why having a different ratio at different times of the day is another way of keeping within limits despite the diurnal rhythm of various hormones involved in BG levels and regulation: Corticosteroid levels are generally lower at night and higher during the day - especially the morning . cortisol promotes lipid and protein breakdown and synthesis of of glucose from amino acids ( protein) Uptake of glucose by muscle and adipose tissue decreases.

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / Bendroflumethiazide effect Your HCP advice should always be used however I believe if your unsure about whether the issue is with BI or QA you should always get the BI right first, then the QA, your evening QA won't sort out the morning reading as its out your system in 4/5 hours...

Feb 12, 2016 john day 54 posts	Topic: Questions for HCPs / Bendroflumethiazide effect Thanks for your comment, novo. I see where you are coming from and see the logic. After posting here I contacted my diabetes nurse who suggested the 'standard' upping my evening ratio from 1.5 to 2 to get the bedtime and possibly breakfast rdgs reasonable again and then look at the levemir as you suggest. She did/could not comment specifically re the medication though. We will see ... Thanks again

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / ratio calculator You have just described a basal test where you go meal free to establish of you BI insulin is holding you steady... Those results suggest not, so its time to up your background.... What are you on and when?

Feb 12, 2016 Kordula B 6 posts	Topic: Questions for HCPs / ratio calculator yes - even without food! example - had a test requiring no food for 7 hours - so no breakfast - just BI - BG 6.8 mmol - 0 QA at 11 o'clock BG 11.5 mmol !! ( needed correcting QAI)

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / ratio calculator Well, everyone is different and that's what the DAFNE approach allows you to do, work it out, once you know it, then you can remember it....I was on 3:1 in the morning when injecting....are you high at lunch then...?...

Feb 12, 2016 Kordula B 6 posts	Topic: Questions for HCPs / ratio calculator novorapidboi26 said: ratio calcualtor? never heard of it, are you looking for something to calculate your dose by simply adding a carb value..? CALCULATE if your ratio is 1 : 2 - you take 2 IU insulin for each CP if your ratio is 1.5 : 1 you take 1.5 IU insulin for each CP Seems I need to make my own - I take more insulin a.m. ( dawn phenomenon ) and trying out ratios - so a little card would help ( I AM LAZY / busy ) rest of the day 1 : 1 - so that is easier

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / Travel to Sri Lanka i have no experience with such long journeys but I would be looking to try and keep your timings the same, at least until you get to your destination..........at least with the basal.... if you wont be getting your meals at the normal times then that's OK, that's the beauty of novoarapid/humalog.... you just need to make sure you are still getting the full coverage of Lantus..... once you get there you can decide how to adjust the Lantus timing so it fits in with the new time zone......this will likely mean you either going without the Lantus for a short period or giving yourself a dose earlier and therefore doubling up on the dose............so you would need to either compensate with a little extra novorapid if you are taking your Lantus later or take less mealtime insulin if your taking your Lantus early.... i hope that makes sense, im getting confused myself reading back....ha ha....

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / Bendroflumethiazide effect it sounds like the tablet may be effecting your BG throughout the whole day, which could be expected as any oral medication is designed to last over a given time period, as opposed to one that releases its ingredients quickly and is out your system quickly, like carbs in a way.... i would experiment with an increase to your basal/BI, that means you don't need to complicate your carb count and insulin/carb ratios...

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: Questions for HCPs / ratio calculator ratio calcualtor? never heard of it, are you looking for something to calculate your dose by simply adding a carb value..?

Feb 12, 2016 novorapidboi26 1,816 posts	Topic: General Discussion / Pump death? what pump are you on? is the clip removable? i ask because my medtronic veo has a belt clip but it comes off, and it breaks at least once every 6 - 9 months.....they happily send a new one, but you could buy one too...... is our situation different...?

Feb 12, 2016 Kordula B 6 posts	Topic: Questions for HCPs / ratio calculator please where can I find the ratio calculator sheet - thought it was in the hand book but isn't?

Feb 10, 2016 Geoff55 2 posts	Topic: General Discussion / Newby and not sure if I'm getting it right Thanks Not really feeling ill It's a dental thing Had a spot on day to day though Just makes it more confusing

Feb 10, 2016 lucy1gus2 13 posts	Topic: Questions for HCPs / Travel to Sri Lanka Am on a night flight with no doubt a late evening meal and arriving at destination at lunchtime.Time difference is about 5 hours and flight time is 10 hours. What adjustments do I need to make? Normally Lantus am & pm and quick acting for mealtimes. I am leaning towards no Lantus at night but what about morning ? Do I run high until I reach destination and back to normal ? Any assistance appreciated Thanks

Feb 10, 2016 Phil Maskell 194 posts	Topic: General Discussion / Newby and not sure if I'm getting it right If you're ill and needing Antibiotics I would expect erratic BG, illness mess me up, normally run high with infection, but then over compensate and hypo. Hope after the Antibiotics things level out. Phil

Feb 10, 2016 Geoff55 2 posts	Topic: General Discussion / Newby and not sure if I'm getting it right I'll be honest struggled at times with the course and since been having erratic levels Been on Antibiotics twice could this be the reason? Diagnosed December 2014 LADA Course attended January 2016

Feb 9, 2016 Victoria Kee... 1 post	Topic: General Discussion / Glucose results My diary during DAFNE course Pleased with my results during DAFNE. Starting to pay off, glucose dropping into target.