Recent Posts - DAFNE Online

Feb 3, 2016

torana 53 posts

Topic: General Discussion / Injections and prescriptions

I really believed when reading about diabetics scrounging for needles for their next shot was a story for last century. In Australia, it was realised after many years the inequities of diabetics having to pay for needles and sharps bins whilst others in the community would be handed out these items for free. In fact, many diabetics were known to frequent clinics where needles and disposal containers were handed out to others with medical requirements such as HIV or methadone. What a sad state of affairs and Diabetes Australia fought a hard battle to give diabetics needles and strips under a national scheme at little or no cost. It is a basic right for diabetics to have needles and not have to beg to a doctor for extra supplies!

Feb 3, 2016

RichFreed 51 posts

Topic: General Discussion / Pump failure.

What a shame Helen.

I have had nothing but a stellar experience with Medtronic. PA hospital organised everything for me & an appointment was made for the switch to pump. The Medtronic rep was there for the initial instruction and setup (they would not make any suggestions for actual ratios or basal rates - they are not qualified for that). But I was prepared with my DAFNE ratios which I converted to grams per unit which I dropped straight into the pump and they were just about perfect. Basal took less than a week to tune.

I get just shy of 3 days out mine, my BASAL alone is set at about 80 units per day at the moment.

FYI Medtronic downloads are wireless.

Feb 2, 2016

HelenP 218 posts

Topic: General Discussion / Pump failure.

Thanks, Rich,

I have an Animas pump...long story but could not get Medtronic to respond when I initially went on a pump and thought that if that was indicative of their service, I would go with Animas who had been most attentive when I first broached the pump topic...

Regret the decision as the CDE they recommended did not program my pump properly and I had difficulties getting started. Subsequent CDEs then denied all responsibility for helping me as they had not done the initial "pump start".

I plan to swap to Medtronic ASAP as I use between 70-80 units most days and the cartridge needs changing every second day!!

As I wear the pump on my waist line at the back on my R side i have slowly narrowed the slot for the clip. I have clips but can not slide them onto the pump. The last time it was a battle to put it in but then when it came time to download the data could not get it off.
Thanks for the info re expected life span.

Helen

Feb 2, 2016

RichFreed 51 posts

Topic: General Discussion / Pump failure.

Your Private health will have a policy on replacement pumps. I'm with HCF and the last time I was notified of pump policy it was - every 5 years a replacement was covered & anything earlier was a co-payment pro-rata'd.

When I first got my Medtronic pump I was sure the inference was get a new one after 3 years. Later I was notified of the HCF policy (probably part of the letter they send send reminding you there is a 30day money back period if you find the Pump is not for you). When the 3 years was up I rang medtronic for advice, they stated that there was absolutely no reason why the pump would not last 5 years+. I am currently in my 4th year like you.

As for clip - You didn't state what pump you have. You should be able to buy them as an accessory from the pump supplier. I would be lucky to get 5 months out of the plastic ones from Medtronic the actual ratchet mechanism is plastic and simply wears out (usually a crack forms on the little actuator arm, eventually breaking off or the whole thing destroys itself if you get sufficiently hooked up on something.LOL). I splurged on the leather one & it has lasted nearly 3 years so far with no signs at all that its going to fail - Im pretty sure the clip mechanism is all metal.

Here's the link to the medtronic clips incase thats the pump you have.
http://shop.medtronic-diabetes.com.au/index.php?option=com_virtuemart&page=shop.browse&category_id=1&Itemid=116

Feb 2, 2016

Peter 109 posts

Topic: General Discussion / Injections and prescriptions

I'd suggest your first option is booking an appointment with your GP and use it to show your diary as above to demonstrate the number of needles you're using. Once you've explained the situation then hopefully the GP will be more responsive to your needs.

If that fails then try and get support from the DSN and/or consultant at your DAFNE centre.

Third (and last option) would be to either change GP or consider switching you snacks to lower CPs which don't require extra QA. Anything up to 1CP falls into that category.

Feb 1, 2016

VHDLMan 2 posts

Topic: General Discussion / Insulin types and doses - Basel/Bolus doses - Novapen 5

Hi

Thanks for the input - I was suffering from quite a few exercise induced, medium hypo's in a week however the Libre has been a great help
to spotting them coming and doing something about them before they happen. I would say that around 50% of the time, I am able to do some
kind of post meal exercise to combat the spike however 50% of the time I can't and the down side of the Libre is that I can now see how high
my BGL gets and for how long in these cases.

I shall push for a Novapen + Novarapid and see if this has any effect - If it does, gerat - If not, I will stop using it.

Thanks again

JD

Feb 1, 2016

Warwick 423 posts

Topic: General Discussion / Injections and prescriptions

It's happening here in Australia too. T1Ds are getting letters if they order more than a certain number of needles. They then need to produce a letter from their GP stating that they require them. Given that reused needles become blunt very quickly which causes brusing and can affect the dose injected, it does seem ridiculous.

Still, better than New Zealand where needles have to be bought with no subsidy :-(

Feb 1, 2016

Warwick 423 posts

Topic: General Discussion / Insulin types and doses - Basel/Bolus doses - Novapen 5

I had never heard of Insulatard InnoLet, I had to look it up. It's a long-acting insulin that starts acting after about 1.5 hours, peaks between 3-12 hours, and lasts up to 24 hours.

When I was diagnosed 5 years ago, I was put on a long-acting insulin twice a day for the first 14 months. The reason for this is that at the time of diagnosis, we are usually still in the honeymoon period where our pancreas is still making insulin, so to avoid lots of hypos, basal insulin is prescribed, and that can work well. I was getting HbA1Cs below 7 while I did this with a very careful diet, avoiding anything sugary, and foods like white rice which would send my BGLs into orbit. Like you, I also saw lots of spikes after the meals, but before each meal time, I was usually in a good range, so my endo was quite happy.

Once your honeymoon period is over, you are much more likely to be prescribed basal and bolus together. That certainly helps with the post-meal spikes, but also can lead to more hypos.

Do you know if your honeymoon period is over? As the beta cells slowly die, you go from needing a small amount of insulin to needing more to get the same BGL levels as previously. Once the honeymoon period ends, your need to make changes stops as you'll reach a state where because all of the beta cells are now dead, the amount of insulin you need to inject stays largely the same from day to day. If it is over, then it could be worth looking at quick acting insulin. If it isn't, then you may be fine to stay as you are for now. That will be a decision for your endo, but it would be worth asking them.

It sounds like you are doing fabulously well though, so don't stress about it too much. While quick acting insulin certainly helps, especially when you want to get down from high levels quickly, it can still be frustrating to manage BGLs and hypos tend to occur more often and more rapidly than with just basal insulin.

While most T1Ds will use a mixture of short and long acting insulin if injecting (and just short-acting if on a pump), there is a growing number of T1Ds who are successfully switching to a low-carb diet to avoid the need to worry about large shifts in BGLs due to lower insulin doses. There are articles about this such as http://www.dietdoctor.com/low-carb-manage-type-1-diabetes and also some books which are helpful are:

The Art and Science of Low Carbohydrate Living by Jeff S. Volek and Stephen D. Phinney. The authors, both doctors, promote cutting carbohydrates down to a minimum and using fat in place of carbohydrate as a fuel source. Both authors have implemented this diet for several decades with no ill effects.

The second book is Dr Bernsteinâ€™s Diabetes Solution. Dr Bernstein promotes a low carbohydrate diet for diabetics and is type 1 himself. His reasoning is that lowering the intake of carbohydrate requires much less insulin and therefore errors in the amount injected are much smaller leading to much less serious consequences.

Hope that helps.

Feb 1, 2016

Warwick 423 posts

Topic: General Discussion / Help with BI

Hi Derek,

Follow the DAFNE principles for changing BI and see how that helps. Only increase by 1 unit or 10% of the dose given. Wait three days before making any further changes. If it leads to hypos, then cut the dose back.

In practise, I think it may depend a bit on the type of basal insulin. When I was on Levemir, I found that changes were very quick to filter through and I didn't need to worry about the three day principal. With Lantus which I am on at the moment though, changes can easily take three days before any noticeable changes are visible.

Also, hypos may occur as a result of a QA dose, so I try and work out whether a hypo could be because of my QA before I change my BI dosing.

I wouldn't rely on a formula to work out your BI dose. It's works to get a starting value, but my BI doses change all year around. This time last year, I was on 6 in the morning and 6 at night. Now I am on 10 in the morning and 12 at night. Who knows where I will be in a couple of months :-)

All the best with it.
Warwick.

Jan 31, 2016

derekh1965 90 posts

Topic: General Discussion / Help with BI

hi alturn
thanks for your reply and help. I will try your suggestion and take my BI at 10:30 tonight and then 10:30 tomorrow morning. I took 8 units BI this morning and will take 12 this evening, giving a total of 20 units.
Hope my BS isn't high tomorrow..
Iwill post my results in a couple of days.
Derek

Jan 31, 2016

alturn 78 posts

Topic: General Discussion / Help with BI

I would suggest not calculating your BI. It may take a while, but try to find the number of units to keep you stable, and one of the DSNs suggested minimising difference between am and pm units. After a BI change, don't alter it for a while (I try 3 days). QA should be calculated for meals and corrections. You may need to correct until BI is correct. May also need to try fasting (no carbs) to get BI correct.

The formula (Weight * 0.5) is a rough guide to your total (QA + BI) per day, so your range would be 38 up to about 60 (based on DAFNE manual). Assuming 38, about 1/2 is BI so maybe try 10 am and 10 pm.

For comparison, I weigh 65Kg and currently take 11 Levemir am and pm and about 12 Novorapid so I am nowhere near 50/50 BI/QA.

Hope this helps.

Jan 31, 2016

derekh1965 90 posts

Topic: General Discussion / Help with BI

Hi
I am strugglig with my BI dosage.
I take levermir and when calculating I am using the formula for calculatig the total insulin dose, 0.5 x weight in kilos and I weigh 77k = 38/ /2 = 19 total BI. So I inject half or less upon waking and the rest in the evening. But I always wake up high no matter what time I inject my evening BI. I hope I am correct in my calculating if not please correct me.
As you see from my diary There are a lot of high sugars although my HBA1C has been excellent for the past year according to the HCP.

Jan 30, 2016

VHDLMan 2 posts

Topic: General Discussion / Insulin types and doses - Basel/Bolus doses - Novapen 5

Hi All

New to the forum so I hope the following question is OK - Been a T1 for just over a year having had serious necrotic pancreatitis at Xmas 2014.

I am on Innolet Insultard, one jab in the morning and one at night if my BG is high. I have done a lot of reading, the latest on basel/bolus dose
insulin. One thing I suffer with is post meal, BG spikes. I eat the best 'diabetic' meals I can (Shredded wheat, Livlife bread, no mash or chips
or pizza but the odd gingernut) but I still spike from 6.0 to 11.0, typically, and it takes a few hours or a good 2 mile, post meal walk to get it
back down below 7.0. I am committed to 'doing my best' and walk 5 to 7 miles a day, kayak, swim, ride a bike, have lost 7.5 stone in 2015
(I was VERY overweight) and have even purchased a Freestyle Libre to monitor my numbers.

The question: Should I be using a bolas dose 'pen' before meals to combat the spikes or should the Innolet be enough?

I have been reading about Novapen 4 or 5 and NovaRapid cartridges and I have an appointment with my GP next week to discuss getting
one. Thoughts?

Thanks

Jan 30, 2016

Peter 109 posts

Topic: General Discussion / freestyle libra

NB. The new factory seems to have come on stream now, and availability is much better if you want to buy it.

Jan 30, 2016

Popey81 5 posts

Topic: General Discussion / Injections and prescriptions

If you need to inject then you need to inject. Not really sure how they can say your using to many needles. Maybe try having your sachets half hour after a meal that way you could inject for a snack the same time as you inject for a meal?? Save on a few needles that way but not really sure why GPs are moaning about it.
As for testing every time you dont need too. Test the 4 times a day. But for snacks just cover the CP's dont worry about testing.
I try to keep my snacks with meals. Otherwise you will nearly always get a high BG reading. 2.5 hours after any meal i eat shows high BG readings. Then 4-5 hours they are back to normal. Snacking between will keep them high and you will never get a true reading.
GP's dont like spending money so maybe thats why they moaning about to many needles??

Jan 30, 2016

Popey81 5 posts

Topic: Questions for HCPs / 2 Hour rise after a meal and HbA1c results

Thanks all for the replies. Keep doing what im doing until my next HbA1c test Smile

Jan 29, 2016

AMcD 38 posts

Topic: Questions for HCPs / 2 Hour rise after a meal and HbA1c results

Novo Nordisk who manufacturer novorapid fast acting insulin have completed stage 3a clinical trials on a modified version of their fast acting insulin that achieves a faster rate of absorption and than novorapid. .. They applied to the FDA for a NDA (new drug application) in December 15.... They have called it onset 1 for type 1 use... if successful in getting to market this insulin will peak quicker than current fast acting insulin and hopefully make some further improvement on reducing post meal spikes. .. Andy

Jan 29, 2016

derekh1965 90 posts

Topic: General Discussion / Injections and prescriptions

Thought I would add my diary to this post

Jan 29, 2016

derekh1965 90 posts

Topic: General Discussion / Injections and prescriptions

Hi, Hope everyone is well. I wanted to ask about needles and injecting. I am being told by my GP I am ordering too many needles.
I order needles on 19th November and then again on the 30th December as it was close to the weekend, and I got a phone cal from the GP asking me why I needed more needles so soon. I got them, but ordered more on 27th January and never received them. If you are to use a new needle for every injection that is upto 9 injections a day. 2 BI, 4 meals, Breakfast,Lunch,Dinner and supper and 3 - 4 snacks. Snacks are nescafe sachets of latte which have between 10 and 15 g carbs each.
Am I using too many needles.
They also said I was testing too often. I test before I have carbs.
Thanks for reading.
Kind regards
Derek

Jan 29, 2016

HelenP 218 posts

Topic: General Discussion / Pump death?

Hi,

I am wondering if anyone has experienced a "pump death". My health fund (I'm in Australia) has denied a replacement pump as my current pump is "fully functional" even though it is 12 months out of warranty. I am wondering whether pumps have a slow and painful demise or they just stop being fully functional! The pump is working but I can not use the clip as after years of wearing it on my right hip I have somewhat distorted the area where the clip slide in. As a consequence I am carrying it in my pocket (not clipped in) and it does have a tendency to bungee jump especially when exiting the car. I have tried various systems without the clip and have resorted to pinning a child's sock to pyjamas etc but it is far from convenient. Helen

Jan 28, 2016

JohnCook 3 posts

Topic: Questions for HCPs / Johncook

Many thanks Helen. Very helpful. I will also refrain from my evening BI due to very high overdose this morning. Regular monitoring is essential as you say and adjust QA to suit. John

Feb 3, 2016 torana 53 posts	Topic: General Discussion / Injections and prescriptions I really believed when reading about diabetics scrounging for needles for their next shot was a story for last century. In Australia, it was realised after many years the inequities of diabetics having to pay for needles and sharps bins whilst others in the community would be handed out these items for free. In fact, many diabetics were known to frequent clinics where needles and disposal containers were handed out to others with medical requirements such as HIV or methadone. What a sad state of affairs and Diabetes Australia fought a hard battle to give diabetics needles and strips under a national scheme at little or no cost. It is a basic right for diabetics to have needles and not have to beg to a doctor for extra supplies!

Feb 3, 2016 RichFreed 51 posts	Topic: General Discussion / Pump failure. What a shame Helen. I have had nothing but a stellar experience with Medtronic. PA hospital organised everything for me & an appointment was made for the switch to pump. The Medtronic rep was there for the initial instruction and setup (they would not make any suggestions for actual ratios or basal rates - they are not qualified for that). But I was prepared with my DAFNE ratios which I converted to grams per unit which I dropped straight into the pump and they were just about perfect. Basal took less than a week to tune. I get just shy of 3 days out mine, my BASAL alone is set at about 80 units per day at the moment. FYI Medtronic downloads are wireless.

Feb 2, 2016 HelenP 218 posts	Topic: General Discussion / Pump failure. Thanks, Rich, I have an Animas pump...long story but could not get Medtronic to respond when I initially went on a pump and thought that if that was indicative of their service, I would go with Animas who had been most attentive when I first broached the pump topic... Regret the decision as the CDE they recommended did not program my pump properly and I had difficulties getting started. Subsequent CDEs then denied all responsibility for helping me as they had not done the initial "pump start". I plan to swap to Medtronic ASAP as I use between 70-80 units most days and the cartridge needs changing every second day!! As I wear the pump on my waist line at the back on my R side i have slowly narrowed the slot for the clip. I have clips but can not slide them onto the pump. The last time it was a battle to put it in but then when it came time to download the data could not get it off. Thanks for the info re expected life span. Helen

Feb 2, 2016 RichFreed 51 posts	Topic: General Discussion / Pump failure. Your Private health will have a policy on replacement pumps. I'm with HCF and the last time I was notified of pump policy it was - every 5 years a replacement was covered & anything earlier was a co-payment pro-rata'd. When I first got my Medtronic pump I was sure the inference was get a new one after 3 years. Later I was notified of the HCF policy (probably part of the letter they send send reminding you there is a 30day money back period if you find the Pump is not for you). When the 3 years was up I rang medtronic for advice, they stated that there was absolutely no reason why the pump would not last 5 years+. I am currently in my 4th year like you. As for clip - You didn't state what pump you have. You should be able to buy them as an accessory from the pump supplier. I would be lucky to get 5 months out of the plastic ones from Medtronic the actual ratchet mechanism is plastic and simply wears out (usually a crack forms on the little actuator arm, eventually breaking off or the whole thing destroys itself if you get sufficiently hooked up on something.LOL). I splurged on the leather one & it has lasted nearly 3 years so far with no signs at all that its going to fail - Im pretty sure the clip mechanism is all metal. Here's the link to the medtronic clips incase thats the pump you have. http://shop.medtronic-diabetes.com.au/index.php?option=com_virtuemart&page=shop.browse&category_id=1&Itemid=116

Feb 2, 2016 Peter 109 posts	Topic: General Discussion / Injections and prescriptions I'd suggest your first option is booking an appointment with your GP and use it to show your diary as above to demonstrate the number of needles you're using. Once you've explained the situation then hopefully the GP will be more responsive to your needs. If that fails then try and get support from the DSN and/or consultant at your DAFNE centre. Third (and last option) would be to either change GP or consider switching you snacks to lower CPs which don't require extra QA. Anything up to 1CP falls into that category.

Feb 1, 2016 VHDLMan 2 posts	Topic: General Discussion / Insulin types and doses - Basel/Bolus doses - Novapen 5 Hi Thanks for the input - I was suffering from quite a few exercise induced, medium hypo's in a week however the Libre has been a great help to spotting them coming and doing something about them before they happen. I would say that around 50% of the time, I am able to do some kind of post meal exercise to combat the spike however 50% of the time I can't and the down side of the Libre is that I can now see how high my BGL gets and for how long in these cases. I shall push for a Novapen + Novarapid and see if this has any effect - If it does, gerat - If not, I will stop using it. Thanks again JD

Feb 1, 2016 Warwick 423 posts	Topic: General Discussion / Injections and prescriptions It's happening here in Australia too. T1Ds are getting letters if they order more than a certain number of needles. They then need to produce a letter from their GP stating that they require them. Given that reused needles become blunt very quickly which causes brusing and can affect the dose injected, it does seem ridiculous. Still, better than New Zealand where needles have to be bought with no subsidy :-(

Feb 1, 2016 Warwick 423 posts	Topic: General Discussion / Insulin types and doses - Basel/Bolus doses - Novapen 5 I had never heard of Insulatard InnoLet, I had to look it up. It's a long-acting insulin that starts acting after about 1.5 hours, peaks between 3-12 hours, and lasts up to 24 hours. When I was diagnosed 5 years ago, I was put on a long-acting insulin twice a day for the first 14 months. The reason for this is that at the time of diagnosis, we are usually still in the honeymoon period where our pancreas is still making insulin, so to avoid lots of hypos, basal insulin is prescribed, and that can work well. I was getting HbA1Cs below 7 while I did this with a very careful diet, avoiding anything sugary, and foods like white rice which would send my BGLs into orbit. Like you, I also saw lots of spikes after the meals, but before each meal time, I was usually in a good range, so my endo was quite happy. Once your honeymoon period is over, you are much more likely to be prescribed basal and bolus together. That certainly helps with the post-meal spikes, but also can lead to more hypos. Do you know if your honeymoon period is over? As the beta cells slowly die, you go from needing a small amount of insulin to needing more to get the same BGL levels as previously. Once the honeymoon period ends, your need to make changes stops as you'll reach a state where because all of the beta cells are now dead, the amount of insulin you need to inject stays largely the same from day to day. If it is over, then it could be worth looking at quick acting insulin. If it isn't, then you may be fine to stay as you are for now. That will be a decision for your endo, but it would be worth asking them. It sounds like you are doing fabulously well though, so don't stress about it too much. While quick acting insulin certainly helps, especially when you want to get down from high levels quickly, it can still be frustrating to manage BGLs and hypos tend to occur more often and more rapidly than with just basal insulin. While most T1Ds will use a mixture of short and long acting insulin if injecting (and just short-acting if on a pump), there is a growing number of T1Ds who are successfully switching to a low-carb diet to avoid the need to worry about large shifts in BGLs due to lower insulin doses. There are articles about this such as http://www.dietdoctor.com/low-carb-manage-type-1-diabetes and also some books which are helpful are: The Art and Science of Low Carbohydrate Living by Jeff S. Volek and Stephen D. Phinney. The authors, both doctors, promote cutting carbohydrates down to a minimum and using fat in place of carbohydrate as a fuel source. Both authors have implemented this diet for several decades with no ill effects. The second book is Dr Bernsteinâ€™s Diabetes Solution. Dr Bernstein promotes a low carbohydrate diet for diabetics and is type 1 himself. His reasoning is that lowering the intake of carbohydrate requires much less insulin and therefore errors in the amount injected are much smaller leading to much less serious consequences. Hope that helps.

Feb 1, 2016 Warwick 423 posts	Topic: General Discussion / Help with BI Hi Derek, Follow the DAFNE principles for changing BI and see how that helps. Only increase by 1 unit or 10% of the dose given. Wait three days before making any further changes. If it leads to hypos, then cut the dose back. In practise, I think it may depend a bit on the type of basal insulin. When I was on Levemir, I found that changes were very quick to filter through and I didn't need to worry about the three day principal. With Lantus which I am on at the moment though, changes can easily take three days before any noticeable changes are visible. Also, hypos may occur as a result of a QA dose, so I try and work out whether a hypo could be because of my QA before I change my BI dosing. I wouldn't rely on a formula to work out your BI dose. It's works to get a starting value, but my BI doses change all year around. This time last year, I was on 6 in the morning and 6 at night. Now I am on 10 in the morning and 12 at night. Who knows where I will be in a couple of months :-) All the best with it. Warwick.

Jan 31, 2016 derekh1965 90 posts	Topic: General Discussion / Help with BI hi alturn thanks for your reply and help. I will try your suggestion and take my BI at 10:30 tonight and then 10:30 tomorrow morning. I took 8 units BI this morning and will take 12 this evening, giving a total of 20 units. Hope my BS isn't high tomorrow.. Iwill post my results in a couple of days. Derek

Jan 31, 2016 alturn 78 posts	Topic: General Discussion / Help with BI I would suggest not calculating your BI. It may take a while, but try to find the number of units to keep you stable, and one of the DSNs suggested minimising difference between am and pm units. After a BI change, don't alter it for a while (I try 3 days). QA should be calculated for meals and corrections. You may need to correct until BI is correct. May also need to try fasting (no carbs) to get BI correct. The formula (Weight * 0.5) is a rough guide to your total (QA + BI) per day, so your range would be 38 up to about 60 (based on DAFNE manual). Assuming 38, about 1/2 is BI so maybe try 10 am and 10 pm. For comparison, I weigh 65Kg and currently take 11 Levemir am and pm and about 12 Novorapid so I am nowhere near 50/50 BI/QA. Hope this helps.

Jan 31, 2016 derekh1965 90 posts	Topic: General Discussion / Help with BI Hi I am strugglig with my BI dosage. I take levermir and when calculating I am using the formula for calculatig the total insulin dose, 0.5 x weight in kilos and I weigh 77k = 38/ /2 = 19 total BI. So I inject half or less upon waking and the rest in the evening. But I always wake up high no matter what time I inject my evening BI. I hope I am correct in my calculating if not please correct me. As you see from my diary There are a lot of high sugars although my HBA1C has been excellent for the past year according to the HCP.

Jan 30, 2016 VHDLMan 2 posts	Topic: General Discussion / Insulin types and doses - Basel/Bolus doses - Novapen 5 Hi All New to the forum so I hope the following question is OK - Been a T1 for just over a year having had serious necrotic pancreatitis at Xmas 2014. I am on Innolet Insultard, one jab in the morning and one at night if my BG is high. I have done a lot of reading, the latest on basel/bolus dose insulin. One thing I suffer with is post meal, BG spikes. I eat the best 'diabetic' meals I can (Shredded wheat, Livlife bread, no mash or chips or pizza but the odd gingernut) but I still spike from 6.0 to 11.0, typically, and it takes a few hours or a good 2 mile, post meal walk to get it back down below 7.0. I am committed to 'doing my best' and walk 5 to 7 miles a day, kayak, swim, ride a bike, have lost 7.5 stone in 2015 (I was VERY overweight) and have even purchased a Freestyle Libre to monitor my numbers. The question: Should I be using a bolas dose 'pen' before meals to combat the spikes or should the Innolet be enough? I have been reading about Novapen 4 or 5 and NovaRapid cartridges and I have an appointment with my GP next week to discuss getting one. Thoughts? Thanks

Jan 30, 2016 Peter 109 posts	Topic: General Discussion / freestyle libra NB. The new factory seems to have come on stream now, and availability is much better if you want to buy it.

Jan 30, 2016 Popey81 5 posts	Topic: General Discussion / Injections and prescriptions If you need to inject then you need to inject. Not really sure how they can say your using to many needles. Maybe try having your sachets half hour after a meal that way you could inject for a snack the same time as you inject for a meal?? Save on a few needles that way but not really sure why GPs are moaning about it. As for testing every time you dont need too. Test the 4 times a day. But for snacks just cover the CP's dont worry about testing. I try to keep my snacks with meals. Otherwise you will nearly always get a high BG reading. 2.5 hours after any meal i eat shows high BG readings. Then 4-5 hours they are back to normal. Snacking between will keep them high and you will never get a true reading. GP's dont like spending money so maybe thats why they moaning about to many needles??

Jan 30, 2016 Popey81 5 posts	Topic: Questions for HCPs / 2 Hour rise after a meal and HbA1c results Thanks all for the replies. Keep doing what im doing until my next HbA1c test

Jan 29, 2016 AMcD 38 posts	Topic: Questions for HCPs / 2 Hour rise after a meal and HbA1c results Novo Nordisk who manufacturer novorapid fast acting insulin have completed stage 3a clinical trials on a modified version of their fast acting insulin that achieves a faster rate of absorption and than novorapid. .. They applied to the FDA for a NDA (new drug application) in December 15.... They have called it onset 1 for type 1 use... if successful in getting to market this insulin will peak quicker than current fast acting insulin and hopefully make some further improvement on reducing post meal spikes. .. Andy

Jan 29, 2016 derekh1965 90 posts	Topic: General Discussion / Injections and prescriptions Thought I would add my diary to this post

Jan 29, 2016 derekh1965 90 posts	Topic: General Discussion / Injections and prescriptions Hi, Hope everyone is well. I wanted to ask about needles and injecting. I am being told by my GP I am ordering too many needles. I order needles on 19th November and then again on the 30th December as it was close to the weekend, and I got a phone cal from the GP asking me why I needed more needles so soon. I got them, but ordered more on 27th January and never received them. If you are to use a new needle for every injection that is upto 9 injections a day. 2 BI, 4 meals, Breakfast,Lunch,Dinner and supper and 3 - 4 snacks. Snacks are nescafe sachets of latte which have between 10 and 15 g carbs each. Am I using too many needles. They also said I was testing too often. I test before I have carbs. Thanks for reading. Kind regards Derek

Jan 29, 2016 HelenP 218 posts	Topic: General Discussion / Pump death? Hi, I am wondering if anyone has experienced a "pump death". My health fund (I'm in Australia) has denied a replacement pump as my current pump is "fully functional" even though it is 12 months out of warranty. I am wondering whether pumps have a slow and painful demise or they just stop being fully functional! The pump is working but I can not use the clip as after years of wearing it on my right hip I have somewhat distorted the area where the clip slide in. As a consequence I am carrying it in my pocket (not clipped in) and it does have a tendency to bungee jump especially when exiting the car. I have tried various systems without the clip and have resorted to pinning a child's sock to pyjamas etc but it is far from convenient. Helen

Jan 28, 2016 JohnCook 3 posts	Topic: Questions for HCPs / Johncook Many thanks Helen. Very helpful. I will also refrain from my evening BI due to very high overdose this morning. Regular monitoring is essential as you say and adjust QA to suit. John