Recent Posts - DAFNE Online

Oct 3, 2015

AMcD 38 posts

Topic: Questions for HCPs / Insulin out of the fridge

Since yesterdays comment I have looked up the shelf life of novorapid from the pharmaceutical particulars data which gives a maximum 4 weeks storage when stored below 30 degree's. C. I would be more than suprised if your pharmacy had this stored on their premises out of the fridge......if so change pharmacy! ! Hope this

Oct 3, 2015

Stew B 125 posts

Topic: General Discussion / Diary's....

Yep, I get mine from the official DAFNE website. They are 75p each at the moment (plus a bit of postage), just ordered 10 this week - service is always excellent. Ordered over the phone for the first time, they couldn't have been more helpful.

Stew

Oct 2, 2015

AMcD 38 posts

Topic: Questions for HCPs / Insulin out of the fridge

The official line is that insulin will remain effective for 2 weeks once out of the fridge. Andy

Oct 2, 2015

sjohno 37 posts

Topic: General Discussion / Diary's....

Hi Enlli

Just paste the below link in to your web browser it will take you straight to how to order the diaries. Good luck.

http://www.dafne.uk.com/374.html

Oct 2, 2015

Alan 49 284 posts

Topic: Questions for HCPs / Insulin out of the fridge

Thanks Mstarosta, but had to go to ny GP (my doctor) on another matter and I told her about this. She was of the opinion 'better safe than sorry' and told me to ditch the insulin and she prescribed a replacement. I did feel rather guilty scrapping 3 boxes of Humalog -
I've no idea how much that cost the NHS. When I used to go to the pharmacy myself to collect a prescription, the insulin was always packaged separately and kept in the fridge and there was a sticker on the bag containing pills etc to indicate that part of the prescription was in the fridge. I will speak to the pharmacy as you suggest, to make sure they know that insulin should be kept in the fridge.I would have thought that any pharmacist should have already known this.

I want to know if it would be within my rights to reject any insulin which had not been refridgerated.

Oct 2, 2015

Enlli 1 post

Topic: General Discussion / Diary's....

Hi there.. I was wondering if did anybody know where I could get the DAFNE Glucose Monitoring Diary from... when on the course theh said I could buy them off the DAFNE website but when I try and get on there, I can't.... is it the same username and password?????

Oct 1, 2015

mstarosta 5 posts

Topic: Questions for HCPs / Insulin out of the fridge

Hi Alan, I would think that your insulin should be ok to use, I am not sure where you live but generally if it has been <25Â°c, if it has been at the ambient temp for a short time, it should be fine. You can contact the manufacturers to check, there should be a contact number on the packaging. Assuming that you are a DAFNE graduate, you are probably using QA & BI? If your BI is cloudy, make sure that it "mixes" evenly, no "flakes" or residue should be visible. Check your BGLs regularly of course, & if you note any unexplained above target BGLS, or they are higher generally without any other possible causes, change your insulin. Regarding the pharmacy, I am not sure whether they should ensure refrigeration for home delivery - but it is not dispensed in "cold packs" in Australia. Of course you don't know how long it has been out of the fridge if they were doing other deliveries though. I would still talk to your Pharmacist. Good luck.

Sep 30, 2015

Alan 49 284 posts

Topic: Questions for HCPs / Insulin out of the fridge

I always get my prescriptions dispensed at the local Lloyd's Pharmacy. Because of my mobility problems, they now deliver the prescriptions to me at home. The last time I had insulin prescribed it came in a large paper bag along with all my other tablets. I had forgotten that I had requested insulin (memory problems as well!) and I left the bag unopened for a couple of days. When I opened the bag I immediately put the insulin in the fridge.

My first question is - will that insulin be OK to use?

Secondly, would I have been able to refuse that Insulin, on the grounds that it should have been refridgerated?

Sep 28, 2015

Brumfoodie 10 posts

Topic: Carbohydrate Counting / Eating in Japan - any tips?

QQ - Thanks for the help and advice. I've laminated the kanji for carbs so I can keep it to hand.
The convenience stores are brilliant and I suspect I'll end up using their carbs as a guide for typical quantities. Estimating the carb content of dishes I eat in restaurants will be helped by the plastic versions of the food they sell in restaurant windows . They are so accurate that it will reduce the chance of having an unexpectedly large or small bowl put in front of me.
I agree about the deserts - they seem 90% sugar - but I'm going to treat myself to a traditional "cake" with matcha tea. Last week I found that they are about 3CP each so when we visit a tea room in Kyoto I'll nibble one of the beautiful creations along with everyone else. Very Happy

Sep 27, 2015

QQ 2 posts

Topic: General Discussion / New NICE Guidelines for Type 1 diabetes in adults: diagnosis and management

Thks for the information!

Sep 27, 2015

Nat-Sav 15 posts

Topic: Site Development / Add Multiple Diary Entries

Aha! Great. I thought it must be something simple like that! Couldn't see the wood for the trees. Thanks Very Happy

Sep 26, 2015

QQ 2 posts

Topic: Carbohydrate Counting / Eating in Japan - any tips?

Living in Japan for a few months I find that the food there are generally lower in carbs. If you have difficult calculating the CP, head to their convenience stores to get your food instead. Almost all their food there, including packed bento, contains nutrition labels like carbs and fats.

Look out for this kranji character: "ç‚æ°´åŒ–ç‰©". this means carbohydrate content.

Avoid all deserts if possible, high in sugar content.

Sep 25, 2015

Simon 578 posts

Topic: General Discussion / Dosage auto-calculation in apps

Hi Rich,

We have brought this to the attention of DAFNE in the UK however I'm not too hopeful of help with the certification as we aren't NHS employees and they have always maintained that DAFNE Online and DAFNE are separate entities. I can't speak for DAFNE in other countries but I have a feeling it may be the same.

Simon

Sep 24, 2015

RichFreed 51 posts

Topic: General Discussion / Dosage auto-calculation in apps

Also what are the DAFNE program/administration saying about this development?

This is the site we are directed to for the App & online access to the manual during the official DAFNE training course we do (certainly was the case in AUS). Surely the DAFNE programs from the various jurisdictions around the world should get together & jointly fund the certification. (Make it the official DAFNE app)

Sep 24, 2015

RichFreed 51 posts

Topic: General Discussion / Dosage auto-calculation in apps

Any chance of downgrading using the method described on this article..

http://www.hightechdad.com/2015/03/26/how-to-restore-a-previous-version-of-an-ios-app/

I might give the method a go in the coming weeks. I have at least 1 old phone with a prior version of the app + some actual itunes backups.

However it's kind of a non-issue for me as I have have a pump these days which is more accurate that the app for Carb ratios and fractions but I do still use the app occasionally when I'm running low in my reservoir and revert temporarily to injections or disabled bolus calcs to revert to Dafne (pump freedom can a bad thing sometimes). One thing that my pump doesn't hold a candle to in this App is adjustments. Apparently the smart people who put the software together for my pump ()Medtronic) decided that ALL T1 diabetics have a uniform insulin sensitivity no mater what BG they have. What a major failing!

Sep 23, 2015

Annette Bell 72 posts

Topic: General Discussion / Apple watch

Ok, point taken! Wink

Sep 23, 2015

Annette Bell 72 posts

Topic: General Discussion / Dosage auto-calculation in apps

If anyone is interested, I received this e-mail reply to the one I sent re this subject:

Dear Mrs Bell

Thank you for your e-mail. Details of compliance investigations are confidential, however we are able to provide some general information on apps.

Full details of the guidance on â€˜Medical device stand-alone software including appsâ€™ can be found at the following link:

https://www.gov.uk/government/publications/medical-devices-software-applications-apps/medical-device-stand-alone-software-including-apps

This guidance sets out why apps in some instances are considered to be medical devices and in the section entitled â€˜Software appsâ€™ there is a reference to the measurement of blood sugars.

Apps that are considered to be medical devices should have a CE mark as this shows it has met the legal requirements for safety, quality and performance when it is used as the manufacturer instructs.

We trust this information is helpful.

Yours Sincerely

Leo Syron
Compliance Inspector
European Regulatory Affairs
Medicines and Healthcare products Regulatory Agency
4th Floor, 151 Buckingham Palace Road
London
SW1W 9SZ
Tel 020 3080 7207
Fax 0203 118 9809
Mobile: 07770 678 430
To report suspected non-compliant medical device:
E: [email protected]

To report suspected counterfeit products:
E: [email protected]

Sep 23, 2015

alturn 78 posts

Topic: General Discussion / Levemir

You've got a lot going on now but try to be consistent in meals etc will help. And just because you don't feel stressed doesn't mean you aren't (even a little bit).

It's also possible you are still adjusting to Levemir. You need to take what is required to get best control, and this may take some time and continuous monitor and change.

J

Sep 23, 2015

Ellen 10 posts

Topic: General Discussion / Levemir

Thanks for your rely, At least I'm not the only one I thought maybe levemir wasn't working for me and have considered changing back to lantus which I was on when I was first diagnosed about 6 years ago, but it used to sting so they changed me.

Maybe it will keep changing until I have got it right or thinking about it I start university on Monday and will have to drive from Northampton to Leicester so maybe I am stressed about that even though I don't feel like I am. I also stopped doing my thighs for a while and went to buttock and have gone back to thighs again so it could also be this I suppose. I have also had to change my breakfast ratio for 2;1 to 3:1 which I find strange maybe once the levemir is right this might change again.

Ive rang the DSN as well so hopefully they might be able to help as well.

Thanks
Ellen

Sep 23, 2015

alturn 78 posts

Topic: General Discussion / Levemir

I keep changing mine as well, and until recently was always upwards.

Few months ago I was on 14/11 then DSN suggested balancing a bit more, and ended up at 14/14 and considering 15/15. In the last few weeks reduced to 10/10 and may have to reduce further. About the start of reduction, I stopped using my thighs (use stomach for Novarapid) and use buttocks, using areas not used before and which are softer. I expect to keep changing as might depend on site, activity, stress, temperature, mood etc - or it's just unpredictable. And I also reduced by DINNR ratio from 3:1 to 2:1 - I would like to know why (even 3:1 seemed insufficient at times)

Think you just have to accept that you need to change. Perhaps your insulin sensitivity is changing especially if relatively recently diagnosed.

Hope this helps,
J

Sep 23, 2015

Ellen 10 posts

Topic: General Discussion / Levemir

Hello

Does anyone find that they have to change their Levemir dose about every month? A certain amount in the morning and evening seem to hold me level for so long but after a month or so I'm raising overnight.

Thanks
Ellen

Sep 21, 2015

Simon 578 posts

Topic: General Discussion / Dosage auto-calculation in apps

I've been reliably informed it would be upwards of Â£3000 for certification, potentially nearer Â£10k Shocked

Sep 21, 2015

Bananaman 34 posts

Topic: General Discussion / Dosage auto-calculation in apps

How much would it cost, Im up for it

Sep 21, 2015

Garry 328 posts

Topic: Site Development / Updated Forum Items

Sorry I forgot to get back to you. I logged out that day and logged back in again and it hadn't changed.
But it must be fixed as today we are back to the usual, helpful green indicator showing new forum entries.
Thanks very much.
Regards
Garry

Oct 3, 2015 AMcD 38 posts	Topic: Questions for HCPs / Insulin out of the fridge Since yesterdays comment I have looked up the shelf life of novorapid from the pharmaceutical particulars data which gives a maximum 4 weeks storage when stored below 30 degree's. C. I would be more than suprised if your pharmacy had this stored on their premises out of the fridge......if so change pharmacy! ! Hope this

Oct 3, 2015 Stew B 125 posts	Topic: General Discussion / Diary's.... Yep, I get mine from the official DAFNE website. They are 75p each at the moment (plus a bit of postage), just ordered 10 this week - service is always excellent. Ordered over the phone for the first time, they couldn't have been more helpful. Stew

Oct 2, 2015 AMcD 38 posts	Topic: Questions for HCPs / Insulin out of the fridge The official line is that insulin will remain effective for 2 weeks once out of the fridge. Andy

Oct 2, 2015 sjohno 37 posts	Topic: General Discussion / Diary's.... Hi Enlli Just paste the below link in to your web browser it will take you straight to how to order the diaries. Good luck. http://www.dafne.uk.com/374.html

Oct 2, 2015 Alan 49 284 posts	Topic: Questions for HCPs / Insulin out of the fridge Thanks Mstarosta, but had to go to ny GP (my doctor) on another matter and I told her about this. She was of the opinion 'better safe than sorry' and told me to ditch the insulin and she prescribed a replacement. I did feel rather guilty scrapping 3 boxes of Humalog - I've no idea how much that cost the NHS. When I used to go to the pharmacy myself to collect a prescription, the insulin was always packaged separately and kept in the fridge and there was a sticker on the bag containing pills etc to indicate that part of the prescription was in the fridge. I will speak to the pharmacy as you suggest, to make sure they know that insulin should be kept in the fridge.I would have thought that any pharmacist should have already known this. I want to know if it would be within my rights to reject any insulin which had not been refridgerated.

Oct 2, 2015 Enlli 1 post	Topic: General Discussion / Diary's.... Hi there.. I was wondering if did anybody know where I could get the DAFNE Glucose Monitoring Diary from... when on the course theh said I could buy them off the DAFNE website but when I try and get on there, I can't.... is it the same username and password?????

Oct 1, 2015 mstarosta 5 posts	Topic: Questions for HCPs / Insulin out of the fridge Hi Alan, I would think that your insulin should be ok to use, I am not sure where you live but generally if it has been <25Â°c, if it has been at the ambient temp for a short time, it should be fine. You can contact the manufacturers to check, there should be a contact number on the packaging. Assuming that you are a DAFNE graduate, you are probably using QA & BI? If your BI is cloudy, make sure that it "mixes" evenly, no "flakes" or residue should be visible. Check your BGLs regularly of course, & if you note any unexplained above target BGLS, or they are higher generally without any other possible causes, change your insulin. Regarding the pharmacy, I am not sure whether they should ensure refrigeration for home delivery - but it is not dispensed in "cold packs" in Australia. Of course you don't know how long it has been out of the fridge if they were doing other deliveries though. I would still talk to your Pharmacist. Good luck.

Sep 30, 2015 Alan 49 284 posts	Topic: Questions for HCPs / Insulin out of the fridge I always get my prescriptions dispensed at the local Lloyd's Pharmacy. Because of my mobility problems, they now deliver the prescriptions to me at home. The last time I had insulin prescribed it came in a large paper bag along with all my other tablets. I had forgotten that I had requested insulin (memory problems as well!) and I left the bag unopened for a couple of days. When I opened the bag I immediately put the insulin in the fridge. My first question is - will that insulin be OK to use? Secondly, would I have been able to refuse that Insulin, on the grounds that it should have been refridgerated?

Sep 28, 2015 Brumfoodie 10 posts	Topic: Carbohydrate Counting / Eating in Japan - any tips? QQ - Thanks for the help and advice. I've laminated the kanji for carbs so I can keep it to hand. The convenience stores are brilliant and I suspect I'll end up using their carbs as a guide for typical quantities. Estimating the carb content of dishes I eat in restaurants will be helped by the plastic versions of the food they sell in restaurant windows . They are so accurate that it will reduce the chance of having an unexpectedly large or small bowl put in front of me. I agree about the deserts - they seem 90% sugar - but I'm going to treat myself to a traditional "cake" with matcha tea. Last week I found that they are about 3CP each so when we visit a tea room in Kyoto I'll nibble one of the beautiful creations along with everyone else.

Sep 27, 2015 QQ 2 posts	Topic: General Discussion / New NICE Guidelines for Type 1 diabetes in adults: diagnosis and management Thks for the information!

Sep 27, 2015 Nat-Sav 15 posts	Topic: Site Development / Add Multiple Diary Entries Aha! Great. I thought it must be something simple like that! Couldn't see the wood for the trees. Thanks

Sep 26, 2015 QQ 2 posts	Topic: Carbohydrate Counting / Eating in Japan - any tips? Living in Japan for a few months I find that the food there are generally lower in carbs. If you have difficult calculating the CP, head to their convenience stores to get your food instead. Almost all their food there, including packed bento, contains nutrition labels like carbs and fats. Look out for this kranji character: "ç‚æ°´åŒ–ç‰©". this means carbohydrate content. Avoid all deserts if possible, high in sugar content.

Sep 25, 2015 Simon 578 posts	Topic: General Discussion / Dosage auto-calculation in apps Hi Rich, We have brought this to the attention of DAFNE in the UK however I'm not too hopeful of help with the certification as we aren't NHS employees and they have always maintained that DAFNE Online and DAFNE are separate entities. I can't speak for DAFNE in other countries but I have a feeling it may be the same. Simon

Sep 24, 2015 RichFreed 51 posts	Topic: General Discussion / Dosage auto-calculation in apps Also what are the DAFNE program/administration saying about this development? This is the site we are directed to for the App & online access to the manual during the official DAFNE training course we do (certainly was the case in AUS). Surely the DAFNE programs from the various jurisdictions around the world should get together & jointly fund the certification. (Make it the official DAFNE app)

Sep 24, 2015 RichFreed 51 posts	Topic: General Discussion / Dosage auto-calculation in apps Any chance of downgrading using the method described on this article.. http://www.hightechdad.com/2015/03/26/how-to-restore-a-previous-version-of-an-ios-app/ I might give the method a go in the coming weeks. I have at least 1 old phone with a prior version of the app + some actual itunes backups. However it's kind of a non-issue for me as I have have a pump these days which is more accurate that the app for Carb ratios and fractions but I do still use the app occasionally when I'm running low in my reservoir and revert temporarily to injections or disabled bolus calcs to revert to Dafne (pump freedom can a bad thing sometimes). One thing that my pump doesn't hold a candle to in this App is adjustments. Apparently the smart people who put the software together for my pump ()Medtronic) decided that ALL T1 diabetics have a uniform insulin sensitivity no mater what BG they have. What a major failing!

Sep 23, 2015 Annette Bell 72 posts	Topic: General Discussion / Apple watch Ok, point taken!

Sep 23, 2015 Annette Bell 72 posts	Topic: General Discussion / Dosage auto-calculation in apps If anyone is interested, I received this e-mail reply to the one I sent re this subject: Dear Mrs Bell Thank you for your e-mail. Details of compliance investigations are confidential, however we are able to provide some general information on apps. Full details of the guidance on â€˜Medical device stand-alone software including appsâ€™ can be found at the following link: https://www.gov.uk/government/publications/medical-devices-software-applications-apps/medical-device-stand-alone-software-including-apps This guidance sets out why apps in some instances are considered to be medical devices and in the section entitled â€˜Software appsâ€™ there is a reference to the measurement of blood sugars. Apps that are considered to be medical devices should have a CE mark as this shows it has met the legal requirements for safety, quality and performance when it is used as the manufacturer instructs. We trust this information is helpful. Yours Sincerely Leo Syron Compliance Inspector European Regulatory Affairs Medicines and Healthcare products Regulatory Agency 4th Floor, 151 Buckingham Palace Road London SW1W 9SZ Tel 020 3080 7207 Fax 0203 118 9809 Mobile: 07770 678 430 To report suspected non-compliant medical device: E: [email protected] To report suspected counterfeit products: E: [email protected]

Sep 23, 2015 alturn 78 posts	Topic: General Discussion / Levemir You've got a lot going on now but try to be consistent in meals etc will help. And just because you don't feel stressed doesn't mean you aren't (even a little bit). It's also possible you are still adjusting to Levemir. You need to take what is required to get best control, and this may take some time and continuous monitor and change. J

Sep 23, 2015 Ellen 10 posts	Topic: General Discussion / Levemir Thanks for your rely, At least I'm not the only one I thought maybe levemir wasn't working for me and have considered changing back to lantus which I was on when I was first diagnosed about 6 years ago, but it used to sting so they changed me. Maybe it will keep changing until I have got it right or thinking about it I start university on Monday and will have to drive from Northampton to Leicester so maybe I am stressed about that even though I don't feel like I am. I also stopped doing my thighs for a while and went to buttock and have gone back to thighs again so it could also be this I suppose. I have also had to change my breakfast ratio for 2;1 to 3:1 which I find strange maybe once the levemir is right this might change again. Ive rang the DSN as well so hopefully they might be able to help as well. Thanks Ellen

Sep 23, 2015 alturn 78 posts	Topic: General Discussion / Levemir I keep changing mine as well, and until recently was always upwards. Few months ago I was on 14/11 then DSN suggested balancing a bit more, and ended up at 14/14 and considering 15/15. In the last few weeks reduced to 10/10 and may have to reduce further. About the start of reduction, I stopped using my thighs (use stomach for Novarapid) and use buttocks, using areas not used before and which are softer. I expect to keep changing as might depend on site, activity, stress, temperature, mood etc - or it's just unpredictable. And I also reduced by DINNR ratio from 3:1 to 2:1 - I would like to know why (even 3:1 seemed insufficient at times) Think you just have to accept that you need to change. Perhaps your insulin sensitivity is changing especially if relatively recently diagnosed. Hope this helps, J

Sep 23, 2015 Ellen 10 posts	Topic: General Discussion / Levemir Hello Does anyone find that they have to change their Levemir dose about every month? A certain amount in the morning and evening seem to hold me level for so long but after a month or so I'm raising overnight. Thanks Ellen

Sep 21, 2015 Simon 578 posts	Topic: General Discussion / Dosage auto-calculation in apps I've been reliably informed it would be upwards of Â£3000 for certification, potentially nearer Â£10k

Sep 21, 2015 Bananaman 34 posts	Topic: General Discussion / Dosage auto-calculation in apps How much would it cost, Im up for it

Sep 21, 2015 Garry 328 posts	Topic: Site Development / Updated Forum Items Sorry I forgot to get back to you. I logged out that day and logged back in again and it hadn't changed. But it must be fixed as today we are back to the usual, helpful green indicator showing new forum entries. Thanks very much. Regards Garry