Recent Posts - DAFNE Online

Sep 3, 2015

bejt1 3 posts

Topic: General Discussion / Dosage auto-calculation in apps

novorapidboi26 said:
All dosage calculations should be done at the meter end I think, not an app..........

getting more meters with some kind of bolus wizard is key..........there are a few out there already.......

As a DAFNE graduate you will have received education on how to calculate your insulin dosage manually and this is the correct approach. The use of meters and DAFNEONLINE to determine the insulin dosage is simply the application of algorithm or calculations that follow the DAFNE principals. The answer is not at"the meter end" as you say but in whatever device you may want to use. DAFNEONLINE was a very good tool to use for this purpose but is of little use now.

Sep 3, 2015

bejt1 3 posts

Topic: General Discussion / Dosage auto-calculation in apps

marke said:
Hi bejt1, sorry I don't understand your post at all. Who are you aiming it at ? If its us at dafneonline then you need to read the thread properly. No the auto-calculate won't be re-introduced and we have explained why. If its aimed at the MHRA, then they don't read or care about dafneonline....

If you follow the thread and observe the comments about people making decisions using DAFNEONLINE then you will understand my post!
I get very frustrated by organisations making decisions that affect others which are accepted without significant opposition. To say that MHRA don't care about DAFNE would suggest that you just want an easy life and are prepared to role over and have your tummy tickled. Why not organise a petition or campaign that gets this issue resolved, I am sure that it would be supported!

Sep 3, 2015

novorapidboi26 1,819 posts

Topic: General Discussion / Dosage auto-calculation in apps

All dosage calculations should be done at the meter end I think, not an app..........

getting more meters with some kind of bolus wizard is key..........there are a few out there already.......

Very Happy

Sep 3, 2015

marke 686 posts

Topic: General Discussion / Dosage auto-calculation in apps

Hi bejt1, sorry I don't understand your post at all. Who are you aiming it at ? If its us at dafneonline then you need to read the thread properly. No the auto-calculate won't be re-introduced and we have explained why. If its aimed at the MHRA, then they don't read or care about dafneonline....

Sep 3, 2015

bejt1 3 posts

Topic: General Discussion / Dosage auto-calculation in apps

I have just updated my DAFNE ONLINE APP and discovered that the auto calculation feature is no longer available. It appears that a decision to remove the facility has been made without user consultation and that users are now dissatisfied with the app.
I don't agree with the reason given for the removal of the auto calculation as it does not credit the user for the interaction with the app in setting targets and ratios in response to historical diary data but appears to insult users by suggesting that the app is used to make decisions about insulin dosage on a purely mechanistic process. Obviously DAFNE cannot be used without some understanding of the calculation process and the auto calculation simply speeded up the dose calculation by allowing users to more conveniently determine their dose once the settings had been entered. In addition the automatic uploading of the data to DAFNEONLINE created a convenient diary record which I found very useful when visiting a clinic.
The question I now need to consider is: why should I continue to use DAFNEONLINE as it has now been reduced to a carb counter and diary, should I look for another app, or will the auto calculation be reinstated?
I have always been hopeless at keeping a paper diary but enter about six readings a day into DAFNEONLINE for my clinician to observe, the loss of this facility is a backwards and negative decision which I feel has been made by people who don't understand to use of the app.
Please put it right Embarassed

Sep 3, 2015

Alan 49 284 posts

Topic: Site Development / Diary changes

Looks like the Multiple Entry page has been compressed slightly - is this deliberate?

Sep 2, 2015

Politikaal 6 posts

Topic: General Discussion / Dosage auto-calculation in apps

Hi Carolina, Yes, I have had a look on the App Store and there is a plethora of apps available with automatic dose calculation. I have been experimenting with RapidCalc as was recommended by another member last week and am quite impressed. I guess these apps are developed in other countries that aren't subject to such restrictive nanny state bureaucracies. I don't want to be promoting other apps on this forum, one thing that none of them have is the automatic upload and contact with our DAFNE community. The auto calculation really does make a difference for me though; anything to make diabetic life just that little bit easier is always going to be a plus. Again, I hope our hardworking team can find a way to get around this.

Sep 2, 2015

carolinapast... 1 post

Topic: General Discussion / Dosage auto-calculation in apps

There is an App called Insulin Pro which is basically a dose calculator. You just have to adjust your settings and you're good to go Smile

Sep 1, 2015

alturn 78 posts

Topic: General Discussion / Bruising on injection sites

Welcome to the forums, no harm in being a lurker especially if you can improve your control - we don't all need to contribute actively to appreciate other peoples' contribution.

It might depend on how what you are injecting into, and needle length - if its softer (stomach probably softer than thighs) then I think less chance of bruising - smaller needles may lead to less bruising, especially if you are slim.

I sometimes bruise on stomach (less often now) but not enough to be a problem but have reduced to 4mm needles for some time.

But I've currently stopped using my thighs as they were bruising (and getting lumps). I am now using my buttocks (for BI, stomach for QA) and reduced my BI. But more difficult to reach. This was after seeing DSN.

If you are clumsy, could you ask your DSN (or raise at DAFNE review - I doubt if you are unique) to review your technique?. If you can stay calm, focused and consistent then that might help to identify what causes bruises. And are you spreading your injections around stomach and thighs to use the maximum area (I found DSN are good at this - they see things from a different view)?

Hope this helps.

Sep 1, 2015

mllegarf 1 post

Topic: General Discussion / Bruising on injection sites

Hi all,

Have been T1 since Jan 2008, and am a long-time 'lurker' in the forums but this is my first post.

I have a history of bruising on my injection sites (stomach and upper thighs). I am quite clumsy, and think I bruise quite easily, but these are definitely injection-related. Is this normal? Has anyone else experienced this, and are there ways of minimising this? Obviously we have to inject ourselves several times a day, and I want to make sure I'm not damaging my body permanently and that this isn't a sign of a more sinister underlying condition.

Thanks in advance for taking this post seriously - would welcome any responses.

Sep 1, 2015

lgarden 1 post

Topic: General Discussion / Mount Kilimanjaro

Hi,

I have a patient who is due to climb Mount Kilimanjaro in a month and wondered whether anyone else had done this? If so do you have any tips?

Thanks

Leonie

Aug 31, 2015

Theodore Taylor 2 posts

Topic: General Discussion / Dosage auto-calculation in apps

Hi All,

I'd really like to get the app cleared by MHRA. Would a kickstarter help in any way?

Im sure we'd all be willing to give 50 quid to get this feature back.

Perhaps i am missing the point.

Either way, thanks to the whole team for making a great app (even without the calc)

Aug 31, 2015

Nat-Sav 15 posts

Topic: Carbohydrate Counting / Restaurants - Nutritional Information

Yesterday I came across a helpful list done by UCLH of restaurants & food outlets & cinemas who publish their nutritional info: . Nutritional info (I will post this link on the Carb Links section too.)

Harvester is 1 place that has recently published its nutritional info. I went there for lunch today, was able to calculate my QA dose accurately, and my BG now is a lovely 7.0. Very Happy

Nice when things work! So glad they have published the info now. I would have got it completely wrong otherwise - just a little example, there was 1.42cp just in the tiny pot of sauce, who knew!

If I'm arranging a meal out I like to choose places who've published carb information. It's nice on the odd occassion to be able to tuck in to some good food without worrying too much about the consequences over the next few hours... even if it something as simple as a bread roll with chips (which can sometimes be tricky to estimate because of variations in size/portion/fat content etc).

Hopefully you will find the UCLH link useful. It would be nice if there were some more Indian/Chinese places on it, but I suppose you can't expect everything! I have been in touch with some local restaurants & a some want to look into getting their nutritional information calculated, because a few customers have already asked for this. I wonder if anyone knows how I could point them in the right direction? I have no idea how a restaurant would go about this? Presumably there is a lab?

Aug 30, 2015

DavidBlackman 6 posts

Topic: General Discussion / Dosage auto-calculation in apps

Hi Simon,
Really disappointed by the MHRA decision, what a bunch of Pricks! These sorts of apps are an absolute life changer for us Type 1s and our medical teams and the removal of this function, which is available on a lot of other apps, significantly reduces its usability and makes our lives just a bit harder, again.

Well done for all the work you and others have put into this app, as you can see and probably already know it is appreciated by many.

Any suggestions from anyone on who we might be raise the issue with to see if it can be changed?

David, Melbourne Australia Mad

Aug 30, 2015

Simon 578 posts

Topic: General Discussion / Dosage auto-calculation in apps

Hi Graeme,

Unfortunately not, there is no way to go backwards with mobile apps. Sorry about that.

Thanks to all who have been understanding about this issue, it really helps in spite of the fact that others have been less supportive and some even abusive on the App Store reviews.

Aug 29, 2015

Graeme Skipper 1 post

Topic: General Discussion / Dosage auto-calculation in apps

I have just yesterday innocently updated my app, and was really surprised at the removal of the auto calc feature. Is there any way of removing the update and going back to previous version?

Aug 28, 2015

marke 686 posts

Topic: General Discussion / Dosage auto-calculation in apps

Hi Annette,
Sorry but you letter enforces the fact that the app was being used to make decisions on insulin doses. Since insulin is considered a 'serious' drug i.e it can easily kill you, the fact people are saying they use it to make judgements like driving will just convince the MHRA they have made the right decision. Most drug companies invest large amounts of money into this kind of thing, not because it is hugely complicated but because of the potential consequences if the dose suggested is wrong. Thus the calculations are subject to lots of regulations and the drug companies all have large liability insurance to cover 'accidents'.
That's not so say I agree with the MHRA in any way, all we were doing is implementing a calculation that the user now has to do manually and is more likely to get wrong. However if we do get it wrong we can only blame ourselves and sadly in the current world thats all the MHRA care about. Your Diabetes Nurse may well say she disagrees 'unofficially', however her CCG will not say that they will support the MHRA for fear of being sued by patients.
Cynical me ? No, I have to work with people like the MHRA and NHS. I know how they work. Sorry.

Aug 28, 2015

Annette Bell 72 posts

Topic: General Discussion / Dosage auto-calculation in apps

JenC said:
Unfair to direct frustrations at the site admin - to have an app at all is such an improvement on how things used to be. I have Type 1 diabetes 20 years and really appreciate advances such as this which make life that little bit easier - like carrying around tatty diaries in your handbag.

Yes, the auto calc function was very useful - but a simple calculation can be done (like you would have to have done previously!)

If you read my post properly, you'll see that I wasn't having a go at site admin, it was a copy of an e-mail which I sent to the MHRA.

Aug 28, 2015

Ellen 10 posts

Topic: General Discussion / High blood sugars

I upped my levemir by 1 unit last night and things seemed to have settled down and sugar levels stayed level all night Smile

thanks for all your help
Ellen

Aug 28, 2015

alturn 78 posts

Topic: General Discussion / High blood sugars

Have you checked your injection sites? As you are high, may be worth changing if possible as insulin sensitivity may change (I was using my thighs for Levemir and then switched to bottom to give thighs a rest. But other factors may be at work e.g. temperature/exercise).

Or could you still be on an emotional "high" from the festival, or as Warwick mentioned, changed activity?

Should have put this in my original post but can't think of more than thing at one time - senior moments Question

Aug 28, 2015

JenC 4 posts

Topic: General Discussion / Dosage auto-calculation in apps

Unfair to direct frustrations at the site admin - to have an app at all is such an improvement on how things used to be. I have Type 1 diabetes 20 years and really appreciate advances such as this which make life that little bit easier - like carrying around tatty diaries in your handbag.

Yes, the auto calc function was very useful - but a simple calculation can be done (like you would have to have done previously!)

Aug 28, 2015

Warwick 425 posts

Topic: General Discussion / High blood sugars

Sometime random things can happen like this. I suggest upping your basal insulin as per the DAFNE guidelines - 10% increase and wait for three days, and keep trying to correct any highs with QA as you have been doing. Sometimes our bodies can just become more insulin resistant, and larger doses of insulin are required than previously.

It may also be that one of your insulins has stopped working. Levemir worked brilliantly for me for over a year, but I am coming off it in the next few weeks as I've had to increase my doses dramatically recently and also I now get pain and swelling at each injection site which lasts about a week.

I find when I stop exercising, my insulin sensitivity decreases. I also tend to need more insulin during colder months than summer.

Sep 3, 2015 bejt1 3 posts	Topic: General Discussion / Dosage auto-calculation in apps novorapidboi26 said: All dosage calculations should be done at the meter end I think, not an app.......... getting more meters with some kind of bolus wizard is key..........there are a few out there already....... As a DAFNE graduate you will have received education on how to calculate your insulin dosage manually and this is the correct approach. The use of meters and DAFNEONLINE to determine the insulin dosage is simply the application of algorithm or calculations that follow the DAFNE principals. The answer is not at"the meter end" as you say but in whatever device you may want to use. DAFNEONLINE was a very good tool to use for this purpose but is of little use now.

Sep 3, 2015 bejt1 3 posts	Topic: General Discussion / Dosage auto-calculation in apps marke said: Hi bejt1, sorry I don't understand your post at all. Who are you aiming it at ? If its us at dafneonline then you need to read the thread properly. No the auto-calculate won't be re-introduced and we have explained why. If its aimed at the MHRA, then they don't read or care about dafneonline.... If you follow the thread and observe the comments about people making decisions using DAFNEONLINE then you will understand my post! I get very frustrated by organisations making decisions that affect others which are accepted without significant opposition. To say that MHRA don't care about DAFNE would suggest that you just want an easy life and are prepared to role over and have your tummy tickled. Why not organise a petition or campaign that gets this issue resolved, I am sure that it would be supported!

Sep 3, 2015 novorapidboi26 1,819 posts	Topic: General Discussion / Dosage auto-calculation in apps All dosage calculations should be done at the meter end I think, not an app.......... getting more meters with some kind of bolus wizard is key..........there are a few out there already.......

Sep 3, 2015 marke 686 posts	Topic: General Discussion / Dosage auto-calculation in apps Hi bejt1, sorry I don't understand your post at all. Who are you aiming it at ? If its us at dafneonline then you need to read the thread properly. No the auto-calculate won't be re-introduced and we have explained why. If its aimed at the MHRA, then they don't read or care about dafneonline....

Sep 3, 2015 bejt1 3 posts	Topic: General Discussion / Dosage auto-calculation in apps I have just updated my DAFNE ONLINE APP and discovered that the auto calculation feature is no longer available. It appears that a decision to remove the facility has been made without user consultation and that users are now dissatisfied with the app. I don't agree with the reason given for the removal of the auto calculation as it does not credit the user for the interaction with the app in setting targets and ratios in response to historical diary data but appears to insult users by suggesting that the app is used to make decisions about insulin dosage on a purely mechanistic process. Obviously DAFNE cannot be used without some understanding of the calculation process and the auto calculation simply speeded up the dose calculation by allowing users to more conveniently determine their dose once the settings had been entered. In addition the automatic uploading of the data to DAFNEONLINE created a convenient diary record which I found very useful when visiting a clinic. The question I now need to consider is: why should I continue to use DAFNEONLINE as it has now been reduced to a carb counter and diary, should I look for another app, or will the auto calculation be reinstated? I have always been hopeless at keeping a paper diary but enter about six readings a day into DAFNEONLINE for my clinician to observe, the loss of this facility is a backwards and negative decision which I feel has been made by people who don't understand to use of the app. Please put it right

Sep 3, 2015 Alan 49 284 posts	Topic: Site Development / Diary changes Looks like the Multiple Entry page has been compressed slightly - is this deliberate?

Sep 2, 2015 Politikaal 6 posts	Topic: General Discussion / Dosage auto-calculation in apps Hi Carolina, Yes, I have had a look on the App Store and there is a plethora of apps available with automatic dose calculation. I have been experimenting with RapidCalc as was recommended by another member last week and am quite impressed. I guess these apps are developed in other countries that aren't subject to such restrictive nanny state bureaucracies. I don't want to be promoting other apps on this forum, one thing that none of them have is the automatic upload and contact with our DAFNE community. The auto calculation really does make a difference for me though; anything to make diabetic life just that little bit easier is always going to be a plus. Again, I hope our hardworking team can find a way to get around this.

Sep 2, 2015 carolinapast... 1 post	Topic: General Discussion / Dosage auto-calculation in apps There is an App called Insulin Pro which is basically a dose calculator. You just have to adjust your settings and you're good to go

Sep 1, 2015 alturn 78 posts	Topic: General Discussion / Bruising on injection sites Welcome to the forums, no harm in being a lurker especially if you can improve your control - we don't all need to contribute actively to appreciate other peoples' contribution. It might depend on how what you are injecting into, and needle length - if its softer (stomach probably softer than thighs) then I think less chance of bruising - smaller needles may lead to less bruising, especially if you are slim. I sometimes bruise on stomach (less often now) but not enough to be a problem but have reduced to 4mm needles for some time. But I've currently stopped using my thighs as they were bruising (and getting lumps). I am now using my buttocks (for BI, stomach for QA) and reduced my BI. But more difficult to reach. This was after seeing DSN. If you are clumsy, could you ask your DSN (or raise at DAFNE review - I doubt if you are unique) to review your technique?. If you can stay calm, focused and consistent then that might help to identify what causes bruises. And are you spreading your injections around stomach and thighs to use the maximum area (I found DSN are good at this - they see things from a different view)? Hope this helps.

Sep 1, 2015 mllegarf 1 post	Topic: General Discussion / Bruising on injection sites Hi all, Have been T1 since Jan 2008, and am a long-time 'lurker' in the forums but this is my first post. I have a history of bruising on my injection sites (stomach and upper thighs). I am quite clumsy, and think I bruise quite easily, but these are definitely injection-related. Is this normal? Has anyone else experienced this, and are there ways of minimising this? Obviously we have to inject ourselves several times a day, and I want to make sure I'm not damaging my body permanently and that this isn't a sign of a more sinister underlying condition. Thanks in advance for taking this post seriously - would welcome any responses.

Sep 1, 2015 lgarden 1 post	Topic: General Discussion / Mount Kilimanjaro Hi, I have a patient who is due to climb Mount Kilimanjaro in a month and wondered whether anyone else had done this? If so do you have any tips? Thanks Leonie

Aug 31, 2015 Theodore Taylor 2 posts	Topic: General Discussion / Dosage auto-calculation in apps Hi All, I'd really like to get the app cleared by MHRA. Would a kickstarter help in any way? Im sure we'd all be willing to give 50 quid to get this feature back. Perhaps i am missing the point. Either way, thanks to the whole team for making a great app (even without the calc)

Aug 31, 2015 Nat-Sav 15 posts	Topic: Carbohydrate Counting / Restaurants - Nutritional Information Yesterday I came across a helpful list done by UCLH of restaurants & food outlets & cinemas who publish their nutritional info: . Nutritional info (I will post this link on the Carb Links section too.) Harvester is 1 place that has recently published its nutritional info. I went there for lunch today, was able to calculate my QA dose accurately, and my BG now is a lovely 7.0. Nice when things work! So glad they have published the info now. I would have got it completely wrong otherwise - just a little example, there was 1.42cp just in the tiny pot of sauce, who knew! If I'm arranging a meal out I like to choose places who've published carb information. It's nice on the odd occassion to be able to tuck in to some good food without worrying too much about the consequences over the next few hours... even if it something as simple as a bread roll with chips (which can sometimes be tricky to estimate because of variations in size/portion/fat content etc). Hopefully you will find the UCLH link useful. It would be nice if there were some more Indian/Chinese places on it, but I suppose you can't expect everything! I have been in touch with some local restaurants & a some want to look into getting their nutritional information calculated, because a few customers have already asked for this. I wonder if anyone knows how I could point them in the right direction? I have no idea how a restaurant would go about this? Presumably there is a lab?

Aug 30, 2015 DavidBlackman 6 posts	Topic: General Discussion / Dosage auto-calculation in apps Hi Simon, Really disappointed by the MHRA decision, what a bunch of Pricks! These sorts of apps are an absolute life changer for us Type 1s and our medical teams and the removal of this function, which is available on a lot of other apps, significantly reduces its usability and makes our lives just a bit harder, again. Well done for all the work you and others have put into this app, as you can see and probably already know it is appreciated by many. Any suggestions from anyone on who we might be raise the issue with to see if it can be changed? David, Melbourne Australia

Aug 30, 2015 Simon 578 posts	Topic: General Discussion / Dosage auto-calculation in apps Hi Graeme, Unfortunately not, there is no way to go backwards with mobile apps. Sorry about that. Thanks to all who have been understanding about this issue, it really helps in spite of the fact that others have been less supportive and some even abusive on the App Store reviews.

Aug 29, 2015 Graeme Skipper 1 post	Topic: General Discussion / Dosage auto-calculation in apps I have just yesterday innocently updated my app, and was really surprised at the removal of the auto calc feature. Is there any way of removing the update and going back to previous version?

Aug 28, 2015 marke 686 posts	Topic: General Discussion / Dosage auto-calculation in apps Hi Annette, Sorry but you letter enforces the fact that the app was being used to make decisions on insulin doses. Since insulin is considered a 'serious' drug i.e it can easily kill you, the fact people are saying they use it to make judgements like driving will just convince the MHRA they have made the right decision. Most drug companies invest large amounts of money into this kind of thing, not because it is hugely complicated but because of the potential consequences if the dose suggested is wrong. Thus the calculations are subject to lots of regulations and the drug companies all have large liability insurance to cover 'accidents'. That's not so say I agree with the MHRA in any way, all we were doing is implementing a calculation that the user now has to do manually and is more likely to get wrong. However if we do get it wrong we can only blame ourselves and sadly in the current world thats all the MHRA care about. Your Diabetes Nurse may well say she disagrees 'unofficially', however her CCG will not say that they will support the MHRA for fear of being sued by patients. Cynical me ? No, I have to work with people like the MHRA and NHS. I know how they work. Sorry.

Aug 28, 2015 Annette Bell 72 posts	Topic: General Discussion / Dosage auto-calculation in apps JenC said: Unfair to direct frustrations at the site admin - to have an app at all is such an improvement on how things used to be. I have Type 1 diabetes 20 years and really appreciate advances such as this which make life that little bit easier - like carrying around tatty diaries in your handbag. Yes, the auto calc function was very useful - but a simple calculation can be done (like you would have to have done previously!) If you read my post properly, you'll see that I wasn't having a go at site admin, it was a copy of an e-mail which I sent to the MHRA.

Aug 28, 2015 Ellen 10 posts	Topic: General Discussion / High blood sugars I upped my levemir by 1 unit last night and things seemed to have settled down and sugar levels stayed level all night thanks for all your help Ellen

Aug 28, 2015 alturn 78 posts	Topic: General Discussion / High blood sugars Have you checked your injection sites? As you are high, may be worth changing if possible as insulin sensitivity may change (I was using my thighs for Levemir and then switched to bottom to give thighs a rest. But other factors may be at work e.g. temperature/exercise). Or could you still be on an emotional "high" from the festival, or as Warwick mentioned, changed activity? Should have put this in my original post but can't think of more than thing at one time - senior moments

Aug 28, 2015 JenC 4 posts	Topic: General Discussion / Dosage auto-calculation in apps Unfair to direct frustrations at the site admin - to have an app at all is such an improvement on how things used to be. I have Type 1 diabetes 20 years and really appreciate advances such as this which make life that little bit easier - like carrying around tatty diaries in your handbag. Yes, the auto calc function was very useful - but a simple calculation can be done (like you would have to have done previously!)

Aug 28, 2015 Warwick 425 posts	Topic: General Discussion / High blood sugars Sometime random things can happen like this. I suggest upping your basal insulin as per the DAFNE guidelines - 10% increase and wait for three days, and keep trying to correct any highs with QA as you have been doing. Sometimes our bodies can just become more insulin resistant, and larger doses of insulin are required than previously. It may also be that one of your insulins has stopped working. Levemir worked brilliantly for me for over a year, but I am coming off it in the next few weeks as I've had to increase my doses dramatically recently and also I now get pain and swelling at each injection site which lasts about a week. I find when I stop exercising, my insulin sensitivity decreases. I also tend to need more insulin during colder months than summer.