Recent Posts - DAFNE Online

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 14 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 574 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 646 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 58 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 430 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.

Aug 27, 2015

Ellen 10 posts

Topic: General Discussion / High blood sugars

Hi

I've checked for ketones and haven't had any even when I've been 18 or over. They have been over 10 for days now hopefully the nurses will get back to me soon and thank you.

Ellen

Aug 27, 2015

alturn 78 posts

Topic: General Discussion / High blood sugars

Could you picked up an infection of some sort? May be worth checking for ketones if "high" (I would use the DAFNE definition for this, but I think of anything over 10 as high, don't know what you regard as high).

If "high" it can be more difficult to get BGs down so correction ratios and BI may need to changed.

Hope this helps.
J

Aug 27, 2015

Ellen 10 posts

Topic: General Discussion / High blood sugars

Hello

For the past 4/5 days I've had high blood sugars, have managed to get them down to 8 and then th went straight back up again, I have rang the diabetic nurses but still waiting on a phone call back and just wondered if any of you could help. I have changed all my insulin cartridges and I went to a festival at he weekend so thought it might be that they had gone off but I'm still having problems. I have upped my novorapid doses with all meals by 30% and will try upping my levimir tonight but the problem is none of my correction doses are working for some reason has any one else experienced this?

Thanks
Ellen

Aug 26, 2015

Annette Bell 58 posts

Topic: General Discussion / Dosage auto-calculation in apps

I have sent this e-mail to the address you provided. Probably won't make any difference, but I wanted to make my feelings, and opinion, known!:

I am a DAFNE graduate and have been using this app ever since completeing the DAFNE course in 2008. I was appalled when I realised that the latest update has removed the auto calculation of QA insulin from the app.The auto calculation of QA insulin is an invaluable component of this app as I have variable insulin doses depending on time of day. It also reminds me to reduce my dosage if my BG is low, especially before driving, as a low BG when driving is extremely dangerous for myself, and other road users! I think it is very short sighted of you to insist that this part of the app be removed as it will make diabetic control for DAFNE graduates more difficult and, therefore, could, in the long term, end up costing the NHS more money in hospital admissions. Obviously, we donâ€™t rely entirely on this calculation, and use it at our discretion, but it is a useful guide in moments of uncertainty, e.g when going hypoglycaemic! It is not a â€œmedical deviceâ€ as it does not have to be followed strictly. It is, as I say, just a very useful guide, which can be ignored if required. There are obviously no diabetics in the team which made this decision. Maybe you should talk to some, especially DAFNE graduates!
I have spoken to my diabetes nurse and she thinks this is a ludicrous decision too. She doesnâ€™t see how this can be classed as a medical device either.

I sincerely hope you will rethink & reverse this decision.

Annette Bell (Mrs)

Aug 26, 2015

Stew B 123 posts

Topic: General Discussion / Dafne diary and melt down

Hi

I've posted before to say that you can get "official" DAFNE diaries via the DAFNE website: http://www.dafne.uk.com/dafneshop-64.html . 75p each.

Really good service too.

Stew

Aug 25, 2015

Paul Patterson 7 posts

Topic: General Discussion / Dosage auto-calculation in apps

Apparently there is another app called RapidCalc. It's only on iOS, is a paid app $10, it doesn't link with the DAFNE app. However, it's been based on the smart features of an insulin pump so it's possibly more reliable than other insulin bolus calculators.

Aug 25, 2015

dolly girl 1 post

Topic: General Discussion / Dosage auto-calculation in apps

Hi Everyone, Yes I'm very disappointed regarding the removal of the auto calculation as this is an invaluable tool! Noboby at the hospital was aware of this removal either! Rolling Eyes

Aug 25, 2015

Paul Patterson 7 posts

Topic: General Discussion / Dosage auto-calculation in apps

bummer as it was a very useful tool after completing the DAFNE NZ course, I noticed my control lis bit all over the show after the update, the calc helped me keep in touch with my CP calculations.

Aug 25, 2015

alturn 78 posts

Topic: General Discussion / Dafne diary and melt down

You might get diaries from your meter supplier.

Aug 25, 2015

dunkers7 24 posts

Topic: General Discussion / Dafne diary and melt down

Hi Martine,

Sounds like it's sorted now but may also be worth having a look at the diarys from diabetes.co.uk for the future. Not quite as good for space as the DAFNE ones but if you have access to a printer you could print off a few sheets quickly:

http://www.diabetes.co.uk/downloads/blood-glucose-monitoring-diary/weekly-diary-with-doses.pdf

Aug 24, 2015

Frazer 16 posts

Topic: General Discussion / Cyborg Times (new BG meter)

Yes - ordered last Monday and they say will be delivered end of next week.

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 14 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 574 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 646 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 58 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 430 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.

Aug 27, 2015 Ellen 10 posts	Topic: General Discussion / High blood sugars Hi I've checked for ketones and haven't had any even when I've been 18 or over. They have been over 10 for days now hopefully the nurses will get back to me soon and thank you. Ellen

Aug 27, 2015 alturn 78 posts	Topic: General Discussion / High blood sugars Could you picked up an infection of some sort? May be worth checking for ketones if "high" (I would use the DAFNE definition for this, but I think of anything over 10 as high, don't know what you regard as high). If "high" it can be more difficult to get BGs down so correction ratios and BI may need to changed. Hope this helps. J

Aug 27, 2015 Ellen 10 posts	Topic: General Discussion / High blood sugars Hello For the past 4/5 days I've had high blood sugars, have managed to get them down to 8 and then th went straight back up again, I have rang the diabetic nurses but still waiting on a phone call back and just wondered if any of you could help. I have changed all my insulin cartridges and I went to a festival at he weekend so thought it might be that they had gone off but I'm still having problems. I have upped my novorapid doses with all meals by 30% and will try upping my levimir tonight but the problem is none of my correction doses are working for some reason has any one else experienced this? Thanks Ellen

Aug 26, 2015 Annette Bell 58 posts	Topic: General Discussion / Dosage auto-calculation in apps I have sent this e-mail to the address you provided. Probably won't make any difference, but I wanted to make my feelings, and opinion, known!: I am a DAFNE graduate and have been using this app ever since completeing the DAFNE course in 2008. I was appalled when I realised that the latest update has removed the auto calculation of QA insulin from the app.The auto calculation of QA insulin is an invaluable component of this app as I have variable insulin doses depending on time of day. It also reminds me to reduce my dosage if my BG is low, especially before driving, as a low BG when driving is extremely dangerous for myself, and other road users! I think it is very short sighted of you to insist that this part of the app be removed as it will make diabetic control for DAFNE graduates more difficult and, therefore, could, in the long term, end up costing the NHS more money in hospital admissions. Obviously, we donâ€™t rely entirely on this calculation, and use it at our discretion, but it is a useful guide in moments of uncertainty, e.g when going hypoglycaemic! It is not a â€œmedical deviceâ€ as it does not have to be followed strictly. It is, as I say, just a very useful guide, which can be ignored if required. There are obviously no diabetics in the team which made this decision. Maybe you should talk to some, especially DAFNE graduates! I have spoken to my diabetes nurse and she thinks this is a ludicrous decision too. She doesnâ€™t see how this can be classed as a medical device either. I sincerely hope you will rethink & reverse this decision. Annette Bell (Mrs)

Aug 26, 2015 Stew B 123 posts	Topic: General Discussion / Dafne diary and melt down Hi I've posted before to say that you can get "official" DAFNE diaries via the DAFNE website: http://www.dafne.uk.com/dafneshop-64.html . 75p each. Really good service too. Stew

Aug 25, 2015 Paul Patterson 7 posts	Topic: General Discussion / Dosage auto-calculation in apps Apparently there is another app called RapidCalc. It's only on iOS, is a paid app $10, it doesn't link with the DAFNE app. However, it's been based on the smart features of an insulin pump so it's possibly more reliable than other insulin bolus calculators.

Aug 25, 2015 dolly girl 1 post	Topic: General Discussion / Dosage auto-calculation in apps Hi Everyone, Yes I'm very disappointed regarding the removal of the auto calculation as this is an invaluable tool! Noboby at the hospital was aware of this removal either!

Aug 25, 2015 Paul Patterson 7 posts	Topic: General Discussion / Dosage auto-calculation in apps bummer as it was a very useful tool after completing the DAFNE NZ course, I noticed my control lis bit all over the show after the update, the calc helped me keep in touch with my CP calculations.

Aug 25, 2015 alturn 78 posts	Topic: General Discussion / Dafne diary and melt down You might get diaries from your meter supplier.

Aug 25, 2015 dunkers7 24 posts	Topic: General Discussion / Dafne diary and melt down Hi Martine, Sounds like it's sorted now but may also be worth having a look at the diarys from diabetes.co.uk for the future. Not quite as good for space as the DAFNE ones but if you have access to a printer you could print off a few sheets quickly: http://www.diabetes.co.uk/downloads/blood-glucose-monitoring-diary/weekly-diary-with-doses.pdf

Aug 24, 2015 Frazer 16 posts	Topic: General Discussion / Cyborg Times (new BG meter) Yes - ordered last Monday and they say will be delivered end of next week.