Recent Posts - DAFNE Online

Aug 17, 2015

Phil Maskell 194 posts

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

Anyone else having issues with Abbot not being able to produce/deliver sensors.

I think they are a victim of their own success, I don't think they can keep up with demand. Who would have thought a cheap alternative CGM for T1 diabetics would be popular?

I am out of sensors, keen cyclist and feel lost without it on rides now!

Aug 17, 2015

JayBee 582 posts

Topic: General Discussion / Dosage auto-calculation in apps

I noticed the change first thing this morning.
Not impressed.

Aug 14, 2015

Simon 574 posts

Topic: General Discussion / Dosage auto-calculation in apps

Unfortunately we will have to remove the auto-calculation of insulin dosage from the iOS and Android apps in the next update. By including a calculation function it means the app is classed as a "medical device" and as such needs to be regulated by the MHRA. This involves a long and expensive certification process (thousands of pounds) which as DAFNE Online is done in our spare time as DAFNE graduates is something we simply cannot afford to do. We were approached by the MHRA who in no uncertain terms told us to either remove the apps from sale or get them certified; we did however manage to agree with them that by removing the calculation function from the apps then it would declassify them as medical devices so the rest of the functions can remain and they can stay on sale in the app stores.

I know this was a useful feature for many of you, so I apologise that it will be disappearing from the apps. We will work with the NHS DAFNE team to see what is possible regarding certification, but in the short term we needed to get the apps back under compliance to allow them to continue to be available for DAFNE Graduates.

Simon

Aug 14, 2015

Phil Maskell 194 posts

Topic: General Discussion / Night time Hypo - Depression!

novorapidboi26,

From the freestyle website:

Sensor water resistance IP27: Can withstand immersion into one metre (3 ft) of water for up to 30 minutes

https://www.freestylelibre.co.uk/freestyle-libre-sensor-kit-en-gb-es.html

I've had baths/showers with it on, but not been swimming yet, holiday next week will be a good test Very Happy

I honestly think they should be on NHS, I forgot to order new one quick enough and feel lost without it at the moment, HbA1c gone from 7.9 to 6.7, purely due to seeing that I was running high overnight. I also feel happier running lower as I know the trend, if I test and am 4, I don't know if I'm going up or down based on this, but with Libre I get an arrow to tell me.

Hope this helps.

Phil

Aug 14, 2015

Warwick 430 posts

Topic: General Discussion / Burnout

Also, please look at getting some professional counselling, preferably from someone who has experience with burnout from diabetes management. It is incredibly common to experience burnout from managing diabetes. Here in Australia, diabetics are twice as likely as the general population to experience depression. Your GP should be able to refer you to a good counsellor, and sharing your issues with someone who can help with strategies to overcome the burnout is likely to be very helpful in escaping from this.

Managing T1D is hard enough without dealing with burnout too, so please get some help in tackling this, and everything else will get easier.

Aug 14, 2015

Warwick 430 posts

Topic: Questions for HCPs / morning BI

Hi Ruth,

That would be completely up to you. If your BGs are high at 6 am, you may want to inject your BI a bit earlier. If (like me) you tend to hypo when having a nap, then you might not. It is completely up to you depending on how your body responds to an earlier basal injection.

Aug 13, 2015

novorapidboi26 1,816 posts

Topic: Questions for HCPs / morning BI

rising and retiring............. Very Happy

is this a new slogan?

I say new but I graduated in 2009, so a while back now......

Aug 13, 2015

dunkers7 24 posts

Topic: General Discussion / Burnout

Yeah, if you've been diabetic for long enough, you've been there. I'm 22 years in.

My experience is this is just a temporary state caused by elevated BGs. You need to do what you can to get out of that situation.

It sounds like carb counting isn't working too well just now, I'd suggest going back to basics. Simplify the problem. Test your basal insulin, this needs to be right before the carb counting can work as intended. Take notes so you know what works and what doesn't.

The main point of all this effort is to be able to look back years from now and know you did good.

Good luck.

Aug 12, 2015

novorapidboi26 1,816 posts

Topic: General Discussion / Night time Hypo - Depression!

Is the Libre sensor water proof?

Aug 11, 2015

lucy1gus2 13 posts

Topic: General Discussion / Apple Cider Vinegar

Hi Pippa,

Apparently it's an old fashioned folk remedy which I read about. Then I found victoriahealth.com were also suggesting the benefits were worth considering. The theory is that the acetic acid found in Apple Cider Vinegar slows the digestion of starch leading to low sugar levels in the bloodstream.I purchase Organic Apple Cider Vinegar with mother from Higher Nature. Â£6-70/350ml

I take 5ml in 250ml of water as I start eating before meals and then use the Dafne regime with regards to CP and insulin..

Admittedly its early days but there does seem to be some sort of effect ( for the better ) on my blood glucose levels. I am using a 1 to !0CP ratio and am on Novorapid at meals and Lantus at bed ( but also on Metformin 850 x3 times day )

Need to fine tune but looking good. Also look up apple cider vinegar on the internet

Aug 11, 2015

Pippa Mc 4 posts

Topic: General Discussion / Apple Cider Vinegar

Hi Lucy,

No, I haven't heard of it before, what is the science behind it? Where did you hear of it from?

How is it working?

Aug 9, 2015

hypo 18 posts

Topic: General Discussion / Needle Bins

I order my sharps bin on my repeat prescription and return it to the pharmacy when full.

Aug 9, 2015

lucy1gus2 13 posts

Topic: General Discussion / Apple Cider Vinegar

Has anybody tried using this vinegar before meals and bed to reduce their BG. I'm Type 1 and have been trying it for the past week. Getting some good readings but also some lows which as usual is a pain.

Regards

Aug 7, 2015

Warwick 430 posts

Topic: General Discussion / Low Carb

Unfortunately everyone is different, and what works for me may or may not work for you. Prior to low carb, I'd have a couple of Weetbix with milk prior to a half ironman, but before the last one I didn't have anything at all except water to ensure I was not going to dehydrate. That was after a period of acclimatisation though. When keto-adapted, you don't need to fuel up as you do when you are used to when on a high-carb diet. The body can store 2000 KCal from carbs which can be used up quickly during a long event hence the need for constant replenishment. The body can store 40,000 KCal using fat, so there is far less need to fuel up when keto-adapted.

I did a half marathon the weekend before last, and had scrambled eggs prior to the event and had no issues during the event. It was my 42nd half marathon though, so my stomach got used to shutting up about discomfort a while ago :-)

It is very common for insulin needs to increase initially over the first few weeks. Most people trying this do experience that. I don't know the science behind it, I just know that it happens and that it does settle down after a few weeks.

I find that when I eat a low carb meal that has protein in it, I have to bolus for the protein. Other T1Ds have no such trouble, again it is all individual. If your body is used to using carbs as fuel and you suddenly limit the amount of carb you are eating, then if your body can make carbs from protein (and it can), then it probably will.

Oh, and if you start getting headaches, read the section of the book about broth. It is VERY common to get headaches in the transition period but very easily treated.

Aug 7, 2015

Phil Maskell 194 posts

Topic: General Discussion / Low Carb

Warwick,

I went for a 10+ hour bike ride last weekend on no carbs, had spinach and cheese omelette for breakfast, cooked in butter for fat content. After 2 to 3 hours this didn't sit very well, felt sooo sick.

I have since read that eggs on a low carb diet are not the best idea before alot of exercise, what do you eat prior to ironman training?

I have also found going low carb this week that for some strange reason my BGs have risen and I seem to be injecting quite alot of QA for nuts and salad, is this just me needing some QA anyway, is this normally included in my carb QA? Did you notice anything similar?

Phil

Aug 7, 2015

HelenH 9 posts

Topic: Questions for HCPs / High BG's after fracture

Thanks all,
Starting to get back on track; think it was a combination of everything! I have increased my qa:carb ratios & that seems to be working. Also now getting a bit more mobile - injuries other than the fracture have made crutches very difficult!

Aug 5, 2015

Warwick 430 posts

Topic: Carbohydrate Counting / Beans and lentils

I experimented with doing two half doses, 3 hours apart which worked better than a single dose of the full amount which led to hypos. I am also experimenting with a slower-acting insulin (not basal and not QA) which has an action time of about 6-8 hours but the jury is still out on that.

Aug 4, 2015

Pippa Mc 4 posts

Topic: Carbohydrate Counting / Beans and lentils

Hello,

I have a similar query related to butter beans - I had them in quesadillas mashed up and didn't account for these, as per DAFNE guidelines.. I just accounted for the tortillas. However at nighttime my BG was sky high.. whilst I haven't been very well so my BG readings have been slightly high I don't think that it would account for this.

I suspect that mashing these up has impacted upon the way they are digested - has anyone else experienced this? I am thinking of trying half insulin dosage, unless anyone else has any ideas that have worked for them.

Thanks,

Aug 3, 2015

michaelj 45 posts

Topic: Questions for HCPs / High BG's after fracture

Broke my foot on 1st July and my BS were all over the place for 2 days. Now moving around on crutches and thanks to the extra effort to get anywhere, bloods have more or less gone back to normal. Stick with it, it'll come right in the end. The body does all sorts of weird things in times of stress.

Jul 31, 2015

Whyters 2 posts

Topic: General Discussion / Needle Bins

I live in Maidstone Kent and I order a sharps box on my repeat prescription and then call the council to pick up my full one the council store my details of where to find them if I am out I just give address and they usually collect from my front porch normally on a Tuesday morning I usually call when I have 4 of the 1 ltr boxes this is my choice as I feel collecting one is wasting the council time and money never had any issues with this superb service.

Jul 31, 2015

Warwick 430 posts

Topic: General Discussion / Low Carb

My basal insulin needs went from 10 in the morning and 16 at night to two doses of 6 each. There were a few hypos involved. Just test more often and gradually lower basal. You'll find a sweet spot, but your risk of hypos will increase a bit.

Fat has twice the energy of carbs, so you probably don't need to worry about weight loss too much. I lost a bit of weight, but I weighed more than I did at diagnosis so I was quite happy with that. You don't need a lot of extra fat in the diet to maintain your weight. Go for the healthy fats like avocados and olives, but you don't need very much.

I don't tell other people what I am doing unless they notice. It is difficult eating out (especially as I am vegetarian too), but assuming you eat meat, if you order a steak, or salmon steak etc with a side salad then that will be low carb and higher fat. I need to eat out at a pub next week and looking at the menu, I'm going to be ordering a side salad and the cheese board. :-) Also, just because you are served carbs at a restaurant doesn't mean you have to eat them. Eating out with some other diabetics who are practicing LCHF, we were served quiche in pastry. We just ate the quiche part, without eating the pastry, and bundled the pastry into napkins for a bin on the way home.

The transition will be trial and error with insulin needs, but once you are there, it will be much easier on your long bike rides.

Jul 31, 2015

Pippa Mc 4 posts

Topic: Carbohydrate Counting / Greenwheat Freekeh

Just been doing a little googling and found below - working on this logic would it be fair to consider that I should consider halving insulin - might give this a go and see how I get on..

"Low carb" food. Resistant starch plus high in fiber (up to 16.5% fiber). Available carbs are about 45 units / 100.

Jul 31, 2015

Pippa Mc 4 posts

Topic: Carbohydrate Counting / Greenwheat Freekeh

Hello,

I am looking for some advice in relation to Greenwheat Freekeh.

Nutritional information suggests that 100g of the stuff equates to 6-6.5 CP - however as a low GI food I'm not sure what to do with it - I can't find anything specifically related to this grain..

Any help greatly appreciated - lunch is calling!

Thanks,

Pippa

Jul 31, 2015

Phil Maskell 194 posts

Topic: General Discussion / Low Carb

Warwick,

Quick question, like I said above I often go out on 5+ hour rides (sometime 15+), while trying to become fat adapted how did you deal with low BG? For the interim did you cut insulin to allow BG to run higher? I like the idea of not needing so many gels in my pockets, but until I am fat adapted do I ease off the exercise?

With all the exercise I do I am also on the low end of my ideal weight, being fat adapted, will this cause more weight loss? I just want to stay the same weight... What did you notice?

How do you deal with the stigma from family/friends? What do you order when eating out?

Sorry for all the questions, nice to find a diabetic that's actually done it.

Thanks,

Phil

Aug 17, 2015 Phil Maskell 194 posts	Topic: General Discussion / Cyborg Times (new BG meter) Anyone else having issues with Abbot not being able to produce/deliver sensors. I think they are a victim of their own success, I don't think they can keep up with demand. Who would have thought a cheap alternative CGM for T1 diabetics would be popular? I am out of sensors, keen cyclist and feel lost without it on rides now!

Aug 17, 2015 JayBee 582 posts	Topic: General Discussion / Dosage auto-calculation in apps I noticed the change first thing this morning. Not impressed.

Aug 14, 2015 Simon 574 posts	Topic: General Discussion / Dosage auto-calculation in apps Unfortunately we will have to remove the auto-calculation of insulin dosage from the iOS and Android apps in the next update. By including a calculation function it means the app is classed as a "medical device" and as such needs to be regulated by the MHRA. This involves a long and expensive certification process (thousands of pounds) which as DAFNE Online is done in our spare time as DAFNE graduates is something we simply cannot afford to do. We were approached by the MHRA who in no uncertain terms told us to either remove the apps from sale or get them certified; we did however manage to agree with them that by removing the calculation function from the apps then it would declassify them as medical devices so the rest of the functions can remain and they can stay on sale in the app stores. I know this was a useful feature for many of you, so I apologise that it will be disappearing from the apps. We will work with the NHS DAFNE team to see what is possible regarding certification, but in the short term we needed to get the apps back under compliance to allow them to continue to be available for DAFNE Graduates. Simon

Aug 14, 2015 Phil Maskell 194 posts	Topic: General Discussion / Night time Hypo - Depression! novorapidboi26, From the freestyle website: Sensor water resistance IP27: Can withstand immersion into one metre (3 ft) of water for up to 30 minutes https://www.freestylelibre.co.uk/freestyle-libre-sensor-kit-en-gb-es.html I've had baths/showers with it on, but not been swimming yet, holiday next week will be a good test I honestly think they should be on NHS, I forgot to order new one quick enough and feel lost without it at the moment, HbA1c gone from 7.9 to 6.7, purely due to seeing that I was running high overnight. I also feel happier running lower as I know the trend, if I test and am 4, I don't know if I'm going up or down based on this, but with Libre I get an arrow to tell me. Hope this helps. Phil

Aug 14, 2015 Warwick 430 posts	Topic: General Discussion / Burnout Also, please look at getting some professional counselling, preferably from someone who has experience with burnout from diabetes management. It is incredibly common to experience burnout from managing diabetes. Here in Australia, diabetics are twice as likely as the general population to experience depression. Your GP should be able to refer you to a good counsellor, and sharing your issues with someone who can help with strategies to overcome the burnout is likely to be very helpful in escaping from this. Managing T1D is hard enough without dealing with burnout too, so please get some help in tackling this, and everything else will get easier.

Aug 14, 2015 Warwick 430 posts	Topic: Questions for HCPs / morning BI Hi Ruth, That would be completely up to you. If your BGs are high at 6 am, you may want to inject your BI a bit earlier. If (like me) you tend to hypo when having a nap, then you might not. It is completely up to you depending on how your body responds to an earlier basal injection.

Aug 13, 2015 novorapidboi26 1,816 posts	Topic: Questions for HCPs / morning BI rising and retiring............. is this a new slogan? I say new but I graduated in 2009, so a while back now......

Aug 13, 2015 dunkers7 24 posts	Topic: General Discussion / Burnout Yeah, if you've been diabetic for long enough, you've been there. I'm 22 years in. My experience is this is just a temporary state caused by elevated BGs. You need to do what you can to get out of that situation. It sounds like carb counting isn't working too well just now, I'd suggest going back to basics. Simplify the problem. Test your basal insulin, this needs to be right before the carb counting can work as intended. Take notes so you know what works and what doesn't. The main point of all this effort is to be able to look back years from now and know you did good. Good luck.

Aug 12, 2015 novorapidboi26 1,816 posts	Topic: General Discussion / Night time Hypo - Depression! Is the Libre sensor water proof?

Aug 11, 2015 lucy1gus2 13 posts	Topic: General Discussion / Apple Cider Vinegar Hi Pippa, Apparently it's an old fashioned folk remedy which I read about. Then I found victoriahealth.com were also suggesting the benefits were worth considering. The theory is that the acetic acid found in Apple Cider Vinegar slows the digestion of starch leading to low sugar levels in the bloodstream.I purchase Organic Apple Cider Vinegar with mother from Higher Nature. Â£6-70/350ml I take 5ml in 250ml of water as I start eating before meals and then use the Dafne regime with regards to CP and insulin.. Admittedly its early days but there does seem to be some sort of effect ( for the better ) on my blood glucose levels. I am using a 1 to !0CP ratio and am on Novorapid at meals and Lantus at bed ( but also on Metformin 850 x3 times day ) Need to fine tune but looking good. Also look up apple cider vinegar on the internet

Aug 11, 2015 Pippa Mc 4 posts	Topic: General Discussion / Apple Cider Vinegar Hi Lucy, No, I haven't heard of it before, what is the science behind it? Where did you hear of it from? How is it working?

Aug 9, 2015 hypo 18 posts	Topic: General Discussion / Needle Bins I order my sharps bin on my repeat prescription and return it to the pharmacy when full.

Aug 9, 2015 lucy1gus2 13 posts	Topic: General Discussion / Apple Cider Vinegar Has anybody tried using this vinegar before meals and bed to reduce their BG. I'm Type 1 and have been trying it for the past week. Getting some good readings but also some lows which as usual is a pain. Regards

Aug 7, 2015 Warwick 430 posts	Topic: General Discussion / Low Carb Unfortunately everyone is different, and what works for me may or may not work for you. Prior to low carb, I'd have a couple of Weetbix with milk prior to a half ironman, but before the last one I didn't have anything at all except water to ensure I was not going to dehydrate. That was after a period of acclimatisation though. When keto-adapted, you don't need to fuel up as you do when you are used to when on a high-carb diet. The body can store 2000 KCal from carbs which can be used up quickly during a long event hence the need for constant replenishment. The body can store 40,000 KCal using fat, so there is far less need to fuel up when keto-adapted. I did a half marathon the weekend before last, and had scrambled eggs prior to the event and had no issues during the event. It was my 42nd half marathon though, so my stomach got used to shutting up about discomfort a while ago :-) It is very common for insulin needs to increase initially over the first few weeks. Most people trying this do experience that. I don't know the science behind it, I just know that it happens and that it does settle down after a few weeks. I find that when I eat a low carb meal that has protein in it, I have to bolus for the protein. Other T1Ds have no such trouble, again it is all individual. If your body is used to using carbs as fuel and you suddenly limit the amount of carb you are eating, then if your body can make carbs from protein (and it can), then it probably will. Oh, and if you start getting headaches, read the section of the book about broth. It is VERY common to get headaches in the transition period but very easily treated.

Aug 7, 2015 Phil Maskell 194 posts	Topic: General Discussion / Low Carb Warwick, I went for a 10+ hour bike ride last weekend on no carbs, had spinach and cheese omelette for breakfast, cooked in butter for fat content. After 2 to 3 hours this didn't sit very well, felt sooo sick. I have since read that eggs on a low carb diet are not the best idea before alot of exercise, what do you eat prior to ironman training? I have also found going low carb this week that for some strange reason my BGs have risen and I seem to be injecting quite alot of QA for nuts and salad, is this just me needing some QA anyway, is this normally included in my carb QA? Did you notice anything similar? Phil

Aug 7, 2015 HelenH 9 posts	Topic: Questions for HCPs / High BG's after fracture Thanks all, Starting to get back on track; think it was a combination of everything! I have increased my qa:carb ratios & that seems to be working. Also now getting a bit more mobile - injuries other than the fracture have made crutches very difficult!

Aug 5, 2015 Warwick 430 posts	Topic: Carbohydrate Counting / Beans and lentils I experimented with doing two half doses, 3 hours apart which worked better than a single dose of the full amount which led to hypos. I am also experimenting with a slower-acting insulin (not basal and not QA) which has an action time of about 6-8 hours but the jury is still out on that.

Aug 4, 2015 Pippa Mc 4 posts	Topic: Carbohydrate Counting / Beans and lentils Hello, I have a similar query related to butter beans - I had them in quesadillas mashed up and didn't account for these, as per DAFNE guidelines.. I just accounted for the tortillas. However at nighttime my BG was sky high.. whilst I haven't been very well so my BG readings have been slightly high I don't think that it would account for this. I suspect that mashing these up has impacted upon the way they are digested - has anyone else experienced this? I am thinking of trying half insulin dosage, unless anyone else has any ideas that have worked for them. Thanks,

Aug 3, 2015 michaelj 45 posts	Topic: Questions for HCPs / High BG's after fracture Broke my foot on 1st July and my BS were all over the place for 2 days. Now moving around on crutches and thanks to the extra effort to get anywhere, bloods have more or less gone back to normal. Stick with it, it'll come right in the end. The body does all sorts of weird things in times of stress.

Jul 31, 2015 Whyters 2 posts	Topic: General Discussion / Needle Bins I live in Maidstone Kent and I order a sharps box on my repeat prescription and then call the council to pick up my full one the council store my details of where to find them if I am out I just give address and they usually collect from my front porch normally on a Tuesday morning I usually call when I have 4 of the 1 ltr boxes this is my choice as I feel collecting one is wasting the council time and money never had any issues with this superb service.

Jul 31, 2015 Warwick 430 posts	Topic: General Discussion / Low Carb My basal insulin needs went from 10 in the morning and 16 at night to two doses of 6 each. There were a few hypos involved. Just test more often and gradually lower basal. You'll find a sweet spot, but your risk of hypos will increase a bit. Fat has twice the energy of carbs, so you probably don't need to worry about weight loss too much. I lost a bit of weight, but I weighed more than I did at diagnosis so I was quite happy with that. You don't need a lot of extra fat in the diet to maintain your weight. Go for the healthy fats like avocados and olives, but you don't need very much. I don't tell other people what I am doing unless they notice. It is difficult eating out (especially as I am vegetarian too), but assuming you eat meat, if you order a steak, or salmon steak etc with a side salad then that will be low carb and higher fat. I need to eat out at a pub next week and looking at the menu, I'm going to be ordering a side salad and the cheese board. :-) Also, just because you are served carbs at a restaurant doesn't mean you have to eat them. Eating out with some other diabetics who are practicing LCHF, we were served quiche in pastry. We just ate the quiche part, without eating the pastry, and bundled the pastry into napkins for a bin on the way home. The transition will be trial and error with insulin needs, but once you are there, it will be much easier on your long bike rides.

Jul 31, 2015 Pippa Mc 4 posts	Topic: Carbohydrate Counting / Greenwheat Freekeh Just been doing a little googling and found below - working on this logic would it be fair to consider that I should consider halving insulin - might give this a go and see how I get on.. "Low carb" food. Resistant starch plus high in fiber (up to 16.5% fiber). Available carbs are about 45 units / 100.

Jul 31, 2015 Pippa Mc 4 posts	Topic: Carbohydrate Counting / Greenwheat Freekeh Hello, I am looking for some advice in relation to Greenwheat Freekeh. Nutritional information suggests that 100g of the stuff equates to 6-6.5 CP - however as a low GI food I'm not sure what to do with it - I can't find anything specifically related to this grain.. Any help greatly appreciated - lunch is calling! Thanks, Pippa

Jul 31, 2015 Phil Maskell 194 posts	Topic: General Discussion / Low Carb Warwick, Quick question, like I said above I often go out on 5+ hour rides (sometime 15+), while trying to become fat adapted how did you deal with low BG? For the interim did you cut insulin to allow BG to run higher? I like the idea of not needing so many gels in my pockets, but until I am fat adapted do I ease off the exercise? With all the exercise I do I am also on the low end of my ideal weight, being fat adapted, will this cause more weight loss? I just want to stay the same weight... What did you notice? How do you deal with the stigma from family/friends? What do you order when eating out? Sorry for all the questions, nice to find a diabetic that's actually done it. Thanks, Phil