Recent Posts by Garry - DAFNE Online

Jun 15, 2011

Garry 328 posts

Topic: Questions for HCPs / Metformin /Type 1

novorapidboi said not to forget the side effects....... he once renamed it 'metfartin' which had me laughing.... as that's what it does to you. Embarassed

I am only taking 1 g a day, 500 morning 500 mg evening and so far, over the last two months, it has not changed my ratios at all.
Consultant said feel free to take metformin at up to 3 g a day but I feel in control and am happy enough with ratios up to 2.5 - 3.0.
But we are all different, so as usual..... slow changes, a step at a time, so you can clearly recognise any beneficial effect.
Regards
Garry

Jun 14, 2011

Garry 328 posts

Topic: Site Development / Do you use the Diary Graphs?

Blood Glucose Target Charts are good and bright. Like the way the graph scrolls out when started Very Happy

Is it possible to use these colours throughout all of the graph types as the rest are indistinct and although I have no experience I could imagine them being difficult to see on a smart phone screen in bright light.
chrisinbrum - I just manipulate the data entry to get the info where I want and that keeps the graph right.

Regards
Garry

Jun 12, 2011

Garry 328 posts

Topic: Site Development / Do you use the Diary Graphs?

Bit dull in terms of colour Simon...but perhaps I'm just an old metfartin! Sad

Regards
Garry

May 24, 2011

Garry 328 posts

Topic: General Discussion / Diabetic Survey

I agree...and as a consequence unwilling to supply further info.

May 24, 2011

Garry 328 posts

Topic: General Discussion / Diabetic Survey

Done....a little surprised by some questions however! Shocked

Mar 24, 2011

Garry 328 posts

Topic: General Discussion / Blog: "DIY DAFNE" - An Diabetic Outsider's View

I feel a shudder coming on!
No adjustment....get whatever hole it felt like delivering into your finger...often bruised or unable to staunch the blood flow....glad those days are behind us.
Garry

Mar 9, 2011

Garry 328 posts

Topic: General Discussion / Census Form

I would agree. Yes, limited a little.
We are certainly limited in terms of timing throughout the day.
I try to keep pretty consistent timings for meals. For me personally it helps me understand what is going on.

Mar 2, 2011

Garry 328 posts

Topic: General Discussion / First week concerns

Have a search on the web for your QA insulin type michellem and when there search site for the insulin absorption graph.
This will give you a good indication about action time for your QA.
As you say you will probably find that 2 hours is too short a time for trimming off of the post meal peak.
Regards
Garry

Mar 1, 2011

Garry 328 posts

Topic: General Discussion / First week concerns

It took me nearly 5 months to get things back after doing DAFNE in November 2009.
Here is some encouragement for me though ..... the latest in about 3 green days that I have had since then!
Stick with it.
Once you completely trust the strong framework provided by DAFNE it will work for you.

Feb 24, 2011

Garry 328 posts

Topic: General Discussion / 4mm needles

Seem to remember when I started out on insulin that I was give two reusable needles to put on my one glass syringe. They were 2" long 21 gauge. Many moons ago however.
Then revolution.... disposables..... and at that time the smallest diameter 12.5 mm disposables were 26 gauge. Pleased to say that much smaller needle diameters are now available.
There are so many pen types out there now. Your HCP should provide you with sufficient info to help you make an informed choice and supply you with some options to try. Bear in mind that syringes mean that the needle you use has already been used once in piercing the insulin bottle cap seal before you use it on yourself.
BD disposable needles are available in all the sizes mentioned and some lengths in between too. Length to use really depends upon where you inject and how much subcutaneous fat you have in those areas. I don't carry much fat so am happy with 4 mm and I rarely bruise using them in stomach and thighs.
Current 4 mm long are now 0.23 mm diameter - or old 34 gauge.
Smaller diameters are so much more comfortable to use.
Regards
Garry

Feb 24, 2011

Garry 328 posts

Topic: General Discussion / Not impressed x 2

I see you use your stomach for all injections.
Do you have any lumps or bruising problem areas Jo?
I found when using large doses that it was necessary to spread things around to get repeatable insulin absorption.
Have you discussed alternate injection sites with your HCP?
Try not to miss BED result - and possibly some 03:00 am results especially when changing BI - you need as much info as you can get.
Stick with it. I can imagine that you may be a little dispirited at the minute - but your results seem more controlled. You will put it right.

Garry

Feb 17, 2011

Garry 328 posts

Topic: General Discussion / Whats happening?

Good to see your diary up and running Jo Penn. Good move.
I find that everything seems much clearer to me when I go back and review my own results retrospectivelyâ€¦especially after things have gone awry!
Helps me correct my mistakes and missing entries too. How many times have I seen QA 11.3â€¦must have a very clever and accurate penâ€¦Doh...entered my BG in the wrong field again.
You have a different approach to me in recording.
I only make one entry for breakfast as I take both my QA and BI during breakfast...and again only one entry at tea.
In doing that I find that it helps keep my split dose BI 12 hours apart and good consistent flowing overlap between them.
During the week I normally have breakfast at 06:45 and dinner 18:00 to 19:00 and then breakfast again at 06:45 - so give or take an hour it remains at 12 and 12.
If I get up late on a weekend it normally moves all mealtimes on - and so it tends to stay at 12 and 12 albeit with errors weekend start and finish - but still not too inaccurate.
I see your BI split is around 14 hours during the day and 10 at night. At your new, higher BI, you might try even it up if at all possible.
With recording in the OnLine diary, I hope you gain confidence in making your own decision about BI dose changes too. After all, you change one type of insulin every meal, so why should your BI be any different?
I try to take a steady view of this over 3 or 4 days results though â€“ in the vain hope that I see a clear pattern before making BI changes. It is complicated enough without bringing another factor into play, making it too difficult to recognise the pattern. I use the graph feature on the diary all the time to help me see emerging patterns.
I now realise that I have only tinkered with BI units in the past...1u up or down, but my consultant has just told me to change 10 to 20% if I wanted to change BI and that way to see quick direct effects. He promptly advised me to knock 4u off my 28u BIs which I have done with little adverse effect.
Low dose Metformin has so far not helped my ratios but it is only 8 days. I live in hope.

Regards

Garry

Feb 16, 2011

Garry 328 posts

Topic: Questions for HCPs / Cant stop BG Levels going up

Please remember that your (hard) badminton session may cause an 'adrenalin rush' leading to liver glucagon release and cause BG rise as a consequence. Think insulin resistance is increased by most hormone changes. Alan Constable shared information with us in a thread called exercise within General Discussion back in November 2010 which could be of interest to you. Sounds like you are getting back on track. Well done.

Regards Garry

Feb 14, 2011

Garry 328 posts

Topic: General Discussion / Whats happening?

The DAFNE Online diary is so easy to keep. Why not try it?
Without any CP values it's hard to offer any advice. Note your ratios given, but have to admit that I change ratios up and down after establishing a repeating pattern over 2 or 3 days.
How do you feel? Have you any signs of infection?
Like you I am on high ratios but generally manage to keep things under control - except two days before getting a minor infection such as a cold when my insulin resistance seems to change gear!
Following a routine visit last week to my Db clinic, have just started Metformin to try help reduce ratios but no change yet after 6 days. I'll just take it steady and see what happens.
Stick with it and hopefully someone will be able to offer some good advice.

Regards Garry

Feb 3, 2011

Garry 328 posts

Topic: General Discussion / What are you reading?

Just finished Connelly's Nine Dragons Stew B. Been a while since I last read one of his novels and realised that I do really enjoy a Harry Bosch yarn. Hope to pick up The Reversal soon.
Initially found the web site mentioned useful to complete the A to Z....or however far it goes....list of Sue Grafton novels.
Currently contemplating Hugh Thomas - The Spanish Civil War - a mighty tome......well it has made it out of the wardrobe bottom to the bedside drawers anyway.
Regards Garry

Jan 27, 2011

Garry 328 posts

Topic: General Discussion / What are you reading?

If you like to complete sets...you may find this web site useful: -

http://www.readitswapit.co.uk

Helps with those sometimes hard to find missing book.

Regards Garry

Jan 19, 2011

Garry 328 posts

Topic: Questions for HCPs / Difference in BG from different fingers!

Following SimonC's post where he mentions Optium Exceed meter test solutions, as far as I remember!! the acceptable meter result range using the high solution is around 13 to 21 so that gives us a good idea of the error bound...which reminds me that I have not checked my meter for some time!
You are right....Don't worry about it

Dec 13, 2010

Garry 328 posts

Topic: Questions for HCPs / Can't figure out what I'm doing wrong

Sorry it has taken me 4 days to get round to the promised fridge check.
The results of which sort of surprised me.
Please bear in mind that the digital oven thermometer used could hardly be considered calibrated and traceable to National Standards .... but with an ambient kitchen temperature of 23Â° C ... just finished cooking ... the temperature in my insulin storage area of the fridge had risen to + 7Â° C. Bottom of the fridge at this time was + 6Â° C ... a much lower variation than I expected to find Caimin. I had not bothered in the past to check temperature in the bottom of the fridge. Perhaps the fridge design is better than I expected. I have in the past physically noted the temperature variation across the fridge. So I think I turned down the fridge stat too much a few months ago and have hopefully adjusted it to a more suitable temperature now.
My thanks to you Caimin for getting me to check it out.
Regards
Garry

Dec 9, 2010

Garry 328 posts

Topic: Questions for HCPs / Can't figure out what I'm doing wrong

As you suggest, the cold drops to the bottom of the fridge and your insulin may be too cold.
I'm lucky. Our fridge has a covered tray right at the top of the door.
When I measured using our oven/meat cooking digital thermometer showed this area of the fridge at +2Â°C in summer.....but I must admit I have not checked it under current conditions!
I'll have a look tonight and post the outcome.
Regards
Garry

Dec 8, 2010

Garry 328 posts

Topic: General Discussion / Forums Have Gone Quiet

Hope all those stories are successful ones of keeping control despite the excessive treats that we have to endure! How many units of insulin!!!
Some people were sharing book enjoyment a few weeks ago.
Regards Garry

Dec 8, 2010

Garry 328 posts

Topic: General Discussion / Forums Have Gone Quiet

Wondering whether all is OK with the system...or is it that we all just have too much to do at this time of year?
Have followed with interest many of the threads recently...have they all have reached their natural lifespan at the same time?
Curious
Garry

Dec 2, 2010

Garry 328 posts

Topic: Site Development / Online BG Diaries

Works well.
Thanks to you again Simon.
Regards
Garry

Nov 29, 2010

Garry 328 posts

Topic: Site Development / Online BG Diaries

I also use an Optium Xceed meter to test for Ketones. Very easy to use with digital value given using a specific test strip ... can recommend. Software called Co-Pilot is available free from Abbot, once registered as a an Optium Xceed meter user, and downloads meter to computer through a specific USB lead and will log ketone info too.
Regards
Garry

Jun 15, 2011 Garry 328 posts	Topic: Questions for HCPs / Metformin /Type 1 novorapidboi said not to forget the side effects....... he once renamed it 'metfartin' which had me laughing.... as that's what it does to you. I am only taking 1 g a day, 500 morning 500 mg evening and so far, over the last two months, it has not changed my ratios at all. Consultant said feel free to take metformin at up to 3 g a day but I feel in control and am happy enough with ratios up to 2.5 - 3.0. But we are all different, so as usual..... slow changes, a step at a time, so you can clearly recognise any beneficial effect. Regards Garry

Jun 14, 2011 Garry 328 posts	Topic: Site Development / Do you use the Diary Graphs? Blood Glucose Target Charts are good and bright. Like the way the graph scrolls out when started Is it possible to use these colours throughout all of the graph types as the rest are indistinct and although I have no experience I could imagine them being difficult to see on a smart phone screen in bright light. chrisinbrum - I just manipulate the data entry to get the info where I want and that keeps the graph right. Regards Garry

Jun 12, 2011 Garry 328 posts	Topic: Site Development / Do you use the Diary Graphs? Bit dull in terms of colour Simon...but perhaps I'm just an old metfartin! Regards Garry

May 24, 2011 Garry 328 posts	Topic: General Discussion / Diabetic Survey I agree...and as a consequence unwilling to supply further info.

May 24, 2011 Garry 328 posts	Topic: General Discussion / Diabetic Survey Done....a little surprised by some questions however!

Mar 24, 2011 Garry 328 posts	Topic: General Discussion / Blog: "DIY DAFNE" - An Diabetic Outsider's View I feel a shudder coming on! No adjustment....get whatever hole it felt like delivering into your finger...often bruised or unable to staunch the blood flow....glad those days are behind us. Garry

Mar 9, 2011 Garry 328 posts	Topic: General Discussion / Census Form I would agree. Yes, limited a little. We are certainly limited in terms of timing throughout the day. I try to keep pretty consistent timings for meals. For me personally it helps me understand what is going on.

Mar 2, 2011 Garry 328 posts	Topic: General Discussion / First week concerns Have a search on the web for your QA insulin type michellem and when there search site for the insulin absorption graph. This will give you a good indication about action time for your QA. As you say you will probably find that 2 hours is too short a time for trimming off of the post meal peak. Regards Garry

Mar 1, 2011 Garry 328 posts	Topic: General Discussion / First week concerns It took me nearly 5 months to get things back after doing DAFNE in November 2009. Here is some encouragement for me though ..... the latest in about 3 green days that I have had since then! Stick with it. Once you completely trust the strong framework provided by DAFNE it will work for you.

Feb 24, 2011 Garry 328 posts	Topic: General Discussion / 4mm needles Seem to remember when I started out on insulin that I was give two reusable needles to put on my one glass syringe. They were 2" long 21 gauge. Many moons ago however. Then revolution.... disposables..... and at that time the smallest diameter 12.5 mm disposables were 26 gauge. Pleased to say that much smaller needle diameters are now available. There are so many pen types out there now. Your HCP should provide you with sufficient info to help you make an informed choice and supply you with some options to try. Bear in mind that syringes mean that the needle you use has already been used once in piercing the insulin bottle cap seal before you use it on yourself. BD disposable needles are available in all the sizes mentioned and some lengths in between too. Length to use really depends upon where you inject and how much subcutaneous fat you have in those areas. I don't carry much fat so am happy with 4 mm and I rarely bruise using them in stomach and thighs. Current 4 mm long are now 0.23 mm diameter - or old 34 gauge. Smaller diameters are so much more comfortable to use. Regards Garry

Feb 24, 2011 Garry 328 posts	Topic: General Discussion / Not impressed x 2 I see you use your stomach for all injections. Do you have any lumps or bruising problem areas Jo? I found when using large doses that it was necessary to spread things around to get repeatable insulin absorption. Have you discussed alternate injection sites with your HCP? Try not to miss BED result - and possibly some 03:00 am results especially when changing BI - you need as much info as you can get. Stick with it. I can imagine that you may be a little dispirited at the minute - but your results seem more controlled. You will put it right. Garry

Feb 17, 2011 Garry 328 posts	Topic: General Discussion / Whats happening? Good to see your diary up and running Jo Penn. Good move. I find that everything seems much clearer to me when I go back and review my own results retrospectivelyâ€¦especially after things have gone awry! Helps me correct my mistakes and missing entries too. How many times have I seen QA 11.3â€¦must have a very clever and accurate penâ€¦Doh...entered my BG in the wrong field again. You have a different approach to me in recording. I only make one entry for breakfast as I take both my QA and BI during breakfast...and again only one entry at tea. In doing that I find that it helps keep my split dose BI 12 hours apart and good consistent flowing overlap between them. During the week I normally have breakfast at 06:45 and dinner 18:00 to 19:00 and then breakfast again at 06:45 - so give or take an hour it remains at 12 and 12. If I get up late on a weekend it normally moves all mealtimes on - and so it tends to stay at 12 and 12 albeit with errors weekend start and finish - but still not too inaccurate. I see your BI split is around 14 hours during the day and 10 at night. At your new, higher BI, you might try even it up if at all possible. With recording in the OnLine diary, I hope you gain confidence in making your own decision about BI dose changes too. After all, you change one type of insulin every meal, so why should your BI be any different? I try to take a steady view of this over 3 or 4 days results though â€“ in the vain hope that I see a clear pattern before making BI changes. It is complicated enough without bringing another factor into play, making it too difficult to recognise the pattern. I use the graph feature on the diary all the time to help me see emerging patterns. I now realise that I have only tinkered with BI units in the past...1u up or down, but my consultant has just told me to change 10 to 20% if I wanted to change BI and that way to see quick direct effects. He promptly advised me to knock 4u off my 28u BIs which I have done with little adverse effect. Low dose Metformin has so far not helped my ratios but it is only 8 days. I live in hope. Regards Garry

Feb 16, 2011 Garry 328 posts	Topic: Questions for HCPs / Cant stop BG Levels going up Please remember that your (hard) badminton session may cause an 'adrenalin rush' leading to liver glucagon release and cause BG rise as a consequence. Think insulin resistance is increased by most hormone changes. Alan Constable shared information with us in a thread called exercise within General Discussion back in November 2010 which could be of interest to you. Sounds like you are getting back on track. Well done. Regards Garry

Feb 14, 2011 Garry 328 posts	Topic: General Discussion / Whats happening? The DAFNE Online diary is so easy to keep. Why not try it? Without any CP values it's hard to offer any advice. Note your ratios given, but have to admit that I change ratios up and down after establishing a repeating pattern over 2 or 3 days. How do you feel? Have you any signs of infection? Like you I am on high ratios but generally manage to keep things under control - except two days before getting a minor infection such as a cold when my insulin resistance seems to change gear! Following a routine visit last week to my Db clinic, have just started Metformin to try help reduce ratios but no change yet after 6 days. I'll just take it steady and see what happens. Stick with it and hopefully someone will be able to offer some good advice. Regards Garry

Feb 3, 2011 Garry 328 posts	Topic: General Discussion / What are you reading? Just finished Connelly's Nine Dragons Stew B. Been a while since I last read one of his novels and realised that I do really enjoy a Harry Bosch yarn. Hope to pick up The Reversal soon. Initially found the web site mentioned useful to complete the A to Z....or however far it goes....list of Sue Grafton novels. Currently contemplating Hugh Thomas - The Spanish Civil War - a mighty tome......well it has made it out of the wardrobe bottom to the bedside drawers anyway. Regards Garry

Jan 27, 2011 Garry 328 posts	Topic: General Discussion / What are you reading? If you like to complete sets...you may find this web site useful: - http://www.readitswapit.co.uk Helps with those sometimes hard to find missing book. Regards Garry

Jan 19, 2011 Garry 328 posts	Topic: Questions for HCPs / Difference in BG from different fingers! Following SimonC's post where he mentions Optium Exceed meter test solutions, as far as I remember!! the acceptable meter result range using the high solution is around 13 to 21 so that gives us a good idea of the error bound...which reminds me that I have not checked my meter for some time! You are right....Don't worry about it

Dec 13, 2010 Garry 328 posts	Topic: Questions for HCPs / Can't figure out what I'm doing wrong Sorry it has taken me 4 days to get round to the promised fridge check. The results of which sort of surprised me. Please bear in mind that the digital oven thermometer used could hardly be considered calibrated and traceable to National Standards .... but with an ambient kitchen temperature of 23Â° C ... just finished cooking ... the temperature in my insulin storage area of the fridge had risen to + 7Â° C. Bottom of the fridge at this time was + 6Â° C ... a much lower variation than I expected to find Caimin. I had not bothered in the past to check temperature in the bottom of the fridge. Perhaps the fridge design is better than I expected. I have in the past physically noted the temperature variation across the fridge. So I think I turned down the fridge stat too much a few months ago and have hopefully adjusted it to a more suitable temperature now. My thanks to you Caimin for getting me to check it out. Regards Garry

Dec 9, 2010 Garry 328 posts	Topic: Questions for HCPs / Can't figure out what I'm doing wrong As you suggest, the cold drops to the bottom of the fridge and your insulin may be too cold. I'm lucky. Our fridge has a covered tray right at the top of the door. When I measured using our oven/meat cooking digital thermometer showed this area of the fridge at +2Â°C in summer.....but I must admit I have not checked it under current conditions! I'll have a look tonight and post the outcome. Regards Garry

Dec 8, 2010 Garry 328 posts	Topic: General Discussion / Forums Have Gone Quiet Hope all those stories are successful ones of keeping control despite the excessive treats that we have to endure! How many units of insulin!!! Some people were sharing book enjoyment a few weeks ago. Regards Garry

Dec 8, 2010 Garry 328 posts	Topic: General Discussion / Forums Have Gone Quiet Wondering whether all is OK with the system...or is it that we all just have too much to do at this time of year? Have followed with interest many of the threads recently...have they all have reached their natural lifespan at the same time? Curious Garry

Dec 2, 2010 Garry 328 posts	Topic: Site Development / Online BG Diaries Works well. Thanks to you again Simon. Regards Garry

Nov 29, 2010 Garry 328 posts	Topic: Site Development / Online BG Diaries I also use an Optium Xceed meter to test for Ketones. Very easy to use with digital value given using a specific test strip ... can recommend. Software called Co-Pilot is available free from Abbot, once registered as a an Optium Xceed meter user, and downloads meter to computer through a specific USB lead and will log ketone info too. Regards Garry