Recent Posts by Garry

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328 posts found

Mar 4, 2014
Garry 328 posts

Topic: Questions for HCPs / new to dafne

Welcome hannahlaw Smile
Some consultants suggest dropping BI by 20% to ensure that you see the result. Your HCP team are of the same mindset.
Please give it time. Don't make changes on the back of one overnight result. You dinner may have been slowly digested and, and, and....lots of things get in the way. The body is a mighty complex thing and takes time to adjust.
As Warwick suggested, a minimum of 3 days with consistent results to review to help you decide.
Regards
Garry
 
Feb 26, 2014
Garry 328 posts

Topic: General Discussion / Possible cure for newly diagnosed type 1s

Antitrypsin.
Another word added to the clutter in my aging brain.
I'll have to ask my youngest son of his thoughts.
Not much good for us old f*rts though.
Thanks again Warwick. You come up with some good info.
Regards
Garry
 
Feb 26, 2014
Garry 328 posts

Topic: General Discussion / mihaelas

Welcome to the forum mihaela Smile
Anything we can try to help you with?
The data you provide shows an unusual BI scheme. Are you working shifts?
Must admit I try to check ketones every time I'm above a BG of 15.0...but the DAFNE recommendation is:
if consistently over 13.0 mmol/l and check every time >17.0.
Let us know your needs and the great body of support in here can try and assist.
Regards
Garry
 
Feb 24, 2014
Garry 328 posts

Topic: Questions for HCPs / Help With Evening BI

I find that the Show Summary View hyperlink at the top of your diary helps you spot data errors.
Your BI total for that week would have been out compared to normal weeks.
Stick with your changes for 3+ days to be sure about outcome..especially when altering BIs.
Regards
Garry
 
Feb 21, 2014
Garry 328 posts

Topic: General Discussion / some help please

You can add injection sites for QA and BI which may help you understand absoption rates for different parts of the body better. I also use it to discipline myself about moving injection sites around to help avoid 'blocked' insulin absorption.
As you mentioned, mobile it for convenience and then when you have the time...and memory...which sometimes fails me! you can add the detail to individual entries by edit, clicking the blue time entry which underlines as a hyperlink when hovered over with the cursor.
Regards
Garry
 
Feb 21, 2014
Garry 328 posts

Topic: Questions for HCPs / Help With Evening BI

Have you just missed a 2 off your Mon 17/02 07:02 BI?
Regards
Garry
 
Feb 20, 2014
Garry 328 posts

Topic: General Discussion / some help please

Most HCPs seem to recommend QA stomach and BI thighs as the insulin absorption times seem to line up best for most people.
If you can't do that though..don't worry. We are all different.
Are you filling in your diary on computer, or by mobile?
Lots more facilities available by computer.
Regards
Garry
 
Feb 20, 2014
Garry 328 posts

Topic: General Discussion / some help please

Welcome to the forum Smile
Don't be intimidated by the thought of the online Diary. I'm a Luddite - and even I found it simple to use....and look at all the typing to the forum you'll be saved doing!
Your rounding is fine. Up to 6.49 round down to 6. 6.5 and up..round up to 7.
Could you tell us which lancet device you have? Maybe we can suggest alternatives from our group experience that may suit you better.
I use a Roche Softclix II...which is donkeys years old and I have thought about getting a different one.
Following on from alturn's comment I heard some time ago that there is one that can be used one-handed on different parts of the body but can't remember whether it is combined with a meter or not.
Anyway, when I looked on a medical supplies website I noted that there are at least 16 different manufacturers of these devices out there, so I would hope that we can help you find one that suits.
Try the online diary. Hope you find it easy to use.
Regards
Garry
 
Feb 3, 2014
Garry 328 posts

Topic: General Discussion / different bg reading

Most manufacturer control solutions have a huge range of acceptable results from the meter..."only send us the meter back if outside the range 13.8 to 21.2." What!! I thought at the time, what kind of an acceptable test range is that supposed to be?
Repeat tests using the test solution however, gave me a set of results that did not vary by more than 1 mmol. Meter manufacturers talk about 'precision' and they mean statistical precision...or repeatability.
We always think of accuracy and I have to admit that the language that manufacturers use is deliberate to obfuscate and baffle us into thinking that their meter is the best thing since sliced bread...It ain’t. All they mean is that their meter can potentially give us the wrong answer....repeatedly.
Regards
Garry
 
Jan 27, 2014
Garry 328 posts

Topic: General Discussion / steel toe shoe's

Here in the UK I use Element II...as in roman 2, Warwick.
Goretex uppers and liners that breathe reasonably well.
Must be lots of others out there though using Goretex I would have thought.
Regards
Garry
 
Jan 27, 2014
Garry 328 posts

Topic: General Discussion / steel toe shoes for type 1

Just regular neilbunting.
Regards
Garry
 
Jan 27, 2014
Garry 328 posts

Topic: DAFNE Online Mobile / Android DAFNE app freezing

Since the diary database has been fixed...hope you are now able to upload data without problems.
Regards
Garry
 
Jan 20, 2014
Garry 328 posts

Topic: General Discussion / My Blood Glucose Diary - problems

Thanks to you both.
Regards
Garry
 
Jan 14, 2014
Garry 328 posts

Topic: General Discussion / My Blood Glucose Diary - problems

Thanks marke for looking at it.
I always keep my results in my paper DAFNE diary anyway to upload later using multiple entry format. The automatic date entry seems to stop things on multiple entry and we get presented with the red border cells to input a date. Have tried pasting in dates throughout that input...but I'm afraid once it has gone awry...you get the problem warning window.
Have been able to upload my results from the last few days this morning by using single entries. So maybe multiple result entries time out on the server as it is exceptionally slow.
Regards
Garry
 
Jan 9, 2014
Garry 328 posts

Topic: General Discussion / My Blood Glucose Diary - problems

Managed to get my online diary loaded on screen and I thought you might have fixed it marke, but after making a multiple entry addition it came up with the problem message again.
Regards
Garry
 
Jan 9, 2014
Garry 328 posts

Topic: Carbohydrate Counting / reliable metre readings

Agree with marke.
Here is the content of a post that I wrote in November 2010 on the same subject of meter accuracy when a lady talked of wildly varying BG results:

Most BG kits now use such a small blood sample that any contamination error has a really dramatic effect.
BG 16 to 5.6 in 45 minutes is very unusual.

I say this from experience with an Medisense Abbott Optium Xceed meter which on 5 second Optium Plus test strips uses a tiny blood sample - 0.6 μL.
They did a 3 second strip for a time which used an even smaller blood sample. But not sure whether they are available now.
Anyway I proved contamination error to myself by repeated trials of unwashed hands v washed hands - washed immediately after - and saw errors of up to 8 BG.

My conclusion was that I had to always accept the need for lack of contamination and to stick with washed hands at testing time.




We all want to use small samples for obvious reasons...my finger ends look bad enough already...but we must accept the inaccuracy that goes with the 'instant' result that we demand. We can not expect a piece of kit that your can carry in a pouch, in your pocket, to produce results comparable to a £40 or 50k bench mounted machine set up in an air-conditioned laboratory using a 7 ml sample - or 11,666 times bigger than your instant blood test, to give accurate results...only statistically precise results - and this is the language that meter manufacturers use. I, until I read up on it, misread this as precision - which is wrong. It means...repeatable results under exactly the same conditions...not accurate results.
Hence we are only able to rely on getting repeatable results....may still be inaccurate results...for all the reasons already outlined.
So learn to trust the guidance of your meter and if a wacky result comes up that you do not believe...repeat the test making sure that your hands are perfectly clean....and DRY and see then what you get.

Regards
Garry
 
Jan 8, 2014
Garry 328 posts

Topic: Questions for HCPs / Cholestrol

Welcome Jade_ellen.
Please note I am not an HCP.
But to my knowledge Statins are commonly given to type 1 diabetics. I think it likely that the majority of us here on the forum are prescribed them.
My cholestrol has always been in range in my 34 years as a type 1, but I was given them some 10 years ago when a 5 year American based research programme demonstrated their long term benefits for us.
Currently I take 10 mg Atorvastatin per day and my cholesterol is 3.9...so I'm happy to keep taking them.
There are underlying benefits, which my consultant talked about at the time.
I've copied this for you from the web for you and cut it down a bit to get to the salient points but you can read the whole article at: www/netdoctor.co.uk/diabetes/treatments/statins_and_diabetes_001904.htm

Statins and diabetes
Reviewed by Professor Ian Campbell, consultant physician

While a healthy lifestyle plays a part, the most effective way to reduce cholesterol levels is by using a group of medicines known as statins.
The treatment of diabetes has traditionally focused on controlling the blood sugar level through diet combined with injections of insulin or tablets.

There's no doubt that good glucose control is central to minimising the risk of long-term complications such as damage to nerves, circulation, kidneys and eyes.

But over recent years, attention has focussed on the fact that people with diabetes are up to four times more likely to suffer a major event involving the circulation – for example a heart attack or a stroke (cerebrovascular accident).

In fact, coronary heart disease is the leading cause of death in people who have both type 1 and type 2 diabetes.

All this means it's now recognised that diabetes, particularly type 2, is as much a disease of the circulatory system as it is of blood glucose control.
This leads to:
angina (chest pains)
heart attacks
stroke
poor circulation.
There have been significant inroads in the prevention and treatment of cardiovascular disease.

Stopping smoking and good blood pressure control has a significant impact in reducing long-term damage to the circulation.
Raised cholesterol levels is another factor that increases your cardiovascular risk.
The benefits from stopping smoking, reducing cholesterol levels and lowering high blood pressure multiply up.
Stopping smoking is probably the most important thing you can do to reduce your cardiovascular risk. Many GPs run special smoking cessation clinics. Diet and exercise help lower raised blood pressure. But how can you reduce cholesterol levels?

While a healthy lifestyle plays a part, the most effective way to reduce cholesterol levels is by using a group of medicines known as statins.

How do statins work?
Although we get cholesterol from our diet, more than 80 per cent of cholesterol in our bodies is made by the liver.

Statins slow the action of an enzyme in the liver that plays a key role in the manufacture of cholesterol. This causes the level of blood cholesterol to drop.

There are currently five medicines in this class available for prescription in the UK:

atorvastatin (Lipitor)
fluvastatin (Lescol), (Lescol XL)
pravastatin (Lipostat)
rosuvastatin (Crestor)
simvastatin (Zocor).
All of the statin medicines work in the same way.

How effective are statins for people with diabetes?
Statins lower cholesterol, but would they make a difference for people with diabetes? Two major studies investigated the benefits.

In both, the effects of a daily dose of a statin versus no treatment was compared in people with diabetes.

Collaborative Atorvastatin Diabetes Study (CARDS)
This study involved nearly 3000 people with type 2 diabetes aged 40-75.

It looked at the benefits of taking a 10mg dose of atorvastatin daily.

None of the participants had heart disease at the start of the trial, but they did have an extra risk factor for developing it, such as smoking, high blood pressure, diabetic retinopathy or protein in the urine indicating diabetic kidney disease.

For those taking the statin, the risk of heart attack reduced by 37 per cent and stroke by 48 per cent.

These benefits were seen regardless of age, sex or whether the cholesterol level was high or low.

The trial's success meant it was halted two years early.

The Heart Protection Study (HPS)
The HPS study involved nearly 6000 people with diabetes aged 40-80.

It looked at the benefits of taking a 40mg dose of simvastatin each day. Just under half of the participants showed signs of cardiovascular disease, while half did not.

It found this routine use of statins cut the number of heart attacks and strokes in both groups by a third.

Cholesterol levels
Ideal level: less than 4mmol/l.
Benefits were also seen in people whose cholesterol levels were not high in the first place (less than 5mmol/l) and in those at the top of the age range.

The results showed statins can prevent cardiovascular disease, because they reduced heart attacks and stroke in people who didn't have cardiovascular disease at the start of the trial.

What are the side effects?
Statins are generally well tolerated.

But in some people they cause headaches, affect liver function and cause stomach problems such as abdominal pain, constipation, flatulence, diarrhoea and vomiting.

More rarely, they can cause rashes and disorder of the muscles (myopathy).

Where a statin cannot be tolerated, alternative medications such as ezetimibe or a fibrate drug may be tried but these medications do not lower cholesterol to the same degree as a statin.

Should everyone with diabetes take a statin?
Statins should be considered for all people with diabetes over the age of 40, according to the NICE guidelines in 2008. Statins may be prescribed in diabetic patients who are under 40 years of age if there are additional cardiovascular risk factors, or if there is diabetic eye disease (retinopathy) or kidney disease (neuropathy) present.

The CARDS and HPS studies have clearly shown that statins reduce cardiovascular risk, regardless of how low cholesterol levels are in the first place.

This suggests there shouldn't be a level of blood cholesterol below which statin treatment is considered unbeneficial.

More research is now in progress to try and clarify the broader use of statins in diabetes treatment.

Read more: http://www.netdoctor.co.uk/diabetes/treatments/statins_and_diabetes_001904.htm#ixzz2pncXyfEK
Follow us: @NetDoctor on Twitter | NetDoctorUK on Facebook

So do your best to reduce it yourself but as your liver is the main producer affecting your cholesterol level it is best controlled by pharmaceutical intervention.
Regards
Garry
 
Jan 7, 2014
Garry 328 posts

Topic: General Discussion / Hospital advice before endoscopy

Think Metformin is normally only given to type 1s in an effort to reduce insulin resistance. As you not taking your QA it should not be a problem.
Have been through this procedure myself without any problem though I can't for the life of me remember what my BG got to as it was some time ago. Can't have been anything drastic or I'm sure I would recall it.

Regards
Garry
 
Dec 29, 2013
Garry 328 posts

Topic: Questions for HCPs / High bgl

Welcome Led.
Not a HCP..but we all hope to be able to help.
You have just become insulin resistant whilst your body fights the infection.
Use the sick day rules which you can find in the DAFNE Course Handbook...hyperlink in blue on the top right of the page under DAFNE TOOLS.
When there...go to Coping when you are ill link.
Have been struggling to control my Blood Glucose levels for a number of days too. Grotty Christmas cold strikes again!
Get well soon.
Best Wishes to you all.
Regards
Garry
 
Nov 24, 2013
Garry 328 posts

Topic: General Discussion / will it ever be under control ? doubt it

Have you been asked to up your target range joe from the normal 4.5 to 7.5 or 8.0 by your Health Care Professional team? Thanks.
Regards
Garry
 
Nov 15, 2013
Garry 328 posts

Topic: General Discussion / Flu Jab

Mmmm....Sorry but I forgot to mention the tender arm!
Regards
Garry
 
Nov 15, 2013
Garry 328 posts

Topic: General Discussion / Flu Jab

Had mine 08/10/13 this year here at work...so no appointment problems.
I have recently had to visit three different surgeries: mine, one for mobile diabetic retina camera shots and also to my wife's surgery....all three had walk-in arrangements in place for flu jabs.
Just go to the surgery and hopefully yours will have the same arrangement.
My bloods always go a little high for 10 days or so afterwards as your body becomes somewhat insulin resistant whilst fighting the 'infection'. Easily coped with by compensation though. If unlucky and more severely affected - apply sick day rules. Go for it.
Regards
Garry
 
Oct 29, 2013
Garry 328 posts

Topic: General Discussion / BG Levels creeping up

Don't worry about your results. They are fine...they are red at the minute, but so what. We are looking for long term control within range. Look to the top right of your diary and on screen you will see BG averages for 7, 14, 30 and 90 days. I find these a big help combined with the content of the Summary View which is hyperlinked at the very top of your diary. Good stuff for you to ponder.
Will take you a long time at somewhat elevated BGs to get your hypo awareness back. It will not happen overnight!
Last time With consultant guidance and review, I reset my body and it took 3 months and albeit that we are all different...I can't imagine that a consultant would want to consider short term HBa1c changes.
Stick with it. Your bloods will still be affected during recovery from illness and may take some time to retrun to normal.
Regards
Garry
 
Oct 17, 2013
Garry 328 posts

Topic: Questions for HCPs / Traveling to China

May be a help to have something cool to carry your insulin in. Others have in the past passed comment about commercially available insulating pouches. May be prudent to invest in.
Have had to change QA cartridges in my pen when on holiday as the Humalog has failed to work (over temperature?) but no really relevent experience I'm afraid.
Regards
Garry