Recent Posts by Garry - DAFNE Online

Jul 22, 2012

Garry 328 posts

Topic: Site Development / Graphs of all values vs time, rather than trends

I use an Abbott Optium Xceed meter and their software system Co-Pilot gives you a modal day graph of results based on time of day. Their old software - which I have forgotten the name of - had the ability to create more than a dozen graph types. The current system has been perhaps been over-simplified, but there are 4 graph types available as well as combined display types. Many meter suppliers are going this way now and if you can choose a meter with the right software it may be able to give you just what you need. Some internet research may show you what is out there.

Regards
Garry

Jul 8, 2012

Garry 328 posts

Topic: General Discussion / Ratios & Honeymoon Period.

Most type 1 diabetics initially have some natural insulin production left as the remaining islets of Langerhans cells in your pancreas continue working...but as time goes on these can stop producing too and we become totally dependant on injected insulin.
As others have said this can last months to years.
My consultant talked about 'a honeymoon period' back in 1979 when I was diagnosed and put me on glibenclamides....I promptly lost 20 pounds....so it's unlikely that I had any honeymoon time.
Glibenclamide replaced with porcine insulin within 10 months. Who knows what my BGs were in those times...back then it was still urinalysis testing.

Regards
Garry

Jul 6, 2012

Garry 328 posts

Topic: General Discussion / Carpal Tunnel v's Neuropathy

Take a little while but in around three weeks and you will see an improvement I trust.
Hope it is a nice neat job.

Regards
Garry

Jun 28, 2012

Garry 328 posts

Topic: General Discussion / Any help please?

If you make an error entering data into your diary it is very easy to edit an entry.
Hover the cursor over the time of the entry you want to change and it will underline...click it and you are in edit mode.

Note from the bottom of the diary page: -

To edit or delete an entry, click on the time for that entry. You can now delete more than one entry at a time by selecting the checkbox to the left of each entry's time and clicking the button above.

Hope this helps you add in the additional data for your record keeping.

Regards
Garry

Jun 7, 2012

Garry 328 posts

Topic: General Discussion / Carpal Tunnel v's Neuropathy

Please be aware that a cortisone injection is likely to impair healing and could compromise any surgery later.
My upper limb consultant advised me against cortisone and I went ahead with CTS surgery to both hands....separated by time of course....both hands now in good working order.
Regards
Garry

Jun 4, 2012

Garry 328 posts

Topic: General Discussion / Hello

Welcome

I'm sure that others can benefit from a share of your 20 years experience.

Regards
Garry

Jun 1, 2012

Garry 328 posts

Topic: Questions for HCPs / Morning High

Keep it steady Gordon P - and see how it goes.
If you are repeatedly low on a morning you may need adjust BI again.
Know it's a pain, but as you mentioned, some 03:00 am BGs will help you understand what is happening....and more specifically....when.

Regards
Garry

May 29, 2012

Garry 328 posts

Topic: General Discussion / Exercise and high BG

The release of â€˜fight or flightâ€™ hormones such as adrenaline make us insulin resistant.
So strenuous exercise can have a marked effect on BG post exercise.

Regards
Garry

May 29, 2012

Garry 328 posts

Topic: General Discussion / TDD (Total daily dose)

I have always included corrections Gordon P as I find that as sickness comes on, I am making progressive corrections and if I bring in sick rules I want to get the situation under control quickly. So I always include corrections.

Regards
Garry

May 29, 2012

Garry 328 posts

Topic: Questions for HCPs / Morning High

Only from another graduate like yourself, but I would agree.
We all need recognise how long changes in Lantus dose take to have any effect. Seems to take 3 days for most of us.
My DAFNE consultant recommends 10 to 20% changes in BI to see quick outcome - so I think you are right Smile

Regards
Garry

May 25, 2012

Garry 328 posts

Topic: General Discussion / Split Lantus dose

My recent dinner time results are a disappointment to me but I'll get them back under control in a few days.
Have a think about changed timings though.
I genuinely believe that a practical way to get a good time split is to use meal times. I don't know why some nurses say take BI at bedtime.....can't see the rational and anyway you are the expert about your body needs so do what works for you.
By the time I go to bed all I want to do is sleep....not think about taking another injection.

Regards
Garry

May 25, 2012

Garry 328 posts

Topic: General Discussion / Split Lantus dose

Have split my Lantus for just over 2 years.
Personally I only use equal doses and try to get the timings 12 hours apart.
Seems the simple way to get an 'even' BI always available for your body to use.
Like you I can't see 16 hours versus 8 hours being helpful and going to bed high to avoid hypoing during the night can't be good long term. Need get BI right so you can go to bed at a BG in range and get up in the morning in range. Lots of things get in the way of that....but that's what we must try and achieve.
Lantus dose changes, for most of us, seem to have a long reaction time - up to 3 days to see any resultant BG change. Some other people use BI doses with a small differential of 2 or 4u....depending on your BI resistance of course.
I normally take QA and BI insulin before breakfast at 06:45 and before dinner at around 19:00. So for me it works.
At weekends, or on holiday, when getting up later.....dinner tends to be later too.....so it still works.
Here are the last few days diary included for your consideration DianeW.

Regards
Garry

May 22, 2012

Garry 328 posts

Topic: General Discussion / Testing strips

"Perhaps he's decided that as a diabetic I'm costing him too much money".
I believe it is true that your GP gets paid more patient roll money for you as a diabetic DianeW.

Regards
Garry

May 21, 2012

Garry 328 posts

Topic: General Discussion / Testing strips

Indeed they should. Must be near enough unlimited. If you were to have an infection and using your DAFNE sickness rules you could easily use a box in 3 days.
Get on to your practice and see your GP pointing out the practicalities of what we do.
I get 250 strips at a time which mostly fits my repeat prescription schedule.
Internet repeat prescription ordering with illogical limitations applied drives me potty Evil or Very Mad

Regards
Garry

May 9, 2012

Garry 328 posts

Topic: Questions for HCPs / Glandular fever

Please give it time.
Changes in Lantus dose - for most people....me included....seems to take some 3 days to have any impact.
Go steady and once you are satisfied you have a set pattern you can then make further appropriate adjustments.
I wish you well.
Regards
Garry

May 3, 2012

Garry 328 posts

Topic: General Discussion / How long do meters last?

1661 - came from a year of results in the on-line diary Phil.
Some time ago in another thread we recalled using glass syringes cleaned in surgical alcohol with I think 22 gauge needles which had to be soaked like the syringe before reuse and reuse and reuse and reuse.... two insulins that couldn't be mixed so it was two separate injections.
I'm glad those days have gone. Very Happy

Regards
Garry

May 3, 2012

Garry 328 posts

Topic: General Discussion / Metformin

Should have mentioned that I take 2 x 500 mg daily. Was told that I could take up to 3000 mg daily. But for me, stepping up the dose gradually had no beneficial effect on ratios so have stuck with 1 g per day. Metformin adversely affected my digestion at higher dose anyway.

Regards
Garry

May 3, 2012

Garry 328 posts

Topic: DAFNE Online Mobile / Samsung Galaxy S II smartphone

You'll be able to get all of them.

Regards
Garry

May 2, 2012

Garry 328 posts

Topic: General Discussion / Metformin

I started Metformin use just over 14 months ago following discussion with my consultant who had concerns about my insulin resistance.
Ratios, which at the time of starting were 2.0 to 2.5:1 have not come down much, as now are 2.2, 2.0 and 2.0, Breakfast, Lunch and Dinner.
Took a spell of 10 days off them, to see what impact it had....and would have had to go back to my old ratio regime. So have stuck with them.
Although not a long term user yet....having been used by Type 2s for decades without adverse reports....I would like to think we are on safe ground.

Regards
Garry

May 2, 2012

Garry 328 posts

Topic: General Discussion / How long do meters last?

I expect that it's very likely that they will say YES......of course, DianeW.......have a meter on us. Wink

They can afford it....In my case, that means another 1661 test strips for the year Laughing

Regards
Garry

May 2, 2012

Garry 328 posts

Topic: General Discussion / How long do meters last?

As they are keen to sell a volume of test strips to the NHS most meter manufacturers will supply you a meter free.
Meter models change at a pace. If you have had good service from AccuCheck why not continue with them.
There are some that cost, with gizmos that you are not likely to need. They are in the minority - usually only the very latest developments.
Personally I use an Abbott Medisense Optium Xceed. Current meter is around three years old. Have a look at their website through the link - scrolling the first section at the top shows what they currently have available.

http://www.abbottdiabetescare.co.uk/

Plenty more to choose from though. You may find that your GP has a preference for the cheapest test strips, which is OK if they are for a decent meter.....but there are some poor quality products out there too and they tend to use cheap test strips.
Regards
Garry

Apr 12, 2012

Garry 328 posts

Topic: General Discussion / What has gone wrong with Lantus adjustments

If you are anything like the rest of us, your Lantus BI changes will take 3 days to have any effect. Please allow time before making any further adjustments.
I have confused myself by making too rapid changes in the past.
Regards
Garry

Apr 7, 2012

Garry 328 posts

Topic: General Discussion / The Best Meter?

Like DaveDee, I have used an Abbot Medisense Optium Xceed for years.
Abbot diabetic care support, for me personally, has been exceptional.
If you are handy on the computer their software, called Co-Pilot, allows you to download all info from the meter to computer via a specific USB lead, both available free to Abbot meter users. Enables you to produce graphs for information in many different formats to HCPs. This software also supports pump users too.
Regards
Garry

Mar 31, 2012

Garry 328 posts

Topic: General Discussion / new to DAFNE

If you carry no fat why not ask your Health Care Professionals if you can try shorter needles.
As I said before I use 4 mm 31 gauge, which are the shortest out there at the moment. They may help avoid muscle damage.
Regards
Garry

Mar 30, 2012

Garry 328 posts

Topic: General Discussion / new to DAFNE

I have HUGE needle fear too.....but I get around it by using little itty bitty ones....4 mm 31 gauge Laughing

If you are confident enough to discuss it, I am sure that there are many folk on here with similar problems.
They may be willing and able to share their strategies for overcoming this sort of difficulty.
Regards
Garry

Jul 22, 2012 Garry 328 posts	Topic: Site Development / Graphs of all values vs time, rather than trends I use an Abbott Optium Xceed meter and their software system Co-Pilot gives you a modal day graph of results based on time of day. Their old software - which I have forgotten the name of - had the ability to create more than a dozen graph types. The current system has been perhaps been over-simplified, but there are 4 graph types available as well as combined display types. Many meter suppliers are going this way now and if you can choose a meter with the right software it may be able to give you just what you need. Some internet research may show you what is out there. Regards Garry

Jul 8, 2012 Garry 328 posts	Topic: General Discussion / Ratios & Honeymoon Period. Most type 1 diabetics initially have some natural insulin production left as the remaining islets of Langerhans cells in your pancreas continue working...but as time goes on these can stop producing too and we become totally dependant on injected insulin. As others have said this can last months to years. My consultant talked about 'a honeymoon period' back in 1979 when I was diagnosed and put me on glibenclamides....I promptly lost 20 pounds....so it's unlikely that I had any honeymoon time. Glibenclamide replaced with porcine insulin within 10 months. Who knows what my BGs were in those times...back then it was still urinalysis testing. Regards Garry

Jul 6, 2012 Garry 328 posts	Topic: General Discussion / Carpal Tunnel v's Neuropathy Take a little while but in around three weeks and you will see an improvement I trust. Hope it is a nice neat job. Regards Garry

Jun 28, 2012 Garry 328 posts	Topic: General Discussion / Any help please? If you make an error entering data into your diary it is very easy to edit an entry. Hover the cursor over the time of the entry you want to change and it will underline...click it and you are in edit mode. Note from the bottom of the diary page: - To edit or delete an entry, click on the time for that entry. You can now delete more than one entry at a time by selecting the checkbox to the left of each entry's time and clicking the button above. Hope this helps you add in the additional data for your record keeping. Regards Garry

Jun 7, 2012 Garry 328 posts	Topic: General Discussion / Carpal Tunnel v's Neuropathy Please be aware that a cortisone injection is likely to impair healing and could compromise any surgery later. My upper limb consultant advised me against cortisone and I went ahead with CTS surgery to both hands....separated by time of course....both hands now in good working order. Regards Garry

Jun 4, 2012 Garry 328 posts	Topic: General Discussion / Hello Welcome I'm sure that others can benefit from a share of your 20 years experience. Regards Garry

Jun 1, 2012 Garry 328 posts	Topic: Questions for HCPs / Morning High Keep it steady Gordon P - and see how it goes. If you are repeatedly low on a morning you may need adjust BI again. Know it's a pain, but as you mentioned, some 03:00 am BGs will help you understand what is happening....and more specifically....when. Regards Garry

May 29, 2012 Garry 328 posts	Topic: General Discussion / Exercise and high BG The release of â€˜fight or flightâ€™ hormones such as adrenaline make us insulin resistant. So strenuous exercise can have a marked effect on BG post exercise. Regards Garry

May 29, 2012 Garry 328 posts	Topic: General Discussion / TDD (Total daily dose) I have always included corrections Gordon P as I find that as sickness comes on, I am making progressive corrections and if I bring in sick rules I want to get the situation under control quickly. So I always include corrections. Regards Garry

May 29, 2012 Garry 328 posts	Topic: Questions for HCPs / Morning High Only from another graduate like yourself, but I would agree. We all need recognise how long changes in Lantus dose take to have any effect. Seems to take 3 days for most of us. My DAFNE consultant recommends 10 to 20% changes in BI to see quick outcome - so I think you are right Regards Garry

May 25, 2012 Garry 328 posts	Topic: General Discussion / Split Lantus dose My recent dinner time results are a disappointment to me but I'll get them back under control in a few days. Have a think about changed timings though. I genuinely believe that a practical way to get a good time split is to use meal times. I don't know why some nurses say take BI at bedtime.....can't see the rational and anyway you are the expert about your body needs so do what works for you. By the time I go to bed all I want to do is sleep....not think about taking another injection. Regards Garry

May 25, 2012 Garry 328 posts	Topic: General Discussion / Split Lantus dose Have split my Lantus for just over 2 years. Personally I only use equal doses and try to get the timings 12 hours apart. Seems the simple way to get an 'even' BI always available for your body to use. Like you I can't see 16 hours versus 8 hours being helpful and going to bed high to avoid hypoing during the night can't be good long term. Need get BI right so you can go to bed at a BG in range and get up in the morning in range. Lots of things get in the way of that....but that's what we must try and achieve. Lantus dose changes, for most of us, seem to have a long reaction time - up to 3 days to see any resultant BG change. Some other people use BI doses with a small differential of 2 or 4u....depending on your BI resistance of course. I normally take QA and BI insulin before breakfast at 06:45 and before dinner at around 19:00. So for me it works. At weekends, or on holiday, when getting up later.....dinner tends to be later too.....so it still works. Here are the last few days diary included for your consideration DianeW. Regards Garry

May 22, 2012 Garry 328 posts	Topic: General Discussion / Testing strips "Perhaps he's decided that as a diabetic I'm costing him too much money". I believe it is true that your GP gets paid more patient roll money for you as a diabetic DianeW. Regards Garry

May 21, 2012 Garry 328 posts	Topic: General Discussion / Testing strips Indeed they should. Must be near enough unlimited. If you were to have an infection and using your DAFNE sickness rules you could easily use a box in 3 days. Get on to your practice and see your GP pointing out the practicalities of what we do. I get 250 strips at a time which mostly fits my repeat prescription schedule. Internet repeat prescription ordering with illogical limitations applied drives me potty Regards Garry

May 9, 2012 Garry 328 posts	Topic: Questions for HCPs / Glandular fever Please give it time. Changes in Lantus dose - for most people....me included....seems to take some 3 days to have any impact. Go steady and once you are satisfied you have a set pattern you can then make further appropriate adjustments. I wish you well. Regards Garry

May 3, 2012 Garry 328 posts	Topic: General Discussion / How long do meters last? 1661 - came from a year of results in the on-line diary Phil. Some time ago in another thread we recalled using glass syringes cleaned in surgical alcohol with I think 22 gauge needles which had to be soaked like the syringe before reuse and reuse and reuse and reuse.... two insulins that couldn't be mixed so it was two separate injections. I'm glad those days have gone. Regards Garry

May 3, 2012 Garry 328 posts	Topic: General Discussion / Metformin Should have mentioned that I take 2 x 500 mg daily. Was told that I could take up to 3000 mg daily. But for me, stepping up the dose gradually had no beneficial effect on ratios so have stuck with 1 g per day. Metformin adversely affected my digestion at higher dose anyway. Regards Garry

May 3, 2012 Garry 328 posts	Topic: DAFNE Online Mobile / Samsung Galaxy S II smartphone You'll be able to get all of them. Regards Garry

May 2, 2012 Garry 328 posts	Topic: General Discussion / Metformin I started Metformin use just over 14 months ago following discussion with my consultant who had concerns about my insulin resistance. Ratios, which at the time of starting were 2.0 to 2.5:1 have not come down much, as now are 2.2, 2.0 and 2.0, Breakfast, Lunch and Dinner. Took a spell of 10 days off them, to see what impact it had....and would have had to go back to my old ratio regime. So have stuck with them. Although not a long term user yet....having been used by Type 2s for decades without adverse reports....I would like to think we are on safe ground. Regards Garry

May 2, 2012 Garry 328 posts	Topic: General Discussion / How long do meters last? I expect that it's very likely that they will say YES......of course, DianeW.......have a meter on us. They can afford it....In my case, that means another 1661 test strips for the year Regards Garry

May 2, 2012 Garry 328 posts	Topic: General Discussion / How long do meters last? As they are keen to sell a volume of test strips to the NHS most meter manufacturers will supply you a meter free. Meter models change at a pace. If you have had good service from AccuCheck why not continue with them. There are some that cost, with gizmos that you are not likely to need. They are in the minority - usually only the very latest developments. Personally I use an Abbott Medisense Optium Xceed. Current meter is around three years old. Have a look at their website through the link - scrolling the first section at the top shows what they currently have available. http://www.abbottdiabetescare.co.uk/ Plenty more to choose from though. You may find that your GP has a preference for the cheapest test strips, which is OK if they are for a decent meter.....but there are some poor quality products out there too and they tend to use cheap test strips. Regards Garry

Apr 12, 2012 Garry 328 posts	Topic: General Discussion / What has gone wrong with Lantus adjustments If you are anything like the rest of us, your Lantus BI changes will take 3 days to have any effect. Please allow time before making any further adjustments. I have confused myself by making too rapid changes in the past. Regards Garry

Apr 7, 2012 Garry 328 posts	Topic: General Discussion / The Best Meter? Like DaveDee, I have used an Abbot Medisense Optium Xceed for years. Abbot diabetic care support, for me personally, has been exceptional. If you are handy on the computer their software, called Co-Pilot, allows you to download all info from the meter to computer via a specific USB lead, both available free to Abbot meter users. Enables you to produce graphs for information in many different formats to HCPs. This software also supports pump users too. Regards Garry

Mar 31, 2012 Garry 328 posts	Topic: General Discussion / new to DAFNE If you carry no fat why not ask your Health Care Professionals if you can try shorter needles. As I said before I use 4 mm 31 gauge, which are the shortest out there at the moment. They may help avoid muscle damage. Regards Garry

Mar 30, 2012 Garry 328 posts	Topic: General Discussion / new to DAFNE I have HUGE needle fear too.....but I get around it by using little itty bitty ones....4 mm 31 gauge If you are confident enough to discuss it, I am sure that there are many folk on here with similar problems. They may be willing and able to share their strategies for overcoming this sort of difficulty. Regards Garry