Recent Posts by marke - DAFNE Online

Oct 30, 2009

marke 657 posts

guys, Just a word of caution. I would advise against putting your email addresses in messages on the forums. Not because of anyone on here, but because spammers scan websites for email addresses to use to send spam to. Since these are public forums, anyone or anything can access them and get hold of your email address. As someone who works in the IT industry and has to battle to block my users receiving spam I can assure you its VERY annoying to start receiving large amounts of spam AND also to have your email address used as the apparent source of spam.
You can use the site private message facility to send each other 'private' messages that contain your email addresses. That way they are NOT available publicly to be accessed by spammers. To use private messages just click on 'message inbox' in the right hand menu.

Oct 28, 2009

marke 657 posts

Topic: General Discussion / I would appreciate anybody's help!

hi, you don't say what area you are in but I guess the circumstances are largely the same in most areas. I would suggest you or her speak to her Diabetes support team and make sure they let the DAFNE Educators in your area know that she is available to attend at short notice, if she can. People often 'drop out' of a course before it starts and places have to be filled by whoever is available. This is how I got on the DAFNE Course.
I would also suggest you check out Diabetes UK, they run single day courses for Diabetics that provide Diabetes education and this may help in the same way as DAFNE, in that you get to spend a day with people who understand exactly what you are going through because they are going through the same thing as well. Its not as good as DAFNE however they are easier to attend than the DAFNE Course.
I know it doesn't help but she is not the only one to behave like this, I have met many many people with a similiar story. The key is being prepared to change and take the condition seriously. Its never too late to do this and there are plenty of other
diabetics who are willing to support and help your friend, both on this site and at Diabetes UK.

Oct 28, 2009

marke 657 posts

Topic: General Discussion / Dawn Phenomenon

Hi Sam, Well to be honest All I have done so far is reduce my BI by 1 unit. I will leave this a while and then think about what to do next. The secret to it all is take your time and don't expect instant results. A few high readings for a while is not going to do any long term damage. Its better to take it slowly and get it right.
I would also wait and see what your consultant says, hopefully they are DAFNE aware and understand how you are managing your Diabetes. The thing about the 'dawn phenomenon' is like all other aspects of Diabetes it will vary from person to person.
I also note you are taking metformin which suggests you have a degree on insulin resistance. Unfortunately this I would guess could be causing issues. I am NOT a HCP, however having been on steriods this year and seeing the bizzare effects that they had on my BG's I know that insulin resistance is not a straight forward 'even' factor in BG's. Thats why its probably better to get the advice of experts, although it does no harm to ask for advice here. You will get support if nothing else on here.

Oct 28, 2009

marke 657 posts

Topic: Site Development / Recipes

hi, yes its possible, we just need to think about how to implement it. Perhaps people could discuss it a bit more in this forum thread and firm up a bit more on what is required. If we have a good idea on what is required we will be more than happy to implement it. The site is here to meet users needs, so if people want recipies we will give it a go. On one condition, no one asks
us to cook them ourselves ;^)

Oct 26, 2009

marke 657 posts

Topic: General Discussion / New Job

I agree with Katy B, there is no rule that says you cannot use a 0.5:1 ratio. Any ratio is valid if it works for you ! I would say though its
worth you re-reading the section of the course on exercise ( either online or on paper). The effects of exercise can last a long time easily into the next day. I would suggest drop to 0.5/1 see how it goes, then adjust BI as well ( seperately of course, not at the same time !). Its problably worth you running high for a few days, just to ensure you keep your hypo warning signs and to try to fix the issue. Its not going to cause you a problem to run high for a week and then you can wind down your BG's and increase your insulins to get things back in line. How you adjust for days when you don't do exercise I guess is going to be tricky, it will be the next day most likely when you see the effects of no exercise NOT the same day. Unfortuantely I think its just trial and error, just like the rest of life :-)

Oct 26, 2009

marke 657 posts

Topic: General Discussion / Dawn Phenomenon

Hi,
Just to prove the people running the site, are just the same as you ;-) I am having a similiar issue to you regarding my BG being too high in the morning. Last nights 'fast' proved that its not my BI as I hypo-ed in the night, so I will now lower it slightly and investigate other options. As a point of interest when I went to the DAFNE Collaborative this year ( see User Group forum), there was a presentation by Prof Simon Heller about the dawn phenomeon. The relavent extract is
'The next two speakers gave a presentation relating to background insulin and its capability to last over 24 hours and probably more interestingly the misconceptions surrounding the Somogyi effect or rebound Hyperglycemia. It has been suggested that many high blood sugars in the morning are caused by night-time hypos. The presenters contended that this is generally NOT the case, the night time hypos only result in a relatively small rise in blood sugar. So if this is not the cause then what is ? It was suggested that the cause is a form of the Dawn Phenomenon where the body releases hormones. The factors that cause this rise are length of sleep, duration that a person has had diabetes and horizontal posture. The biggest issue with this hormone release is it occurs from 5am onwards. This means using an increase of background insulin the night before is not a good way to treat it, since a hypo would occur in the hours before the increase in hormones. The only effective way to treat it is by injecting fast acting insulin, which is a bit of an issue since most people are not awake at 5am. One method would be the use of insulin pumps, but since these are still not widely available to all Diabetics there is no easy solution.'

That doesn't provide a solution I'm afraid but it might provide an insight into what is happening to you as well as me. Unfortunately I have not seen any follow up to this, if I see any follow ups I will post on this site.

Oct 20, 2009

marke 657 posts

Topic: Site Development / Meter Upload Development

Hi, I have an Ultra Smart as well I'm afraid :-( I like all the geeky features on it, being able to enter more than just BG readings.
The bluetooth meter sounds interesting in principle, however what does it do to the battery life ? Usually bluetooth tends to eat batteries so it might not be a great idea, it would be interesting to hear if anyone has tried one.
Yes it would be good to have a common standard however the rest of the computer industry has never managed it, so why believe that meter companies can do it. I am suprised by the minutes since 2000 approach, the seconds since 1970 is fairly standard on most unix/linux derivatives which I'm guessing these devices run. It would be nice to have published protocols, even better software API's. If its windows software its most likely been written using COM and it would be easy to publish an API for people to use. Although there is unlikely to be much demand for it I guess ;-)
Anyway keep at it, as soon as you have something read we can work out how to interface it to the website so we can upload.

Oct 19, 2009

marke 657 posts

Topic: Site Development / Meter Upload Development

Hi, we would be interested ( as Simon has said in the past) in anything you produce. I guess once you can 'extract' the data from the meter we need to get it into a format that can be 'uploaded' to the site. Let us know when you are in a position to do this and we can work on it.
I was also intetrested in the link you posted on the Roche meters. To be honest I gave up on Compass and switched to lifescan because I couldn't put up with their obsession with Infra-red any longer. In my experience I have never used a 'good' infra-red device, its a technology that had its day in the 80's and is long past its useby date. Especially as USB is now such a 'standard', its much better supported and widely used. Roche now have this 'smartpix' device that uses USB to the PC but still uses infra-red to the device :-( I would like to get my hands on a 'smartpix' but they won't send me one without charging and since I don't use a Roche meter, I can't see the point. One day maybe we can do something with Roche, however Lifescan seem much more friendly AND use USB !!

Oct 14, 2009

marke 657 posts

Topic: General Discussion / Do you have access to the Online Handbook?

nk2965, if you contact us via the link at the bottom of this ( and every page), telling us your full name and the dates you attended the course ( as accurately as you can) we then contact DAFNE central who contact the former DAFNE Educators who ran the course to check you are a graduate. This site doesn't directly contact DAFNE Educators/HCP's for a DAFNE Centre since they already have enough to cope with. When contacted by DAFNE Central they usually provide an answer quite quickly and this is then relayed back to us. We are aware of the issue of centres that 'leave the family' and are trying to find a solution ( other than threats of violence to make them rejoin ;^) )

Oct 1, 2009

marke 657 posts

Topic: General Discussion / Introductions

John, the text at the bottom right of the table shows what type of view is being displayed i.e verified> All > my. The button at the top shows you what will be displayed if the click on it. I can look at highlighting the text at the bottom right more and also add a better description on the introduction page.

With regard to your request for selection and excel download, this should be possible and I have noted your request. However at the moment I am focused on getting the Australian DAFNE documents in the correct format for the site and changing the site to work with them. I then have the user group pages to do. Simon is working on new features that will be released soon as well. Unfortunately with just two of us, we can only do what we can in the time we have. We will try to implement your request in future, I just can't give a timescale at the moment.

Oct 1, 2009

marke 657 posts

Topic: General Discussion / How many Test Strips ?

David, thanks for sharing this experience with everyone, hopefully it shows others that it IS possible to make sure your get the tools you need to manage your diabetes properly. If anyone has been unable to get test strips please post and let us know. With the growing membership here AND the User Group now running we should be looking to resolve any issues with PCT's and Doctor practices that are not 'enlightened'. If they refuse to be 'enlightened' then we will send the boys round !!

Oct 1, 2009

marke 657 posts

Topic: General Discussion / Introductions

John, and others, the A5 list sounds interesting but just to point out you can do this with the online carb counting pages. Its possible to add your own entries and display just your own entries on the pages. This coupled with the fact its available on mobile phones (if you have a phone that can do it) means you could save a tree ;-) Well you could have a back up for your
A5 paper copy anyway.

Its also always interesting to read other peoples experiences, one of the great things about the DAFNE course is a week of sharing experiences with other Diabetics, hopefully this site helps extend that sharing experience :-)

Sep 25, 2009

marke 657 posts

Topic: General Discussion / How many Test Strips ?

David, Please keep us posted on what happens. I am fortunate enough to not have had any problems myself, I just write to my GP make my demands and she does as she is told ;-) But seriously in my guise as a DAFNE User Action Group member this is an issue we would be interested to hear about. If DAFNE Graduates cannot get the test strips they need to function then something needs to be done about it. Sadly some people in the medical profession believe short term savings are good. However if you cannot test properly have a hypo and need hospital treatment all those savings go flying out the window. Sometimes they need this explaining to them :-)

Sep 23, 2009

marke 657 posts

Topic: General Discussion / DAFNE BG Diaries

If you have run out of BG Diaries and need some more there are two ways of getting them.

1) Contact your DAFNE Educator who should have some as they are sent them by DAFNE Central for distribution to graduates.

2) Go to this page and select what you want to order on the forms and they will send you some.

We would like to give you the option of printing it out from this site, however the electronic version is in a format for the 'printing' company and will not easily print on a home printer. We will continue to work on this and if/when its online we will let you know.

Sep 17, 2009

marke 657 posts

Topic: DAFNE Online Mobile / Mobile Feature Requests

Gem, the function to remember passwords is usually implemented on the client i.e your PC or phone. web browsers have an option to remember passwords that you can use to achieve this function. in internet explorer you can enable it under tools->internet options, go to the content tab and clikc on the 'auto complete' settings button. here you can enable the remembering of passwords. In firefox is usually asks you in a bar below the top menu bar if you want to remember a password. Of course being involved in IT security I would never do this but I'm paranoid ;-(

With regard to the mobile site layout issue of carb values can you try to describe what it looks like ? On the HTC TYTN II I had it worked ok and that should be a similiar screen to yours, however I have never played with a HTC Touch. We will always try to fix any issues if they are reported.

Aug 19, 2009

marke 657 posts

Topic: General Discussion / Changes to HbA1c reporting

jess, see this post for links to further details and the rationale for why it is being done.

Aug 19, 2009

marke 657 posts

Topic: General Discussion / Meeting up after the course

interesting points, at the DAFNE Collaborative a few months ago, one of the presentations was about research on post course experiences and its was clear that some people need further support/training and some need something less formal but still need support to help them stay focused on DAFNE Principles. I think this is one of the areas the DAFNE User Action Group
should address (there will be a section on the website for the group, when I work out how to format it) and I will raise it as a discussion point at the next meeting. One of the current DUAG objectives is to find the 'missing' 12,000 DAFNE Graduates who did the course before permission was asked to hold their details centrally. Once we 'find' the missing 12,000 we will need a plan to keep them involved/updated. Since not everyone has, or will have, access to this website having localised meetings for those interested would be a sensible option.

Aug 18, 2009

marke 657 posts

Topic: General Discussion / Do you have access to the Online Handbook?

Jess,
I have contacted DAFNE Central about 'verifying' you as a graduate, as soon as I have a result I will let you know.

Aug 15, 2009

marke 657 posts

Topic: Questions ? / Can anyone put numbers (%) on ideal split between above target, on target and below target BGs?

As ever I will start by saying I am NOT a HCP just a run of the mill DAFNE Graduate.

So, what should you be aiming for, perfection ! Will you ever acheive it ? Very probably no, but it doesn't hurt to try :-) I don't believe a view has been formed because I don't think one can. We are all different and the answer will differ slightly for each of us. Keeping your BG's within target range reduces your risks of complications, the key here is 'reduces'. Life doesn't come with an guarantees and especially not if you have Diabetes. You could keep your BG's perfect and still suffer complications and vice-versa, again because we are ALL different our risk factors will vary. It's just life !
So at least you are seeing an improvement, making progress, thats something to be happy about ! So well done.
By the way we are glad that you are finding the graphs useful :-)

Aug 15, 2009

marke 657 posts

Topic: General Discussion / Do you have access to the Online Handbook?

John,
I'm really sorry but we cannot give you access to the handbook at the moment. I appreciate you don't get to choose what Diabetes Education course you do and it sounds a bit 'them' and 'us', but we are only allowed to provide access to validated DAFNE Graduates.
Why is this ? Well amonst other things, there is concern that non DAFNE people will try to use information in the handbook without the backup of a DAFNE Educator and do themselves harm. I know there are some that do not agree with this and think eveyone should be treated as though they are capable of managing without DAFNE Educators. Unfortunately this is not a risk DAFNE Central or DAFNEOnline are prepared to take.
In addition DAFNE Central are concerned about 'variations' on DAFNE like BIANCA. The point of DAFNE is it is rigidly based on the original german version and has a very tight management scheme of the DAFNE Educators. All DAFNE courses should be pretty much identical in course content regardless of where they are run, the educators are also all trained the same and are audited every year. This means the course meets all the NHS criteral for Diabetes Education and is consistent.
Unfortunately PCT variations do NOT have this kind of control or management and are often cut down versions of DAFNE. This may mean what are considered vitial elements are missed out. I appreicate this doesn't help you and I would like to be able to help, however we have to stick to the rules laid down by DAFNE Central since we work so closely with them. If the situation changes we will let you know.

Aug 15, 2009

marke 657 posts

Topic: General Discussion / Do you have access to the Online Handbook?

Jess,
If you can remember who your dAFNE educator was or when you did the course we might be able to cross reference it with DAFNE
Central and give you access i.e change your account status to graduate. Why do we need to do this, see my response to John below.

Aug 13, 2009

marke 657 posts

Topic: General Discussion / Introductions

To Shelia and others, it is probably better if you start a new topic to ask questions. This topic now goes on for 6 pages and chances are people will not see your question buried in all the other posts.
You are welcome to ask questions here if you want, its just likely to get a better response as a seperate topic.

Thanks

Aug 3, 2009

marke 657 posts

Topic: General Discussion / Increasing awareness of this fourm.

Widster,
Thanks for your positive actions, I agree it would be good if others could do the same with such positive results. To this end we will be approaching members of the site in the near future in the guise of the DAFNE User Action Group. This is the elected 'users group' for the DAFNE programme. The group has only just had its first meeting and is still getting orgainised, but in the near future there will be more information about the group on this site and requests for your involvement in publicising and moving DAFNE forward.

In the mean time thank you again for your efforts !

Jul 29, 2009

marke 657 posts

Topic: DAFNE Online Mobile / Mobile site released

I seem what you mean about the black text on grey background... I thought the grey was much lighter than that, I will get it changed so that its more readable.

Jul 12, 2009

marke 657 posts

Topic: General Discussion / Introductions

welcome john, there will be a lot more about the DAFNE User Group soon. I attended the 'introductory/training' meeting this friday and saturday and the group is now up and running. However obviously we are at a very early stage and it will take time to acheive our objectives. I will be posting more about this in the user group forum once I receive some write-ups from the meeting. I also recently posted a report on the DAFNE collarobative in that forum that has a paragraph on the dawn effect, sadly its not a solution just more of a realisation of its effect. hopefully more research in the area will produce a means of 'treating' it effectively.
Be careful what you volunteer for :-) , one of our terms of reference in the user group is to allow us to co-opt others to help in certain areas. Although obviously at this stage we have no idea what for. In the meantime I'm sure you you can help others by being active in the forums posting replies to questions.