Recent Posts by Alan 49

Dec 24, 2010

Alan 49 284 posts

Topic: General Discussion / A very Merry Christmas to you all

Thanks Simon, Mark and everybody at DAFNE Online for all the hard work you do to give us a really helpful resource that I'm sure we all find very useful. Best wishes to all of you.

Nov 19, 2010

Alan 49 284 posts

Topic: Carbohydrate Counting / Carb Free Breakfast

The bread content in sausages depends on how much you pay for them: the cheaper sausages will have a higher percentage of bread - that's why they are cheap. The more you pay the more meat you get and therefore the less bread. It's always worth checking the package to get the carb content.

Alan

Nov 12, 2010

Alan 49 284 posts

Topic: General Discussion / Exercise

Andy - as Novorapidboi says, you shouldn't normally have QA before exercise - but it depends. When I go for my early morning swim, my BG goes up by 3 or 4 mmol. My diabetic consultant told me that it is because of an 'adrenalin rush' when I go to the pool, which triggers the release of glucagon from the liver. What I do if my BG is over 7.5 is to give myself 1 unit of QA and this stops it going too high. This doesn't happen when I go on my exercise-bike at home: my BG goes down by about 4, so I make sure it's not less than 8 before I start. It may depend on where you take your exercise - if you go to a gym, then you may get the 'adrenalin rush' like I do when I go to the swimming baths.
But everyone is different, Andy - if your BG goes up by 6 mmol consistently you my need 1 or 2 units of QA before. Try 1 at first and take it from there. Remember: good decisions depend on information, so make sure you make the necessary entries in your diary.

Oct 21, 2010

Alan 49 284 posts

Topic: General Discussion / Shortage of test strips

What a strange world we live in, Mark. So something can be manufactured in the UK, transported to the EU, relabelled for the UK and then transported back to the UK - is that what you are saying? But the Accu-Chek test strips are manufactured in Germany, so that wouldn't apply to them.

Oct 20, 2010

Alan 49 284 posts

Topic: General Discussion / Shortage of test strips

I have been told that last week, on the One Show (on BBC1), there was a piece about a cancer patient who was having trouble getting the drugs prescribed to treat her condition. The programme went on to say that after investigation, it was found that drug companies and wholesalers were restricting supplies to UK pharmacies because of the weakness of the Pound. They were maximising their profits by shipping more of their products to European countries - hence the shortages in the UK. I didn't see the programme myself, but it sounds feasible. On searching the BBC website, I found the following page: http://news.bbc.co.uk/1/hi/health/8516080.stm which is dated in February this year and would seem to be about the same problem. I wonder whether this was the cause of the problem I had.

Oct 11, 2010

Alan 49 284 posts

Topic: General Discussion / Insurance for pump

Have you tried contacting the Diabetes UK Careline (0845 120 2960) - it might be worth getting them involved in this.

Oct 8, 2010

Alan 49 284 posts

Topic: Questions for HCPs / wound healing

Sorry to show my ignorance here, but what is an endocrinologist?

Oct 7, 2010

Alan 49 284 posts

Topic: General Discussion / Shortage of test strips

I contacted Accu-Chek (who manufacture the strips) and asked if there was a problem their end and they told me that there were no problems at all. I then contacted the pharmacy at the local Morrison's supermarket who said that they had some in stock and that there were no problems with supply. Obviously the problem was confined to my local Lloyd's pharmacy. Anyway, i called in today and got the remainder of my prescription. I asked the assistant what the problem was and she said she didn't know, I then asked if it was likely to happen again and again the answer was 'Don't Know' - she seemed narked that I was asking - probably thought i was a grumpy old man. She got that right right, anyway. I'm not very impressed with Lloyd's.

Oct 2, 2010

Alan 49 284 posts

Topic: General Discussion / Shortage of test strips

On Thursday (30th September) I went to my local Lloyd's chemist to pick up my prescription and they could only give me one pot of Aviva test strips - my prescription is for three pots. I went back today to pick up the rest of my prescription and was told that they had not come in - they said that Lloyd's were having trouble with their supplier and could not forecast when they would get any more. Has anybody else had this problem?

Sep 18, 2010

Alan 49 284 posts

Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present

Instead of 'free mixing', why can't you give yourself your dose of QA insulin and then the small dose of BI from a different pen?

Alan

Aug 8, 2010

Alan 49 284 posts

Topic: General Discussion / Diabetes.............

If you have problems remembering if you've injected or not and you're on Humalog insulin, there is a pen with a display and a memory, so you can see the date & time of your last injection - see: http://www.dafneonline.co.uk/forums/1/topics/328

Alan

Aug 4, 2010

Alan 49 284 posts

Topic: General Discussion / Diabetes.............

I think that life is full of inconveniences: some mornings I find it inconvenient to have to get up; sometimes I find it inconvenient to go shopping or mowing the lawn or putting petrol in the car or shaving. Likewise, I sometimes find it inconvenient to test my BG before a meal or before I drive; to remember to take some glucose tablets with me before I go out; to have to calculate the CPs in a meal; to try not to be conspicuous when I inject at the table in a restaurant. As I said, life is full of inconveniences - be they medical or non-medical, but we deal with them.

Alan

Aug 3, 2010

Alan 49 284 posts

Topic: General Discussion / Diabetes.............

I think you've both missed the point of Claire's clever play on the word 'disease'. She's not saying that it's a disease but more of an inconvenience. That's my interpretation of her comment. anyway.

Alan

Jul 17, 2010

Alan 49 284 posts

Topic: General Discussion / Insulin Pens

Wow! I didn't realise Lilly supplied Memoir pens Free - the last time I got a replacement from my GP, the nurse said they were expensive (Â£54 I think she said). My back-up pen looks very much like the Memoir, but with an ordinary dial - so no battery to run down (and no memory, obviously) - but it's OK for emergency use, till you get a replacement. Remember that all the time you've got your spare Memoir in a drawer - the battery on that is depleting as well, so when you get round to using it, it won't last as long as you hope.

Jul 12, 2010

Alan 49 284 posts

Topic: General Discussion / Exhaustion

Athena

sounds like a job for your Healthcare Professional

Alan

Jun 25, 2010

Alan 49 284 posts

Topic: General Discussion / Insulin Pens

I have been using a HumaPen Memoir for a couple of years and can recommend them wholeheartedly. At my age 'senior moments' occur several times a day, but the Memoir solves those as far as injections are concerned - it shows the date, time and units of previous injections. Of course it also records the 'priming' of the pen before the actual injection, but you get used to ignoring these if you are scrolling back - they are always within a minute of the real injection. If you are eating out, there's no need to take your diary with you, because you can check the units injected when you get home. A good product.

The only downside to them is that when the battery goes, there's no dial (and no display, obviously), but there are still audible clicks as you dial up the dose. There are no facilities to insert a new battery - it means getting a replacement pen.

May 10, 2010

Alan 49 284 posts

Topic: Questions for HCPs / Washing before testing

I always wash my hands before testing, but there are occasions when this is not possible. For example - being on a plane and not being able to get to the loo before the meal is served, or being on a beach somewhere, where there are no washing facilities. In the past, I've always carried Sterets alcohol wipes to cleanse before finger-pricking, but someone told me that the alcohol can effect the test results. Any ideas?

Apr 16, 2010

Alan 49 284 posts

Topic: Carbohydrate Counting / Carb Links section added

Mark

Would it be appropriate to put a link to the Glycaemic Index here?

Apr 9, 2010

Alan 49 284 posts

Topic: General Discussion / Where you inject matters

Thanks for the feedback - very useful. Regarding the treatment of hypos: I've never found it necessary to have the recommended 2 CPs of medium-acting carbs as well as the 2 fast-acting portions. I used to use hypos as an excuse to 'pig-out' on things ususally forbidden - chocolates etc, but I found that the resuilting BG tests were way too high, so I now keep it to 2CPs - or 3 if it's a bad one. That seems to work for me.
I have to admit that in February I was trying hard to keep my BGs 'withing target'; obviously I was trying too hard and getting lots of 'below 4' tests. I have since (as Marke suggests) reduced my BI by one unit and I've not been so stringent with my QA injections. Consequenlty, my BGs are running a bit on the high side.
I agree with JWo that the DAFNE guidelines are just recommendations - not rules.
Thankfully, the night-time hypos haven't occurred since.

Apr 4, 2010

Alan 49 284 posts

Topic: General Discussion / Where you inject matters

Until recently, it had heen several years since I last had a night-time hypo, but in February, I had two. On the evening of the 25th, my BG before bed was 14.2 - unusually high for me - so as well as my normal dose of BI, I had one unit of QA. At around 3am I had a bad hypo - requiring assistance from my wife. I could see no reason for this hypo, so I assumed it was 'one of those things'.
A few nights later (on the 27th) my BG before bed was 10.0 - but I did not take any corrective QA. I awoke at 3:45am covered in sweat and when I tested my BG, I was 3.6 and was able to take some corrective carbs.
This was now a real concern. I looked at my BG diary, and noticed that I normally inject in the stomach area before dinner, but on these two occasions I had injected into my thighs. I raised this at the 1-year DAFNE review and was told that insulin injected into the legs takes longer to become active and that this could explain my night-time hypos.
Since then I have injected in the stomach before dinner and have had no further night-time problems.
It seems, that for me, where I inject really does matter. I was not aware of this before. Has anyone else noticed this?

Mar 13, 2010

Alan 49 284 posts

Topic: General Discussion / Advice on sugar levels after exercise

I've been early-morning swimming for some time and I noticed that my BG was higher after the swim than before. I mentioned this on the DAFNE course and was told that the swim induced an 'adrenalin rush', which evidently triggers the release of glucagon from the liver - hence the increase in BG. What I do now is - if the BG before the swim is higher that 6 I give myself 1 unit of QA insulin - that seems to work for me.

Feb 26, 2010

Alan 49 284 posts

Topic: Site Development / Glycaemic Index

Marke

Any response on this yet?

Alan

Feb 25, 2010

Alan 49 284 posts

Topic: Questions for HCPs / Hypo recognition.

Further to Cmac's suggestion of contamination: on the DAFNE course I was on, we were told that Carex anti-bacterial handwash can affect blood-glucose tests. Pre DAFNE I used to use Carex, but never noticed anything abnormal. I now use handwashes that are not anti-bacterial - just in case.

Jan 26, 2010

Alan 49 284 posts

Topic: Site Development / Glycaemic Index

I apologise - there IS a reference to the Glycaemic Index in the DAFNE Course Handbook section. It gives a short list of high GI items and a list of low GI items. I appreciate that compiling and maintaining a full Glycaemic Index list would be quite a task, but I'm sure this facility would enhance DAFNE Online's reputation as a source of useful information.

Alan

Jan 25, 2010

Alan 49 284 posts

Topic: Site Development / Glycaemic Index

I couldn't find any reference to GI in DAFNE Online and wondered whether it might be a useful feature. I know that DAFNE allows an 'eat what you like' approach to food, but I've also been told that a meal containing a mixture of low, medium and high GI items can give a steady release of glucose into the system, which is better than a sudden rush of glucose - which a high GI meal gives you.
There are Glycaemic Index tables on the web and I wondered whether a link to one of these (e.g. www.glycaemicindex.com) would be something you might think feasible. A brief explanation of the Glycaemic Index might be necessary for those not familiar with it.

Dec 24, 2010 Alan 49 284 posts	Topic: General Discussion / A very Merry Christmas to you all Thanks Simon, Mark and everybody at DAFNE Online for all the hard work you do to give us a really helpful resource that I'm sure we all find very useful. Best wishes to all of you.

Nov 19, 2010 Alan 49 284 posts	Topic: Carbohydrate Counting / Carb Free Breakfast The bread content in sausages depends on how much you pay for them: the cheaper sausages will have a higher percentage of bread - that's why they are cheap. The more you pay the more meat you get and therefore the less bread. It's always worth checking the package to get the carb content. Alan

Nov 12, 2010 Alan 49 284 posts	Topic: General Discussion / Exercise Andy - as Novorapidboi says, you shouldn't normally have QA before exercise - but it depends. When I go for my early morning swim, my BG goes up by 3 or 4 mmol. My diabetic consultant told me that it is because of an 'adrenalin rush' when I go to the pool, which triggers the release of glucagon from the liver. What I do if my BG is over 7.5 is to give myself 1 unit of QA and this stops it going too high. This doesn't happen when I go on my exercise-bike at home: my BG goes down by about 4, so I make sure it's not less than 8 before I start. It may depend on where you take your exercise - if you go to a gym, then you may get the 'adrenalin rush' like I do when I go to the swimming baths. But everyone is different, Andy - if your BG goes up by 6 mmol consistently you my need 1 or 2 units of QA before. Try 1 at first and take it from there. Remember: good decisions depend on information, so make sure you make the necessary entries in your diary.

Oct 21, 2010 Alan 49 284 posts	Topic: General Discussion / Shortage of test strips What a strange world we live in, Mark. So something can be manufactured in the UK, transported to the EU, relabelled for the UK and then transported back to the UK - is that what you are saying? But the Accu-Chek test strips are manufactured in Germany, so that wouldn't apply to them.

Oct 20, 2010 Alan 49 284 posts	Topic: General Discussion / Shortage of test strips I have been told that last week, on the One Show (on BBC1), there was a piece about a cancer patient who was having trouble getting the drugs prescribed to treat her condition. The programme went on to say that after investigation, it was found that drug companies and wholesalers were restricting supplies to UK pharmacies because of the weakness of the Pound. They were maximising their profits by shipping more of their products to European countries - hence the shortages in the UK. I didn't see the programme myself, but it sounds feasible. On searching the BBC website, I found the following page: http://news.bbc.co.uk/1/hi/health/8516080.stm which is dated in February this year and would seem to be about the same problem. I wonder whether this was the cause of the problem I had.

Oct 11, 2010 Alan 49 284 posts	Topic: General Discussion / Insurance for pump Have you tried contacting the Diabetes UK Careline (0845 120 2960) - it might be worth getting them involved in this.

Oct 8, 2010 Alan 49 284 posts	Topic: Questions for HCPs / wound healing Sorry to show my ignorance here, but what is an endocrinologist?

Oct 7, 2010 Alan 49 284 posts	Topic: General Discussion / Shortage of test strips I contacted Accu-Chek (who manufacture the strips) and asked if there was a problem their end and they told me that there were no problems at all. I then contacted the pharmacy at the local Morrison's supermarket who said that they had some in stock and that there were no problems with supply. Obviously the problem was confined to my local Lloyd's pharmacy. Anyway, i called in today and got the remainder of my prescription. I asked the assistant what the problem was and she said she didn't know, I then asked if it was likely to happen again and again the answer was 'Don't Know' - she seemed narked that I was asking - probably thought i was a grumpy old man. She got that right right, anyway. I'm not very impressed with Lloyd's.

Oct 2, 2010 Alan 49 284 posts	Topic: General Discussion / Shortage of test strips On Thursday (30th September) I went to my local Lloyd's chemist to pick up my prescription and they could only give me one pot of Aviva test strips - my prescription is for three pots. I went back today to pick up the rest of my prescription and was told that they had not come in - they said that Lloyd's were having trouble with their supplier and could not forecast when they would get any more. Has anybody else had this problem?

Sep 18, 2010 Alan 49 284 posts	Topic: Questions for HCPs / Rising morning BG knowing the 'Dawn' Phenomenon is not present Instead of 'free mixing', why can't you give yourself your dose of QA insulin and then the small dose of BI from a different pen? Alan

Aug 8, 2010 Alan 49 284 posts	Topic: General Discussion / Diabetes............. If you have problems remembering if you've injected or not and you're on Humalog insulin, there is a pen with a display and a memory, so you can see the date & time of your last injection - see: http://www.dafneonline.co.uk/forums/1/topics/328 Alan

Aug 4, 2010 Alan 49 284 posts	Topic: General Discussion / Diabetes............. I think that life is full of inconveniences: some mornings I find it inconvenient to have to get up; sometimes I find it inconvenient to go shopping or mowing the lawn or putting petrol in the car or shaving. Likewise, I sometimes find it inconvenient to test my BG before a meal or before I drive; to remember to take some glucose tablets with me before I go out; to have to calculate the CPs in a meal; to try not to be conspicuous when I inject at the table in a restaurant. As I said, life is full of inconveniences - be they medical or non-medical, but we deal with them. Alan

Aug 3, 2010 Alan 49 284 posts	Topic: General Discussion / Diabetes............. I think you've both missed the point of Claire's clever play on the word 'disease'. She's not saying that it's a disease but more of an inconvenience. That's my interpretation of her comment. anyway. Alan

Jul 17, 2010 Alan 49 284 posts	Topic: General Discussion / Insulin Pens Wow! I didn't realise Lilly supplied Memoir pens Free - the last time I got a replacement from my GP, the nurse said they were expensive (Â£54 I think she said). My back-up pen looks very much like the Memoir, but with an ordinary dial - so no battery to run down (and no memory, obviously) - but it's OK for emergency use, till you get a replacement. Remember that all the time you've got your spare Memoir in a drawer - the battery on that is depleting as well, so when you get round to using it, it won't last as long as you hope.

Jul 12, 2010 Alan 49 284 posts	Topic: General Discussion / Exhaustion Athena sounds like a job for your Healthcare Professional Alan

Jun 25, 2010 Alan 49 284 posts	Topic: General Discussion / Insulin Pens I have been using a HumaPen Memoir for a couple of years and can recommend them wholeheartedly. At my age 'senior moments' occur several times a day, but the Memoir solves those as far as injections are concerned - it shows the date, time and units of previous injections. Of course it also records the 'priming' of the pen before the actual injection, but you get used to ignoring these if you are scrolling back - they are always within a minute of the real injection. If you are eating out, there's no need to take your diary with you, because you can check the units injected when you get home. A good product. The only downside to them is that when the battery goes, there's no dial (and no display, obviously), but there are still audible clicks as you dial up the dose. There are no facilities to insert a new battery - it means getting a replacement pen.

May 10, 2010 Alan 49 284 posts	Topic: Questions for HCPs / Washing before testing I always wash my hands before testing, but there are occasions when this is not possible. For example - being on a plane and not being able to get to the loo before the meal is served, or being on a beach somewhere, where there are no washing facilities. In the past, I've always carried Sterets alcohol wipes to cleanse before finger-pricking, but someone told me that the alcohol can effect the test results. Any ideas?

Apr 16, 2010 Alan 49 284 posts	Topic: Carbohydrate Counting / Carb Links section added Mark Would it be appropriate to put a link to the Glycaemic Index here?

Apr 9, 2010 Alan 49 284 posts	Topic: General Discussion / Where you inject matters Thanks for the feedback - very useful. Regarding the treatment of hypos: I've never found it necessary to have the recommended 2 CPs of medium-acting carbs as well as the 2 fast-acting portions. I used to use hypos as an excuse to 'pig-out' on things ususally forbidden - chocolates etc, but I found that the resuilting BG tests were way too high, so I now keep it to 2CPs - or 3 if it's a bad one. That seems to work for me. I have to admit that in February I was trying hard to keep my BGs 'withing target'; obviously I was trying too hard and getting lots of 'below 4' tests. I have since (as Marke suggests) reduced my BI by one unit and I've not been so stringent with my QA injections. Consequenlty, my BGs are running a bit on the high side. I agree with JWo that the DAFNE guidelines are just recommendations - not rules. Thankfully, the night-time hypos haven't occurred since.

Apr 4, 2010 Alan 49 284 posts	Topic: General Discussion / Where you inject matters Until recently, it had heen several years since I last had a night-time hypo, but in February, I had two. On the evening of the 25th, my BG before bed was 14.2 - unusually high for me - so as well as my normal dose of BI, I had one unit of QA. At around 3am I had a bad hypo - requiring assistance from my wife. I could see no reason for this hypo, so I assumed it was 'one of those things'. A few nights later (on the 27th) my BG before bed was 10.0 - but I did not take any corrective QA. I awoke at 3:45am covered in sweat and when I tested my BG, I was 3.6 and was able to take some corrective carbs. This was now a real concern. I looked at my BG diary, and noticed that I normally inject in the stomach area before dinner, but on these two occasions I had injected into my thighs. I raised this at the 1-year DAFNE review and was told that insulin injected into the legs takes longer to become active and that this could explain my night-time hypos. Since then I have injected in the stomach before dinner and have had no further night-time problems. It seems, that for me, where I inject really does matter. I was not aware of this before. Has anyone else noticed this?

Mar 13, 2010 Alan 49 284 posts	Topic: General Discussion / Advice on sugar levels after exercise I've been early-morning swimming for some time and I noticed that my BG was higher after the swim than before. I mentioned this on the DAFNE course and was told that the swim induced an 'adrenalin rush', which evidently triggers the release of glucagon from the liver - hence the increase in BG. What I do now is - if the BG before the swim is higher that 6 I give myself 1 unit of QA insulin - that seems to work for me.

Feb 26, 2010 Alan 49 284 posts	Topic: Site Development / Glycaemic Index Marke Any response on this yet? Alan

Feb 25, 2010 Alan 49 284 posts	Topic: Questions for HCPs / Hypo recognition. Further to Cmac's suggestion of contamination: on the DAFNE course I was on, we were told that Carex anti-bacterial handwash can affect blood-glucose tests. Pre DAFNE I used to use Carex, but never noticed anything abnormal. I now use handwashes that are not anti-bacterial - just in case.

Jan 26, 2010 Alan 49 284 posts	Topic: Site Development / Glycaemic Index I apologise - there IS a reference to the Glycaemic Index in the DAFNE Course Handbook section. It gives a short list of high GI items and a list of low GI items. I appreciate that compiling and maintaining a full Glycaemic Index list would be quite a task, but I'm sure this facility would enhance DAFNE Online's reputation as a source of useful information. Alan

Jan 25, 2010 Alan 49 284 posts	Topic: Site Development / Glycaemic Index I couldn't find any reference to GI in DAFNE Online and wondered whether it might be a useful feature. I know that DAFNE allows an 'eat what you like' approach to food, but I've also been told that a meal containing a mixture of low, medium and high GI items can give a steady release of glucose into the system, which is better than a sudden rush of glucose - which a high GI meal gives you. There are Glycaemic Index tables on the web and I wondered whether a link to one of these (e.g. www.glycaemicindex.com) would be something you might think feasible. A brief explanation of the Glycaemic Index might be necessary for those not familiar with it.