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Dr Katharine Morrison

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The meter doesn't really do anything that you cant do on paper.............

I suppose without it you could round up you carbs, not consider on board doses, but it shouldn't really drop your dose significantly, provided your on the right dose initially..........

But I would recommend it Alan.........
 
novorapidboi26 said:
The meter doesn't really do anything that you cant do on paper.............

I suppose without it you could round up you carbs, not consider on board doses, but it shouldn't really drop your dose significantly, provided your on the right dose initially..........

But I would recommend it Alan.........
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No, it doesn't do anything you can't do on paper, it just does it a heck of a lot quicker and easier if you have fed it the right information when setting it up, but what I was trying to say was that it showed up the fact that I was taking too much insulin when working it out for myself because I was working on the wrong ratio. This leads to your liver putting out more glucose and becomes a spiralling effect where you keep on increasing your doses.

It was only at the course we did when it was set up that my ratios were worked out (by me on a formula we were given) and actually they weren't far out and were less than half what I had assumed them to be.
 
Pattidevans said:
No, it doesn't do anything you can't do on paper, it just does it a heck of a lot quicker and easier if you have fed it the right information when setting it up, but what I was trying to say was that it showed up the fact that I was taking too much insulin when working it out for myself because I was working on the wrong ratio. This leads to your liver putting out more glucose and becomes a spiralling effect where you keep on increasing your doses.

It was only at the course we did when it was set up that my ratios were worked out (by me on a formula we were given) and actually they weren't far out and were less than half what I had assumed them to be.
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Have you done DAFNE?

The end result is good anyway...............I am surprised you didn't go low if you were taking half of what your on now........almost everyone that attends a DAFNE course is on too much background insulin..............how is yours?
 
Yes Dr Katherine ideology is very much based on Bernstein

Yep both with MDI and with my old pump I used to mentally have to calculate my IOB.. It's harder with the pump when you are calculating the extended or multi-wave bolus.. And if the truth was know with the pump extended/Multi-wave my IOB was partly based on a gut instinct stab in the dark😱 But in the 3 years of was using the Spirit I only knowingly stacked my insulin once.. So either my calculation was right or when it comes to a stab in the dark I've got spot of aim🙂

As to the protein/fat I think that with MDI it's impact can be masked by the fluctuations within the basal profile so probably not as noticeable as using a pump where you are working from a much flatter basal profile... As it can be the not allowing for the protein/fat impact that can cause a lot of control issues for the diabetic..

Now that I've got the Combo pump I do use the bolus wizard makes life easier.

Bernstein doesn't like insulin pumps and for patients like me who are sensitive to insulin and the pump can deliver the minute dosages required.. He instructs them to dilute their insulin to achieve the correct strength/dose rather than use a pump
 
Ellie Jones said:
...Bernstein doesn't like insulin pumps and for patients like me who are sensitive to insulin and the pump can deliver the minute dosages required.. He instructs them to dilute their insulin to achieve the correct strength/dose rather than use a pump
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What??? Seems (bordering on) the obsessive to me. So, that's 3 insulins, 20 jabs a day and diluting your insulin, plus an extreme low carb diet....no thanks! 😱
 
Ellie Jones said:
Bernstein doesn't like insulin pumps and for patients like me who are sensitive to insulin and the pump can deliver the minute dosages required.. He instructs them to dilute their insulin to achieve the correct strength/dose rather than use a pump
Click to expand...

WOW, I can see that catching on..................😉
 
novorapidboi26 said:
Have you done DAFNE?

The end result is good anyway...............I am surprised you didn't go low if you were taking half of what your on now........almost everyone that attends a DAFNE course is on too much background insulin..............how is yours?
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No I haven't done a DAFNE or similar course. I was diagnosed T2 8.5 years ago by the GPs nurse because of my age. It was only this summer that I finally got to see an endo who did a CPeptide test and pronounced that I was T1, not just due to the results of the CPeptide, but also to do with symptoms at time of diagnosis (rapid weight loss, ketones) so anything of a diabetic education nature was denied to me. Having said that, there's not actually much in the way of diabetes education in my neck of the woods - there are currently over 100 people waiting for a course that is 4 x half days.

Meantime I pretty much educated myself, did the BDEC online course, read John Walsh's "using insulin" and Gary Scheiner's "Think like a Pancreas". But if all you ever see is the GPs nurse, you don't have a lot of support for working things out, I've had to do it for myself. Don't get me wrong, as far as it goes the GPs nurse is very good and has certainly been helpful in getting me anything I asked for, including the referral to the Endo when I finally told her that I was having a diabetic identity crisis because I was pretty certain I was mis-diagnosed!

The tide has been turned a bit now and I had an invitation to the insulinx course and then this week a long appointment with the Dietitian to do the start of carb counting, but she said I knew what I was doing re carbs and I don't have to go back unless I want to. I've also got an appointment with the DSN at the clinic on 6 Dec to review progress since the Insulinx course.

So in answer to your question of am I on too much basal, yes I do believe I am, in fact I know I am. I have reduced Levemir by 3u at night and 2u in the morning now and things seem to be going well so far. It needs further reduction and I think that will probably influence bolus ratios yet again since at current levels the basal may be propping the bolus up. I'm hanging in there until I see the DSN.
 
You seem to be doing a great job with the resources you have well done.........if you want to chat about the meter or other issues, ask away.........

How much basal are you on currently?
 
Can I just lob a comment in here, that Patti is one of the Admins on www.diabetes-support.org which was started by her and TerryG in 2008 due to the forum they (and quite a few of us) were using at that time (Diabetes Insight) when the owner of that one decided to close it.

So it took off when this here forum was still in the planning stages or in its very early days.

Prior to that - and the emergence of forums! - Patti was a member of the newsgroup ASDUK wher she 'met' the aforesaid TerryG and an Australian bloke called Alan Shanley - he of blog, 'Painless Pricks' and 'What on Earth can I Eat' fame.

If I tried to write a whole Biography of her, we'd be here till next week at least but by heck, you'd be in stitches .......
 
trophywench said:
Can I just lob a comment in here, that Patti is one of the Admins on www.diabetes-support.org which was started by her and TerryG in 2008 due to the forum they (and quite a few of us) were using at that time (Diabetes Insight) when the owner of that one decided to close it.

So it took off when this here forum was still in the planning stages or in its very early days.

Prior to that - and the emergence of forums! - Patti was a member of the newsgroup ASDUK wher she 'met' the aforesaid TerryG and an Australian bloke called Alan Shanley - he of blog, 'Painless Pricks' and 'What on Earth can I Eat' fame.

If I tried to write a whole Biography of her, we'd be here till next week at least but by heck, you'd be in stitches .......
Click to expand...

Nice..............🙂
 
LOL@Trophywench, you have blown my cover! Seriously though, I often look in here and learn something new.

Novorapidboi - I'm currently on 21u basal (11 & 10u Lev), if my boluses are averaging 11u per day then I think my basal should be around 11u total, however I'm not confident to just bring it down that low in one go, so I'm doing it a bit at a time. This weekend I am going to try some basal testing, at least overnight and another day in the morning. I suspect that as the basal comes down I shall need to balance it with ratios, I have a notion that I shall end up with a TDD of around 30 on a 50/50 ish split.

The Insulinx is a bit of a revelation - I would really like to get my hands on an Aviva Expert though for comparison purposes.
 
Pattidevans said:
LOL@Trophywench, you have blown my cover! Seriously though, I often look in here and learn something new.

Novorapidboi - I'm currently on 21u basal (11 & 10u Lev), if my boluses are averaging 11u per day then I think my basal should be around 11u total, however I'm not confident to just bring it down that low in one go, so I'm doing it a bit at a time. This weekend I am going to try some basal testing, at least overnight and another day in the morning. I suspect that as the basal comes down I shall need to balance it with ratios, I have a notion that I shall end up with a TDD of around 30 on a 50/50 ish split.

The Insulinx is a bit of a revelation - I would really like to get my hands on an Aviva Expert though for comparison purposes.
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Interesting Patti. My TDD is split about 25/75 (25% basal!) - seems it's the opposite of yours currently, but about the same TDD! Diabetes, eh? 🙄:D
 
Northerner said:
Interesting Patti. My TDD is split about 25/75 (25% basal!) - seems it's the opposite of yours currently, but about the same TDD! Diabetes, eh? 🙄:D
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Surely our bolus doses depend on what we eat don't they? I mean I eat more or less the same amount of carbs most days, somewhere between 100 & 120g, but if someone was eating say 250 they'd need more? I guess you stick to a fairly low carb diet?

I was quite surprised on the morning of the Insulinx induction course when we were told to put down our average TDD and the young woman opposite me was on a total of 80u. She wasn't overweight and not a teenager. They then asked us to divide the TDD by 50 to find your carb to insulin ratio (my TDD at the time was 56 and my insulin carb ratio therefore 1.1u) I figured this was a bit odd cos your TDD would depend on the amount of carbs you eat per day. I have subsequently tweaked my ratios to 1:6g mornings, 1:8u lunch and 1:6u dinner - even so am on lots less insulin than I was. I wonder if the young woman on 80u TDD has found the same thing. It would be good to get the people on the induction day back together to see how people have found it but I doubt it will happen.

Q for Novorapidboi re: the meter. What can you do if you change your mind about what you're eating after you've logged the dose? i.e. if you suddenly decide to add a biscuit or something?
 
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I would simply test my blood again, and record it that way, obviously the reading is of no use, but the meter knows this and will only offer you a dose for that item............which will be at your normal ratio if within an hour of your previous injection..............

I am about a 50/50 split also........................

As far as insulin goes I would prefer to have large basal dose alongside small bolus doses............
 
You just run it through the bolus wizard, and it will tell you whether you need more insulin or not... And it will be keep tabs of the calculation as you go a long...

The expert meter and Combo remote are both the same with the exception the Combo has the software and bluetooth to communicate with and work the pump..

Is it just your basal insulin or has your bolus insulin dropped as well?

It seems that the HCP like you to have a split in the region of 45/55 or somewhere in this region.. I think that I must sit around 40/60 but a lot will depend on activity levels, if quite active then your basal is going to be a lower than your bolus insulin,,
 
Pattidevans said:
Surely our bolus doses depend on what we eat don't they? I mean I eat more or less the same amount of carbs most days, somewhere between 100 & 120g, but if someone was eating say 250 they'd need more? I guess you stick to a fairly low carb diet?
...
Click to expand...

No, what I meant was you said your daily bolus was around 11 units and your levemir about double that - with me it's the other way around, I have far less lantus than novorapid. I started on 20 units of lantus and it has been as low as 3, a reduction of 85% since diagnosis. My novorapid has reduced by about 50% since diagnosis, now around 22-25 units. I tend to eat a similar amount of carbs each day, around 140-180g (creature of habit!)
 
For the first time in my life I now have a 50/50 split after reducing my lantus down to 18 units yesterday🙂
 
toby said:
For the first time in my life I now have a 50/50 split after reducing my lantus down to 18 units yesterday🙂
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So you only have 18 units of bolus roughly........is that low ratios, or low carbs...:D
 
trophywench said:
That's puzzled me - why?
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And me - hadn't noticed it earlier! Surely you need the amount of basal you need to cover what happens all day, whether you eat or not, and bolus is just for food? If I increased my basal to a 50/50 split I'd be constantly hypoing 😱
 
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