has any members done the DAFNE course

[stevenruck]

Hi.
a question to those who have done the DAFNE coarse.
Can someone please tell how much one unit of insulin reduces your sugar level, I have forgotten ?

Cheers.

 

[helli]

There is no general answer to that question as we are all different with regard to insulin sensitivity.

 

[everydayupsanddowns]

The standard DAFNE default is that

1u = 10g carbs = 3mmol/L BG

But these are just starting points, and your individual sensitivity is likely to be quite different, plus it may vary at different times of the day.

So be cautious, and trust your BG meter and experience, rather than the default suggestions 🙂

Welcome to the forum!

 

[Hepato-pancreato]

When i stared i was 1.5u per 10g carbs. Now some 8 years later i am 0.75u per 10g of carbs. You will need that calculator and digital scales. If you write down regular measurments Saves you weighing and adding everytime. Eg when i use ensure drinks they work out at 40g of carbs therefore i need 3u of humalog with each bottle.

 

[Jenny101]

My insulin sentitivity is now 0.3units humalog to correct 1.0 mmol/L high blood sugar (that changed over the last couple of years as before it took 1.0 units humalog). Carb ratio is, and has always been, 1 unit humalog to 10g carbs.

 

[trophywench]

My insulin sentitivity is now 0.3units humalog to correct 1.0 mmol/L high blood sugar (that changed over the last couple of years as before it took 1.0 units humalog). Carb ratio is, and has always been, 1 unit humalog to 10g carbs.

Which is exactly the same as the DAFNE default position which @everydayupsanddowns quoted, above.

 

[stevenruck]

Hi All.
Yes I know the amount of 1 unit per 10g carbs, when I did my DAFNE course nearly 20 years ago it was 1 unit Humalog per 3g carbs ?
My question actually refers to if when you do a blood sugar reading & it is a bit high 1 unit of humalog will reduce your sugar level count and I can't remember by how many ? I think it was 2 or 3 ?

 

[rebrascora]

Hi Steven.

What you are failing to grasp is that these things vary from person to person. Some people may find that 1 unit of insulin drops their BG by 3mmols, some may find it just drops them 2mmols or 1.5mmols or even 1mmol. Yes, the training guidance is to start by assuming that 1unit of insulin will drop you 3 whole mmols but that is just guidance and needs to be tested and modified depending upon your own personal insulin sensitivity. It is easy to test by injecting 1 unit when your levels are a bit high and seeing how much it drops you.

It is also worth noting that it sometimes depends upon the BG level you are correcting because the higher your BG level the more insulin resistant you can become, so whilst 1 unit will drop me from 9mmols to 6. ie 3 mmols. If my starting BG is 14 and I take a unit of insulin, I might only drop to 12, so because my levels are higher I am less responsive to the insulin and it only drops me 2 mmols instead of 3.

This can also change over time, so I might become more insulin sensitive in the summer when it is hot like the past few days and less sensitive and need more correction units to bring me down in the winter, let alone over 20 years when your metabolism could quite dramatically change.

The guidance of 1 unit drops you 3 is not a rule set in stone but just a guide for you to start testing and experimenting and see how your body actually responds to that unit of insulin.

 

[Jenny101]

I agree, rebrascora , I also find that if my blood sugar is high in the afternoon I change my correction dose of humalog to slightly less. This also may depend on exercise, temperature of the weather, fatty foods or have I had any alcohol - I'm more prone to hypos late afternoon. The rules are that there are no solid rules just personal experience, an open mind and an ability to adjust. For me, the best and safest thing to do is to slightly under-correct and then constantly check blood sugar afterwards. Everyone is, indeed, different. I'm lucky enough to have a Freestyle Libre so will check sugar levels at least 13 times every day.

 

[rebrascora]

The rules are that there are no solid rules just personal experience, an open mind and an ability to adjust.

Oh, I really, really like that statement! So true!

 

[trophywench]

On a pump if you have a tendency to hypo at any time of day - you'd be better advised to reduce your basal from 2 hours prior to usual hypo time.

 

[everydayupsanddowns]

Hi All.
Yes I know the amount of 1 unit per 10g carbs, when I did my DAFNE course nearly 20 years ago it was 1 unit Humalog per 3g carbs ?
My question actually refers to if when you do a blood sugar reading & it is a bit high 1 unit of humalog will reduce your sugar level count and I can't remember by how many ? I think it was 2 or 3 ?

The standard DAFNE starting point is 1u reduces BG my 3mmol/L

But it might be more than that, or less than that for you. And may change in this hot weather too!

 

[Jenny101]

On a pump if you have a tendency to hypo at any time of day - you'd be better advised to reduce your basal from 2 hours prior to usual hypo time.

Hi trophywench, just a random question - I have a pump - I don't have any basal insulin from 10am to 5pm but still find I'm can have a hypo at 5pm. I eat and release insulin (humalog) for lunch at 12pm. Any idea what causes this low sugar level? It's only during the afternoon. I release insulin 20 minutes before I eat and my blood sugar stays level most of the time. I've tried a 25 minute gap between insulin release and eating but that just causes a hypo earlier on! Is it just one of those things like the dawn phenomenon or am I missing something? Answers on a postcard.....

 

[trophywench]

No not a postcard! Some people find that Humalog has a 'sting in its tail' - ie has a sudden burst of activity towards the end of its active life, instead of gradually sliding downwards to Nil. I know that @Pattidevans found this when she used it and commented about it on another forum some years ago. I also happen to know that she and her husband are meeting friends for lunch today - so unlikely to comment on this thread 'instantly'. I myself have no personal experience of Humalog - I used Novorapid on MDI and still use it - since approx 1998-ish. N doesn't have a sting in its tail.

 

[everydayupsanddowns]

Hi trophywench, just a random question - I have a pump - I don't have any basal insulin from 10am to 5pm but still find I'm can have a hypo at 5pm. I eat and release insulin (humalog) for lunch at 12pm. Any idea what causes this low sugar level? It's only during the afternoon. I release insulin 20 minutes before I eat and my blood sugar stays level most of the time. I've tried a 25 minute gap between insulin release and eating but that just causes a hypo earlier on! Is it just one of those things like the dawn phenomenon or am I missing something? Answers on a postcard.....

Well that’s a poser isn’t it!!

I switched from NR to Humalog to get a ‘memoir’ pen (ah! simpler times!), and while I didn’t get a really pronounced and sudden ‘sting’ in the tail, I think I found more activity lasted longer with humalog, if you see what I mean, where NR faded more steeply after 2-3 hours dwindling to not much action at all.

At 5hrs you might expect your lunch dose to be mostly spent, but some people find analogues last 5-6 hours rather than 4-5.

I’m also interested to know if you were diagnosed as an adult, and how long ago - just wondering if there might be a tiny snifter of home grown insulin production lingering on?

Also… have you checked your basal pattern 12-5 (so a couple of hours after it switches to zero) with a fasting check? Is there a chance your meal ratio might be too high and effectively covering some basal need?

Hope you find a way to dodge those afternoon lows - they must be very annoying!

 

[PattiEvans]

Also… have you checked your basal pattern 12-5 (so a couple of hours after it switches to zero) with a fasting check? Is there a chance your meal ratio might be too high and effectively covering some basal need

Exactly. I suffered late afternoon hypos for years. Yes I do think that Humalog had a sting in the tail, but I have been on a pump for almost 8 years now and had the same late afternoon hypos. I have more or less solved it now, though my method is slightly counterintuitive.

Like @Jenny101 I was having very very little basal all afternoon, but I was also having spikes after lunch then a hypo. So I increased my basal a bit (only 0.05u) per hour from noon as I tend to eat a latish lunch, but I correspondingly reduced my ratio from 1:10 to 1:12. So not a huge tweak to either basal or bolus, but it seems to be working.

 

[Jenny101]

Hi www.everydayupsanddowns.co.uk and Pattidevans , thank you for both your replies - it's good to know that I'm not the only one on a low basal rate. I was diagnosed at the age of 10 (quite dramatically as I was fine one day, thirsty the next and in hospital in a coma the next. Something to do with crazy salt levels). I'm now 57 and at the beginning of the year started the menopause so basal rates have been changing regularly. This has just calmed down and you have both reminded me that I really must do a fasting basal rate check - I haven't done that for almost a year now. I think there are so many different reasons for low sugar during a specific time that I needed reminding of the basics. It's helped getting someone elses thoughts, even if it's just to jog my brain into thinking about a problem in a different way. Cheers both, take care.