In the middle of being DAFNE'd

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WorzelGummidge

WorzelGummidge

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Relationship to Diabetes
Type 1
Hello everyone, I'm new here. I've been diabetic for about 8 years, since just before I was 11 - I actually had my 11th birthday in hospital. I've been a pretty bad diabetic, not testing my BG or eating right, but this week I've been attending a DAFNE course and I'm so glad! I feel so much more in control. Unfortunately because they reduced my background insulin by 15 units and put me on 1:1 ratios to start, my sugars have been sky high all week. I'm trying not to get down about it and I know it will take time to get my ratios right but it's horrible feeling ill all day.

If you've done DAFNE, what have your experiences been with it since? Do you still follow it? Still test 4x a day?
 
I was diagnosed 4 years ago and went straight onto the DAFNE course. So Ive pretty much always done carb counting, apart from the first few weeks of having diabetes.

I can't imagine how anyone can control their diabetes well without carb counting to be honest. Must be near impossible!!

I'm on a ratio of 2:1. I would be interested if anyone is on more... and why do people need more than others? If anyone knows please enlighten me :D
 
really don't worry about your sugars going up during dafne, it's all about finding out what's right for you and the only way to do that is to go back to basics, as long as you keep checking and correcting during this time a few weeks of erratic sugars will be countered by improved control. So keep at it!
I did dafne about 18 months ago and really enjoyed the week, I got so much out of it! I stick with the dafne principles now, sometimes I slip a but but it gives you such a good foundation that's it's not too bad to get back on track!
How are you finding the week?
 
meant to add, I was very lucky in that the 24 background they started me on has been right all along and until a month ago I was on 1:1 ratios all the time. So I was the annoying class swot during the week with all target sugars. I'm now on 1.5:1 ratio in the evening but that's all that's changed.
 
can someone explaint he way the ratios work please.
is 1:1 1 unit to 10g carb?
and 2:1 2 units for 10g carb?

I haven't done DAFNE but I do carb count and have been for 2 1/2 years and test my blood sugars at least 4 times a day. I don't think I can imagine not testing that often.

Sometimes I don't exactly count but always guestimate the amount of carbs. I don't knwo how I would decide my dose without
 
Katie - I think the reason different people have different ratios is to do with insulin resistance. My nurse suspects I have both type 1 and 2, meaning my insulin resistance is really high. 1:1 certainly isn't enough for me, I think I'll be on 2:1 in the mornings and 1.5:1 in the evenings but it's hard to tell at this stage.

Aymes - I'm REALLY enjoying this week! We have a great group of people and I think 10 is a really good number of people to have in a group. The first adjustment I made was putting my background insulin (Lantus) up to 28. I did a 3am check last night and I was exactly the same as when I went to sleep (8.7) so I think that dose is perfect, but I also seem to experience the dawn phenomenom as I woke up at 13.6. My morning sugars have always been the worse and it seems like I might go onto a pump if DAFNE can't fix that. Waking up with high BG isn't a good start to the day as I'm sure we all know.

Sofaraway - you have it pretty much right. 1CP is 10g of carbs. I'm on 1:1 so for 3CPs I have 3 units of quick acting insulin. Someone on 2:1 would have 6 units. There are other rules though - alcohol is only ever 1/2 a unit per CP and correction doses (to reduce high sugars) are 1 unit per 2/3 mmol/l no matter what your ratio. You can have 1CP as a snack without injecting anything. I tested 4 times a day for a while after I was diagnosed but I had an awful medical team and not much support at home so I fell into terrible habits. I've gone a whole year testing my BG less than 10 times. I don't know how I survived and I don't know how I got a Hba1c of 7.7%. I suppose our bodies really are great at adapting to the abuse we put them through. There was really no basis for the amount of insulin I injected since I never even carbo counted, I just jabbed what I felt like really.
 
I am on a very high ratio of 3:1. I am a little embarassed about this, even though I know we are all different. I have no clear idea why it is so high. The nurses want to put me on metformin even though I am a type 1, to try and get the ratio down and my sensitivity up. It may have something to do with my eating problems and weight though.

About 18 months after DAFNE, I have to say I am not doing that well, due to depression and job stress, and also the lack of followup which is what lets down the whole course in my opinion. I do still carb count but am slipping and do not always check blood sugar, and have recently stopped writing it down.

But still I think it changed my life, I am far better than I used to be. I feel more confident and less panicky about my diabetes.
 
i must be a terrible type 1, i take my bs b4 meals but just guess how much insulin to take, usually 4-10 units.(humalog) and test bs at about 10pm and take between 24- 28 units of levemir. since changing from lantus to levemir i did start to hypo in mornings anything from 3.4 to 2.7 on waking at 7am or sometimes 3am. luckily i have good hypo awareness, at the moment . my brother has been type1 for approx 20yrs and has started to lose awareness, does anyone know anything about this?
 
Dafne....

I found the course very useful. However, some foods really affect my readings, for example, bagels and brown bread. i think I have a slow digestion and if I inject pre-eating these foods I tend to hypo...thus I now avoid them or inject after eating them.

i am on a ratio of 1 unit humalog = 15g COH
 
Im on carb counting. novo rapid , ratio 4:1. now thats a bucket load.
 
About your brother's hypos. You said that he has started to lose awareness. Does that mean he finds it difficult to recognise symptoms of a hypo? I have had Type 1 diabetes for 32 years (is it THAT long?!!).

I sometimes don't realise I am having a hypo until my blood sugar is down to 2.0!
My diabetes nurse said recently that this is common when you have had diabetes for a long time. Your nerves change due to the diabetes (neuropathy) and so are slower at sending messages to the brain to say that you need sugar.
 
annemarie08 said:
i must be a terrible type 1, i take my bs b4 meals but just guess how much insulin to take, usually 4-10 units.(humalog) and test bs at about 10pm and take between 24- 28 units of levemir. since changing from lantus to levemir i did start to hypo in mornings anything from 3.4 to 2.7 on waking at 7am or sometimes 3am. luckily i have good hypo awareness, at the moment . my brother has been type1 for approx 20yrs and has started to lose awareness, does anyone know anything about this?
Click to expand...

AFAIK hypo unawareness is really common as you age, like Sugarmouse said. Another factor is your HbA1c. It's it's below about 6% you're running your BG very tightly and you're near the cusp of a hypo a lot of the time. The body gets used to elevated/low blood sugars and a reading of 3.5 won't send your body into hypo mode if you're around 4 - 5 a lot of the time. Likewise when I used to have a HbA1c of 12% a reading of 5.0 mmol/l would give me hypo symptoms because it was low for me. It's also really individual regardless of average blood sugars.

Lizzie said:
I am on a very high ratio of 3:1. I am a little embarassed about this, even though I know we are all different. I have no clear idea why it is so high. The nurses want to put me on metformin even though I am a type 1, to try and get the ratio down and my sensitivity up. It may have something to do with my eating problems and weight though.
Click to expand...

Don't be embarassed! Some non-diabetics will produce 3x as much insulin as another non-diabetic and that's certainly not their fault, it's just their metabolism and hormonal profile. Ratios of 1:1 are certainly not enough for me and I think I will need at least 2:1 or 3:1 ratios at each meal as my sugars have been running between 12 and 20 on ratios on 1:1. The lowest I have been all week is 8.7, pre-bed, after two 45 minute walks throughout the day. Today I tried a ratio of 1.5:1 for breakfast and my sugar only dropped 4 mmol#l from 16 to 12. I'm on Metformin and insulin as well as I have very high resistance. I'm hoping this will come down as I lose weight and get better control but often it's a genetic factor that you can't do anything about.

Besides, 3:1 is within DAFNE range so it's not bad at all!
 
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