DAFNE confusion

[noblehead]

What I mean is, do you add up the carbs in cheese. meat, fish, eggs, vegetables etc? Or do you only consider the carbs in starchy foods as the valid ones?

I count some veg such as turnip & carrots, cheese I don't bother, with protein I don't count it as long as there's not a substantial amount on the plate.

If I eat a very low-carb meal such as a cheese omelette then I just bolus going from previous experience, so basically its just trial & error with very low-carb meals.

 

[Blackers183]

Hi, I found DAFNE extremely helpful and it has helped lower my Hba1c from above 8 to low 7s. I'm working on 6.5 (NICE guidelines) but that's a bit harder, have been Type 1 for 24 years. The nutrition aspect mostly made sense to me but it did seem to go against a lot of other stuff I had read.
It's well worth attending, NICE guidelines recommend that all type 1s "attend a structured education program, eg DAFNE".
Cheers
David

 

[AndyS]

Take DAFNE as a basic set of guidelines.

I too had done a lot of homework and calculate my ratios, corrections and basal changes in a completely different way to what they teach on the course.

If what you are doing works for you, stick with it!

If I were to be honest the only new stuff I actually took away from DAFNE were the sick day rules, everything else I more or less do it the way I taught myself, since my A1c is basically similar to a "normal" person and I only have one or two hypos a week I figure I am doing it right.

EDIT: Also since DAFNE they tend to not question what I am doing so much and if I say something they seem more open to accepting it since they can see the tick in the box for "Attended Education Programme"

 

[Bluemarine Josephine]

I count some veg such as turnip & carrots, cheese I don't bother, with protein I don't count it as long as there's not a substantial amount on the plate.

If I eat a very low-carb meal such as a cheese omelette then I just bolus going from previous experience, so basically its just trial & error with very low-carb meals.

Please, how much protein is considered a substantial amount so as to be considered for bolusing?

 

[noblehead]

Please, how much protein is considered a substantial amount so as to be considered for bolusing?

There's no answer to that, it will depend on what effect a portion has on your postprandial bg levels. They say in the absence of carbs protein concerts to glucose by around 50%.

Hope you get your insulin doses sorted.

 

[AndyS]

I think what noblehead is essentially saying is you basically need to test yourself for all of these unknowns and understand how your body responds. If you see a rise with protein then adjust accordingly.

 

[himtoo]

this is a fantastic thread and indeed gets to the heart of the non diabetic nutritional view regarding food.
you stick to your guns @Bluemarine Josephine and with your records to back you up and your excellent knowledge you will certainly get the other D's in the room questioning the conventional wisdom - you might even start a mini revolution in the classroom

 

[Juicyj]

Here is what puzzles me.
Let’s assume they do monitor my results but, the results are on the basis of carbs counting and bolusing for pasta… without including meat/cheese/salad carbs… wouldn’t this produce a different insulin to carbs ratio than if everything was added as carbs?

What I mean is, will the ratio be correct?

P.S. There are Viagra jokes?

Continue what you are doing in regards to bolusing for protein, obviously let them know this is what you are doing as you are completing a food diary you can then show them this, knowing if this ratio is correct can then be determined by monitoring your food intake against your results so I think you will become more clearer on this during the course.

Type 1 men can get viagra prescribed free on the NHS, so this triggered many moments of mirth on my course, I just blushed and looked at the wall alot, they were quite a funny bunch so there was also alot of laughter too !!

By the way I get alot of highs and lows too, I only get a week or so a month where I am stable, i've put it down to my hormones as I don't honestly know why it is and I definately suffer in the run up to my period and then a few days in. I feel like i'm fighting a losing battle most of the time..

 

[Bluemarine Josephine]

Continue what you are doing in regards to bolusing for protein, obviously let them know this is what you are doing as you are completing a food diary you can then show them this, knowing if this ratio is correct can then be determined by monitoring your food intake against your results so I think you will become more clearer on this during the course.

Type 1 men can get viagra prescribed free on the NHS, so this triggered many moments of mirth on my course, I just blushed and looked at the wall alot, they were quite a funny bunch so there was also alot of laughter too !!

By the way I get alot of highs and lows too, I only get a week or so a month where I am stable, i've put it down to my hormones as I don't honestly know why it is and I definately suffer in the run up to my period and then a few days in. I feel like i'm fighting a losing battle most of the time..

I am in the exact same situation... I so feel what you describe.
10 days prior my monthly, my levels are high and so persistant. This insulin resistance lasts for 2 days after my period comes and then, my blood sugar levels drop like a stone. The next 10 days are the days that I have the most hypos during the month, my ratios change completely, my insulin sensitivity changes so much that I don't know what to bolus for... and after these 10 days, when ovulation starts... well, here we go again... up in teens and struggling to find the correct ratio to lower my glucose numbers...

 

[tim2000s]

And there you have the nub of it all @Bluemarine Josephine . The only real way to manage diabetes successfully is to observe your body, it's reaction to stimuli and then adjust your therapy accordingly.

DAFNE is supposed to provide the tools to help you do that, in that it teaches those who don't already know about it Carb Counting, calculating I:C ratios, Correction doses, sick day rules, etc. It also allows people to interact with other T1s in a way they may never have before.

I know it practices record, review, adjust as you go through the course, but I don't know whether it actually hammers home in practice how important this is.

Managing Diabetes is essentially about pattern spotting, then acting systematically on it. If you can take this away from DAFNE then it should at least be helpful.

 

[BeccyB]

I think for anyone who is new to carb counting and ratios DAFNE is an excellent introduction to the principles but, like most things diabetes related, it's often not that simple. Yes DAFNE may be out of step with some of the 'best practice' information on here but it is a hell of a lot more education than many have ever had. And I think we shouldn't be so hard on the nurses - they are only doing their job and passing on what they have been taught themselves.

I would bring up the Grapefruit issue, as it so obviously affects you and you have the evidence, However I disagree with some of the other posts on here about arguing about the 'rules' in general. I think all it would do is wind up the nurses and more importantly completely confuse the rest of the class.

I would suggest you take what you can from the week and then come back here for the more detailed advice regarding your particular diet etc. It would be great if you passed on the details of this forum to the rest of the class too.

.

 

[Juicyj]

I am in the exact same situation... I so feel what you describe.
10 days prior my monthly, my levels are high and so persistant. This insulin resistance lasts for 2 days after my period comes and then, my blood sugar levels drop like a stone. The next 10 days are the days that I have the most hypos during the month, my ratios change completely, my insulin sensitivity changes so much that I don't know what to bolus for... and after these 10 days, when ovulation starts... well, here we go again... up in teens and struggling to find the correct ratio to lower my glucose numbers...[/QUOTE

As Tim has said above we are all unique so as you become your own expert you will learn more about how to respond to events/stress/hormone/diet in due course. I have found that my body has it's own set of rules but if I can be prepared by recording the date I am due on then I can increase my basal as well as my bolus ratio to try respond better to this event - Diaconnect can record events as well as exercise etc so you can view each month and know when to respond.

From doing DAFNE I found that being a woman (in a room of men) that my control is much harder, some men on my course had amazing results and from eating a carb heavy diet too, they kind of gave me inspiration that it could be achieved but sadly i've found this isn't the case.

I've read Dr Bernstein and Think like a pancreas but as they are both written by men they don't exactly advise on dealing with our monthly cycle, I have promised myself that if I ever figure this out that I will write a book about it as I know alot of women struggle too.

 

[alaska]

I did DAFNE as a low carber. Thankfully my DAFNE team were generally happy to let me keep my own system and augment it with DAFNE advice where I found it helpful. Having an excellent HbA1c and few hypos (backed up with a recent set of CGM trial results) certainly helpd with convincing them that I knew what I was doing.

They were surprised that I performed a delayed bolus for proteins and fats but when I showed them the results of not doing the delayed bolus, they could see why I did and just said to the rest of the group that I was handling things differently only because I was having much less carbs.

All in all I found the course helpful as all the techniques I'd built up previously were from experience and experiments.

 

[Deleted member 83869]

Thank you for your message.
That puzzles me even more as, theoretically, we are all been taught the same principles everywhere in the U.K….?

Regards
Josephine

Yeah, I don't get that either! different areas are being told different things :S I cant remember much about the course now though because it was a while ago now but still bizarre isn't it! x

 

[BeccyB]

There was one other woman on my course and the nurse did mention to us that we would probably find our ratios would be different at certain times of the month. I would hope others do the same to stop the total confusion when it suddenly doesn't work anymore but it seems they don't all!

I would get your book @Juicyj

 

[tim2000s]

On that note, does anyone have a DAFNE log-in they don't use that I could borrow? I'd like to look through the course materials so that when I make statements about the course, I am at least speaking from a position of full knowledge rather than supposition based on conversation with many people.

 

[Deleted member 83869]

On that note, does anyone have a DAFNE log-in they don't use that I could borrow? I'd like to look through the course materials so that when I make statements about the course, I am at least speaking from a position of full knowledge rather than supposition based on conversation with many people.

I would let you have mine....if i could remember it

 

[yingtong]

53 years ago I was taught to count all carbs and I still do and will do to the day day I die.I have survived very well doing this.The dietitian I see is very good and not set in her ways,but we have a friendly discussion each time I see her,I have proved to her how fruit and cheese effects blood/glucose and have proved this using my CGM.

 

[novorapidboi26]

I've not read through all the other posts but my point would be that DAFNE as a course, is there to teach you a methodical way of testing, analyzing and adjusting your insulin to deal with carbs, for the most part its just carbs that will have a significant effect on your blood sugar and using just carbs during the course and as a basis for dose adjustment is wise.........

when your done and you have learned how to approach dose adjustment your own personal analysis can begin and ultimately your own strategies and observations will come in to play...

I done DAFNE in 2009,got my pump in 2013 and from then I have never needed to count for protein............is this because it hasn't effected me? maybe not, but its kept thing simple that's for sure.......

really I am just trying to back up the DAFNE team lol....protein does effect people, and of course vegetables and fruit have carbs and I don't think these are omitted in the course....learn what you can then start tweaking when its done......

 

[noblehead]

I think what noblehead is essentially saying is you basically need to test yourself for all of these unknowns and understand how your body responds. If you see a rise with protein then adjust accordingly.

Yep spot on @AndyS



@Bluemarine Josephine, it might be a good idea to start a new thread off and say which meals you have difficulty bolusing for, that way the low-carb memebrs might be able to throw-up some suggestions.