DAFNE did anyone feel like it didn't really help them?

[novorapidboi26]

just to be clear, I never used my basal insulin, Levemir, to mop up the glucose produced from beans, pulses etc..........

however my Novorapid was not used in the delivery of that glucose to my cells either.......

therefore my belief that the surplus basal, which is a certainty when injecting, was used to deliver the glucose to the cells........

now on the pump, my basal, is being used mush more effectively, almost completely effectively, and there is no surplus insulin or surplus of a insulin that is engineered to work slower [Levemir, Lantus].....and so having these beans/pulses will need consideration on a pump, where on injections they will not.....

so again, I didn't use my Levemir in that way, it was simply a theory/observation/explanation for DAFNE teaching us that no insulin was required for these types of foods........

Just to add to the comments about insulin efficiency, I was told by my pump nurse that injections were about 50-60% effective and pumping was over 90%......are these figures accurate, who knows, but I believe that the difference between injecting and pumping is as significant...........my basal dose halved on a pump and I lost a stone effortlessly......

 

[nuun]

Have just completed a five day DAFNE course and feel that I, personally, benefitted from attending. My HbA1c was 'out if it's harness' and as the years have progressed, problems such as Graves (thyroid disease) are beginning to introduce themselves. In an attempt to delay further problems, I agreed to the course but not hopeful of learning much after having the dreaded 'D' for 37yrs. I now feel more confident in the administration of correction doses and counting carb portions appropriately. Have added an extra Lantus jab to control highs early eve and it seems to suit me. The DAFNE nurses seemed to think I would be a suitable candidate for an insulin pump but I'm far from keen. If what I have learned is a benefit, I'll be happy. The DAFNE course isn't for everyone obviously. We are all uniquely individual. I was lucky to have a superb and understanding team and glad I attended.

 

[Spiker]

@novorapidboi26 I am not sure what you mean by "surplus basal", but basal does not hang around in a semi-active state waiting for glucose to remove from the bloodstream. It is constantly active and if no glucose entering the bloodstream from the liver or from the digestion, it will go ahead and drop the glucose out of the blood anyway, 24x7, rain or shine, by the same amount. Our injected or pumped insulin is not in any way adaptive or reactive to the blood sugar level (except for high levels when insulin sensitivity decreases). It carries on like an unstoppable train.

The only exceptions are T2s and some T1s or LADAs who have some residual insulin, glucagon and amylin function in their pancreatic cells.

 

[etmsreec]

I did the Wirral's version of DAFNE a few years ago and some of it was useful and some not. I'd already been doing the dosing of insulin for meals for a while anyway, after having it suggested to me by my DSN. Since I'd been counting carbs since diagnosis in 1981, it wasn't that much of a surprise either. It was always more of a surprise when type 1s DIDN'T count carbs!
Exercise is still an ongoing topic of discussion with my DSN and my consultant. The consultant thinks that I over-compensate when going swimming, so my blood glucose rises after I've finished and can go on rising for some time afterwards. Typically I swim in the evening (about now actually, as I type this!) By the following morning, my blood glucose will be back to normal, suggesting to me that it's more related to glycogen being released and then carbs being absorbed to replace the glycogen that's been released. If I ever get a true answer, I'll let you know!

The issues that I have with the whole glucose control and standards and everything else is that no matter what I eat, my post-prandial will be higher than 8 or 10. I figure that's just me and the way my Novorapid works. My DSN advised me to ignore the post and concentrate on pre-prandial. Some days, that's a load of rubbish too. I suppose that's what I get for taking the old advice of, "you can reuse disposable needles and syringes, you don't have to use them just once!" Now we know that's a load of rubbish and the effect it has on fat and insulin absorption.

The more things change, the more they stay the same. Some advice is valid and some isn't.

 

[noblehead]

@etmsreec,

Have a look at Runsweet and see if there's anything on there that might help with your bg levels:


http://www.runsweet.com/

 

[Spiker]

@etmsreec are you talking about +2 hour post prandials being high or +4-5 hour post prandials being high? At 2 hours yes that is just how Novorapid works (4-5 hour action curve) and it's a minor issue. If you are high after 4-5 hours however then your bolus dose is insufficient and your carb ratio is too low (more insulin needed). Unless you are eating very high-fat or high-protein, in which case you may need a split dose with part of the dose post-meal.

 

[etmsreec]

@etmsreec are you talking about +2 hour post prandials being high or +4-5 hour post prandials being high? At 2 hours yes that is just how Novorapid works (4-5 hour action curve) and it's a minor issue. If you are high after 4-5 hours however then your bolus dose is insufficient and your carb ratio is too low (more insulin needed). Unless you are eating very high-fat or high-protein, in which case you may need a split dose with part of the dose post-meal.

+2hr

 

[Spiker]

+2hr

Ok totally don't worry about +2 hr post prandial until you have first got your +4-5 hr post-injection levels sorted, at pre-meal levels.

 

[Jimmy_Smith]

Hi, first ever post so be gentle

I finished a five day course of DAFNE today. I'd previously been admitted to hospital with DKA numerous times, heading into the 20s at least, and had very poor management of the my diabetes. The last time my HbA1C was in single figures was about four years ago and I attempted to manage my BG through a managled carb counting/guessing style. I had a low mood, didn't see the point of it all and generally just accepted my BG for whatever they were and under the idea that there was nothing I could do.

Now I've been on the course though I feel like I can have control of this condition, that I can control my BG. I'm, for once, positive about my future. And that's because of the DAFNE course.

 

[novorapidboi26]

@novorapidboi26 I am not sure what you mean by "surplus basal",

I basically mean that when injecting, your never going to have the exact amount you require as you cant administer the dose on a hourly basis for example, so at some point in the day there will be a larger dose than you need, and at some point there will be not enough.........

also taking into account that when injecting, if the figures are to be believed, then just above half of that insulin you are putting in to your body is being used as it was intended.......

I imagine this figures greatly varies for each individual...........I was on fairly large doses and so my insulin efficiency wasn't very good on injections....

 

[Ebrownie]

I was completely horrified by some of the things I was told on my DAFNE course. I was cutting down on my carbs at the time, the nurses hated me doing this and they made me feel like a naughty school girl. The message that was coming across all the time. . . .' Eat what you like, as long as you're carb counting properly, that's all that matters ! '
This goes against everything I've been told in the last 36 years. Eat high fibre, low G.I. Not ' it's fine if you want to eat 10 McDonalds a day, inject correctly and you'll be fine '. !!!!!

 

[smidge]

@Ebrownie I had a very similar experience on DAFNE earlier this year. It was absolutely shocking. I documented my experience day by day on another forum and then posted about it on here:

http://www.diabetes.co.uk/forum/threads/dafne-experience-the-good-and-the-bad.52066/

Opinion was definitely split between those who think it's just not acceptable and those that simply won't hear a bad word about it. If no-one ever challenges the bad advice that DAFNE gives though it will never improve and that's a shame because it should be so much better.

Smidge