Eating less. more often - DAFNE

[MichelleJ1985]

Hi everyone, I am wondering if anyone could give me some advice! I have completed the DAFNE program last year and have found it to be okay! However, I am looking to lose weight and I am now eating healthier food, but eating smaller portions more often. The issue is, I always remember being told to check my BG 4 hours after eating! However, I am eating at the moment around every 3 hours during the day! My issue is that I worry that I am getting higher BG results as the fast acting insulin is still working from my last meal (I am on Levemir and NovoRapid). I am wondering if anyone else has followed a similar diet and can advise? I am trying to incorporate carb free snacks, but as you will probably already have found, most things have at least a small amount of carbs present!

I would be grateful if anyone could advise on this if you have any similar experiences!

 

[jopar]

Did you do the actual DAFNE course or one which was similar!

As DAFNE doesn't promote testing 4 hours after eating it's 2 hours!

When you are eating closer together, then you need to add another calculation to avoid Stacking your insulin, this is where you still have active insulin in your body, and it combines itself with what you injecting, causing an hypo..

You need to know the duration of quick acting insulin before it burns out, which for humalog/novorapid is around the four hour mark on average. At 2 hours after eating you would have used roughly 80% of the dose, the remainder will burn of over the next 2 hours... And continual to lower you BG by around 1 or 2 mmol/l

I will an easy insulin/carb ratio of 1u=10g's of carbs

If you inject 10u of insulin, then at 2 hours you've used 8 units, and you have 2 units of insulin still active in your system.

When you make your basic carb/insulin calculation, first make the calculation of active insulin on board, so if you ate at the 2 hour mark, you know you've still got 2 units of active insulin less, so you would deduct this off your dose adjustment that you've calculated for the carb's you are about to eat!

I would ask your team about the 'Expert' meter, this includes a bolus wizard, where you program in all your insulin/carb ratio's, percentage of reductions/increase for periods of exercise etc.. The duration of your insulin as well... Then all you do is tell the wizard the amount of carbs you are going to eat, and it will work out your insulin on board etc.. And give you a dose!

I would also invest in a book such as John Walsh's Using Insulin as this will expand the knowledge you gained on your course

 

[Snodger]

Did you do the actual DAFNE course or one which was similar!

As DAFNE doesn't promote testing 4 hours after eating it's 2 hours!

all great (and very interesting) advice jopar but the OP's right, on the standard DAFNE course they say don't test until your quick acting's finished, i.e. usually 4 hours.
[edit] - rereading that I sound a bit snarky and pedantic, I don't mean to be, sorry if it came over that way.

 

[jopar]

Snodger

I've been on the DAFNE course and that isn't what we were told,

The information we were given, is when working out your ratio's then you needed to test at 2 hours, once this was achieved then you didn't need to test until your next meal or snack!

 

[AMBrennan]

The issue is, I always remember being told to check my BG 4 hours after eating! However, I am eating at the moment around every 3 hours during the day! My issue is that I worry that I am getting higher BG results as the fast acting insulin is still working from my last meal

Well, that's an inevitable result of measuring BG closer to the peak, but obviously the time of the measurement doesn't change anything so that's nothing to worry about.

 

[noblehead]

I would be grateful if anyone could advise on this if you have any similar experiences!

Personally I would just stick with eating 3 meals rather than eating every 3 hours.

 

[MichelleJ1985]

Thanks everyone! Some good advice, especially about stacking the insulin, as I think thats what's been happening! I have reasons for eating less more often, so I just wanted to know if anyone had a similar experience! Thank you

 

[Snodger]

I've been on the DAFNE course and that isn't what we were told,

The information we were given, is when working out your ratio's then you needed to test at 2 hours, once this was achieved then you didn't need to test until your next meal or snack!

Interesting, and useful to know... standard DAFNE teaching is to start on a 1:1 ratio and then tweak it, and test only before meals or when you want to check for hypos/for driving. (pulling rank here: I'm studying it for a PhD ) - I'd be really interested in how they taught it with you, but rather than clog this thread I'll PM you.

 

[iHs]

I've been on the DAFNE course and that isn't what we were told,

The information we were given, is when working out your ratio's then you needed to test at 2 hours, once this was achieved then you didn't need to test until your next meal or snack!

Interesting, and useful to know... standard DAFNE teaching is to start on a 1:1 ratio and then tweak it, and test only before meals or when you want to check for hypos/for driving. (pulling rank here: I'm studying it for a PhD ) - I'd be really interested in how they taught it with you, but rather than clog this thread I'll PM you.

I think (although I don't know) is that the reason why DAFNE educators have appeared to change their advice on how often bg testing should be done, is because of the huge cost that the prescribing of teststrips is having on care trust budgets. It will only be when the companies involved in the manufacture of bg teststrips reduce their prices that things will get better for everyone. As it is, using bolus/basal insulin regimes and not testing often enough to determine what ratio to use, is just going to make many people no longer want to use it and there will be a demand to go back to using the older twice daily insulins again. Usually in life,... history repeats itself