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How long were you on fixed doses for?

Discussion in 'Type 1 Diabetes' started by Bertyboy, Mar 27, 2018.

  1. Bertyboy

    Bertyboy Type 1 · Well-Known Member

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    I'm keen to know when people were first tested and trained for carb counting.

    At my diagnosis in November, I was given some advice on how and when to test and inject. I was prescribed a fixed split basal and bolus doses and sent on my merry way.

    The same nurse at the hospital saw me again in December and said to carry on as I was.

    Then at the end of December, I saw a dietician who concluded I didn't eat **** anyway and to carry on as I was.

    Then I saw a consultant at the end of Jan who said my A1C had come down from 152 to 40, that everything was great and to carry on as I was.

    Then I saw my own GP a few weeks later, mostly just to introduce myself to her. She used me to train a student how to take bloods and give a flu jab, and told me to carry on as I was.

    Then I was called into my surgery for my "annual review" with the DSN there (and an appointment a week earlier to have more bloods done). She at least tested my feet and sorted out my prescriptions so that they were on repeat rather than acute.

    I also have an appointment at the eye hospital later in the year. But at what point would I expect to learn how to adjust doses and who instigates that?
     
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  2. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    You do. Most can be learned online but I assume you want DAFNE training, ask your consultant/DSN to refer you to a course, stress the point you want the flexibility.

    Be aware its classroom based for a week
     
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  3. Deleted Account

    Deleted Account · Guest

    I was never "trained" in carb counting.
    One locum consultant once told me to try 1 unit of bolus insulin for 10g carbs.
    There are online courses such as https://www.bertieonline.org.uk/ if you want to teach yourself.

    I finally went on the local equivalent of the DAFNE course 12 years after being diagnosed. The purpose of this was to jump through one of the hoops to get a pump.
    Thankfully, my area are a little more considerate than some: it was 5 consecutive Monday evenings: so no need for a week off work.
     
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  4. Bertyboy

    Bertyboy Type 1 · Well-Known Member

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    Is there something a bit shorter? I can't really take an entire week off work just to work out my doses. Interestingly, DAFNE has never been mentioned to me by any healthcare professional. I only know about it from here.
     
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  5. Deleted Account

    Deleted Account · Guest

    If it is done properly, there is much more to it than being told "this is your dose".
    Take a look at the DAFNE website and in particular, this page.

    Regarding taking a week off work, you may be entitled to take this in addition to holiday leave.

    Looking back at your original email, you asked who would instigate this - you can ask anyone who you have seen who specialises in diabetes. For example, who was it that prescribed your basal bolus insulin in the first place?
     
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  6. Brunneria

    Brunneria Other · Guru
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    I will tag in @urbanracer because I know that he wanted to switch to multiple daily injections long before his healthcare team let him do it.
     
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  7. becca59

    becca59 Type 1 · Well-Known Member

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    I learnt in my first appointment how to carb count and adjust. This was the day after my hospital admission. The DN kept in touch with me for a month afterwards by phone and email. I was then on my own.

    Rightly or wrongly I’ve always been determined and independent, and experimented myself. I do not feel I need someone else’s permission to adjust my doses. Let’s face it the nature of this beast changes at will, and we need to react to it. I found this became even more apparent as the honeymoon period died off.

    Re DAFNE I thoroughly enjoyed the week I spent with like minded people. It gave me even more confidence to manage myself. Incidentally don’t assume you wouldn’t be given the time off. Three people on with me had been given it off, over and above their holiday entitlement.
     
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  8. kaylz91

    kaylz91 Type 1 · Well-Known Member

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    I was diagnosed in November 2016 and carb counting and adjusting before the Christmas, I've never been on a course and just learned myself by using the back of packets etc, its quite simple to do yourself but then you have to have the will to spend time weighing your food etc, its much more flexible though xx
     
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  9. EllsKBells

    EllsKBells Type 1 · Well-Known Member

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    A lot of areas don't do DAFNE - mostly because of 'cost'. When I lived down south, I eventually went to the locally run equivalent, which was 1 day a week for 4(?) weeks, I think. Postcode lottery I'm afraid.

    As to how long - well over 3 years, but I'd sort of figured out by myself how to adjust when high, and to take more/less for meals that were particularly high/low carb.
     
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  10. db89

    db89 Type 1 · Well-Known Member

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    Within 2 weeks I was on an initial 1:10 ratio and with a few phone calls and emails with my DSN I learned the very basics of adjusting (how much, when etc.) and testing how much insulin drops me by in the absence of food and I've been experimenting since.

    I also read Think Like A Pancreas a few months later which helped fill some knowledge gaps. I'm now eligible for a DAFNE course in my area and I'm just waiting for one to be run.
     
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  11. Rokaab

    Rokaab Type 1 · Well-Known Member

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    Yeah that's what I've been offered as well - 1 day a week for 4 weeks (with homework!) - though not sure when.
     
  12. LooperCat

    LooperCat Type 1 · Expert

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    I was put straight onto Insulatard and Actrapid at diagnosis in 1998, but with no instructions on adjusting dose, carb counting or anything like that. I was told to take a certain amount of basal before bed, 8 units of bolus 45 minutes before a meal and to make sure all my meals were at least 50% starchy food. I fairly quickly took a little more or less according to what my plate of food looked like, but was constantly on a glucose rollercoaster. I did DAFNE in 2010, and it was very useful - I still use the principles I learned, even though I eat very few carbs now. The course isn’t just about carbs in food, it’s about fiddling with your insulin to give you a much more normalised BG level.
     
  13. jlarsson

    jlarsson Type 1 · Well-Known Member

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    I never received any training beyond those initial explanations to how your new life will be affected by everything, which as an at the time 14 year old that felt his life was over wasn't all that helpful. However, over the years you'll have multiple appointments to nurses and various other specialist things where you will discuss how you're doing, how to hopefully work out your current dosage issues, how there's this new thing that will make this part easier or more manageable, and so on and so forth. There is no one solution, it's an iterative process that in itself will change multiple times over your life because what you thought worked well all of a sudden won't.
     
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  14. JMK1954

    JMK1954 Type 1 · Well-Known Member

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    I was diagnosed in 1964, aged 10 and in hospital for three weeks while they adjusted my insulin dose, taught me to count carbs and taught me and both my parents to do insulin injections. As my dad was a pharmacist, he had recognised the symptons of diabetes and got me to the GP, so I escaped having to be put on a drip.

    This is the only advice about counting carbs I have ever been given. Liverpool does not run DAFNE courses. ( I asked for one for years.) They have their own carbohydrate counting courses and this is all they offer, but as I can count carbs perfectly well, for me this would be a complete waste of time. I still remember when the scale I was given on diagnosis broke (dropped on kitchen floor) and it took me years to find one suitable to replace it. I still weigh some things occasionally, as I realised years ago that over time my 'eye' ( ie. accuracy of extimate) goes out.

    I cannot understand why everyone is not taught to count carbs immediately on diagnosis. It's not that difficult !!!
     
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  15. Jeremy_Wood

    Jeremy_Wood Type 1 · Well-Known Member

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    I was diagnosed in 1990 aged 5. Fixed doses twice a day (I think it was ActRapid). I stayed on that until I was around 19 and moved to Glargine and NovoRapid. No carb counting training at all - just told to take whatever I needed. Certainly took some getting used to! I was at university at the time and I think I had the paramedics out five times in the first month!

    Switched over to Tresiba and Fiasp this year (aged 32), had carb counting training as part of the PDAC (Peterborough Dose Adjustment Course - similar to DAFNE) and now I'm running smooth as a baby's bottom.
     
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  16. karen8967

    karen8967 Type 1 · Master

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    i was on fixed doses for about 3 months but was constantly low started adjusting myself by 1 unit at a time was told i had to wait a year to go on dafne course which i will be attending next month its 1 day a week for 4 weeks and i have been using a 1:10 ratio which has worked out quite well but have noticed that my ratios are changing as time goes on but no matter what no 2 people are the the same so what works for 1 might would probably not work for someone else.
     
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  17. karen8967

    karen8967 Type 1 · Master

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    hi im from liverpool and i am attending a dafne course next week ;)
     
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  18. SueJB

    SueJB Type 1 · Well-Known Member

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    Hi, I feel the same. Diagnosed in Aug and told to carry on and in fact our treatment has been very similar. That's why I'm trying to work out exactly what my basal dose should be and how I bolus for protein. Onwards and downwards
     
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  19. ickihun

    ickihun Type 2 · Master

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    What insulin are you on? As some fixed doses insulin isn't suitable for carb counting. You may need to be prescribed different kinds of insulin before bertie courses or dafne courses.

    See what @urbanracer has regarding experience?

    I was on fixed dosed insulin but due to my extreme insulin resistance I was changed to Toujeo300 and novarapid.
    In preparation for an operation and nurses administering my insulin doing their job without fear of giving me nearly 300units of insulin daily. As Toujeo300 is triple strength basal.
     
  20. O_DP_T1

    O_DP_T1 Type 1 · Well-Known Member

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    I was on on 30/70 for almost 40 years until recently and they were kinda fixed doses.

    When I started on MDI end of Dec they said take 20u Long lasting and 1u of NovoRapid for every 10g carbs consumed and off you go.

    No training, no 'watch out for this. or that', No 'this insulin works like this'. The responses found in this forum have given me great knowledge about an 'alien' to me insulin regime
     
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