Tresiba Low

[Esttther]

I know a lot of people say this is impossible, but I just had a hypoglycemia because of Tresiba.
I've been using it for years and this is the first time it's happened, but it's happening for real and it's freaking me out a bit.


I injected 14 units at 8:30 in the morning and within minutes, the CGM showed a rapid drop. I had a coke and easily bounced back, but soon after, I was dropping again. That's been my morning, constantly going up and down. (200 rn)

I didn't see blood in the injection or feel anything different than usual, but Tresiba is the only explanation for this continuous drop.

My question is if the basal effect will speed up in these first few hours and then I'll be left without basal, or if I'm going to be like this for the entire time Tresiba theoretically works.
The latter wouldn't make sense, right? After all, 14 units of insulin are what they are and they can't have such a big effect for so long, right?

Does anyone have experience with Tresiba causing lows? I know this is more common with Lantus, but I've read fewer cases with Tresiba.

 

[Hopeful34]

I know a lot of people say this is impossible, but I just had a hypoglycemia because of Tresiba.
I've been using it for years and this is the first time it's happened, but it's happening for real and it's freaking me out a bit.


I injected 14 units at 8:30 in the morning and within minutes, the CGM showed a rapid drop. I had a coke and easily bounced back, but soon after, I was dropping again. That's been my morning, constantly going up and down. (200 rn)

I didn't see blood in the injection or feel anything different than usual, but Tresiba is the only explanation for this continuous drop.

My question is if the basal effect will speed up in these first few hours and then I'll be left without basal, or if I'm going to be like this for the entire time Tresiba theoretically works.
The latter wouldn't make sense, right? After all, 14 units of insulin are what they are and they can't have such a big effect for so long, right?

Does anyone have experience with Tresiba causing lows? I know this is more common with Lantus, but I've read fewer cases with Tresiba.

Welcome to the forum @Esttther

Sorry you've had this happen to you. I haven't used Tresiba, but just wanted to ask if you'd checked your blood sugar with a finger prick test? Also have you used any fast acting insulin for a meal/correction dose this morning? Any possibility you got your pens mixed up, it's easily done.

Take care and hope the hypo's stop.

 

[Esttther]

Welcome to the forum @Esttther

Sorry you've had this happen to you. I haven't used Tresiba, but just wanted to ask if you'd checked your blood sugar with a finger prick test? Also have you used any fast acting insulin for a meal/correction dose this morning? Any possibility you got your pens mixed up, it's easily done.

Take care and hope the hypo's stop.

Thank you! Yeah, the first thing I did was double-check with a finger test, just in case the CGM went crazy, but it was right. I've been all day without taking fast-acting insulin precisely because I've been struggling to keep my glucose high. Now, almost 7 hours later, this strange effect of the Tresiba is starting to calm down (I'm at 220 as I write this, after drinking 4 cokes). And I definitely didn't mixed up the pens; I keep them in different places for fear of mixing them up (it happened to me once many years ago ).

 

[Hopeful34]

It could be a faulty pen. Do you have a spare one you could use?

 

[Esttther]

It could be a faulty pen. Do you have a spare one you could use?

Actually, I called Novo Nordisk, but they couldn't give me a satisfactory answer: "If you feel confident using the same pen, go ahead, otherwise, grab a new one." Seriously? Is that your response?

This was a new pen, I used it for the first time yesterday (no problem), and I still have another one from the same box. I think I'll just ditch this one and move on to another.

 

[Hopeful34]

Gosh, that's a terrible response from Novo Nordisk!!

I'd be tempted to use a pen from a completely new box if it was me.

Have you considered using a reusable pen and cartridges. They take up less room in the fridge, and it's better for the environment.

Edited to add: I don't know if you're aware, but Tresiba disposable pens are actually out of stock until December 2024 if you're in the uk.

 

[Circuspony]

I can't quite remember the details but when I was first prescribed tresiba my nurse warned me it came in two strengths and to make sure I was given the right one. 7 years on I am clueless as to what the right one is and just assume I'm given it every time - any chance your pens are a stronger version?

 

[Fairygodmother]

I was intrigued so googled Tresiba @Circuspony. Yes, the 100 and 200 strength pens are distinguished by colour: 100 yellow flash on the label; 200 green flash.
Have you checked the strength @Esttther? If you usually take 100 but have been given 200 you’ll have injected 28 units.
I do hope you have an end to the hypo state soon, it’s a nasty situation to be in.

 

[Fairygodmother]

Tresiba® Dosing | Tresiba® (insulin degludec) injection 100 Units/mL, 200 Units/mL

Learn more about Tresiba® (insulin degludec) dosing, including dosing options, and what to do if you miss a dose. Read important safety and prescribing info on this page.

www.mynovoinsulin.com

 

[Esttther]

Gosh, that's a terrible response from Novo Nordisk!!

I'd be tempted to use a pen from a completely new box if it was me.

Have you considered using a reusable pen and cartridges. They take up less room in the fridge, and it's better for the environment.

Edited to add: I don't know if you're aware, but Tresiba disposable pens are actually out of stock until December 2024 if you're in the uk.

Yeah, I was hoping for a more technical response about the effects of insulin, something that would reassure me or even an offer to send me a new box or concern about picking up this pen in case there was a problem with it, but they weren't very helpful, and since I was dealing with the low BS, I didn't want to get into an argument.
I'll go get a new box tomorrow morning. This pen was the third from this box, and so far, I hadn't had any issues, so I'm inclined to think something must have gone awry with the absorption inside my body, but it's all about controlling the factors I have in my hands, so better to get another new box. Right now, I'm in Spain, and I haven't heard Tresiba going out of stock here.

 

[Esttther]

@Circuspony @Fairygodmother
After the first sudden drop, I checked the pen from top to bottom, everything was fine (usual 100). Definitely must have hit a vein or something. Because even if I had injected a lot more, the effect wouldn't have focused so much in those first hours so much; I would simply be low all day. Now I have much more normal levels, and the basal isn't constantly pulling me down. In fact, I guess I'll sleep rather high tonight.

The bad thing now is that I've added a daily worry to my backpack. Knowing it CAN happen makes my brain think it's gonna happen all the time.

 

[Hopeful34]

I can understand your worry, but if you can tell yourself that this is the only time it's happened out of how many injections of Tresiba. Whilst it was scary, and none of us like having hypos, you did all the right things and coped well.

I had something similar happen a few times (I'm not on Tresiba,) for no apparent reason, before I went onto a HCL pump. Once was in front of my endocrinologist!! Talk about embarrassing!!

 

[Esttther]

I can understand your worry, but if you can tell yourself that this is the only time it's happened out of how many injections of Tresiba. Whilst it was scary, and none of us like having hypos, you did all the right things and coped well.

I had something similar happen a few times (I'm not on Tresiba,) for no apparent reason, before I went onto a HCL pump. Once was in front of my endocrinologist!! Talk about embarrassing!!

That's what I've been telling myself for the past 2 days when injecting Tresiba. Of course, without the same effect anymore. I guess it's just a matter of building confidence as I see it doesn't happen again.