Tresiba - morning highs

[slbarron23]

I have just changed from levemir to Tresiba last week.

I was taking 4/5units of Levemir on a morning and 15 units on a night.

I now take 13 units of Tresiba on a night only.

I was planning on increasing my Tresiba does after 3 days as suggested as I thought 13 wouldn’t be quite enough but did not want to start off with a too high dose and be hypoing.

However I have high blood sugars in the morning (11-13 usually) and then after breakfast I tend to drop to between 4/5 and 7 all day which is great.

I can’t really work out what to do as the highs are closest to when I am taking my insulin so it can’t be running out.

I used to get slight dawn phenomenon and I always have to have breakfast and insulin before I do anything but on levemir it would never be high directly upon waking.

 

[Juicyj]

Hi - only a week in is still very early days on Tresiba, I took me over a month to really bed in and get my adjustment sorted from switching across from levemir, however as you're still presenting a high reading in the morning and haven't adjusted since you started it then it's worthwhile looking at increasing it now - are you in touch with your DSN over your adjustments ? I was doing 10% increments on tresiba until I found the right level, as you probably are aware tresiba stays in your system around 36 hours hence why the need to relax on adjusting too frequently, i'd give it 4 days before reviewing. I also didn't notice any great DP impact when I was on tresiba, it really did hold me steady during the night, great insulin so it will come right

 

[slip]

Could there possibly be a need to also change the bolus ratio - pre-tresiba your ratios could have be helping/masking the basal you were on? I have no evidence or experience with this so could be talking a load of gibberish!

 

[slbarron23]

I have been checking my levels at 5am ish for the last few nights and my levels have been exactly the same then as when going to bed - then this has been the same as when I wake up (almost identical!) I have figured if I eat too late to going to bed this means I am not being able to get the correct level before sleeping and therefore I am staying high all night! No more carbs late at night seems to do the trick!
Tresiba seems like a good fit so far - my average before was between 9 and 10 daily and this past week it is 8

 

[slbarron23]

So I have been on the tresiba for almost three months and and starting to feel that it is just not for me.

I upped my dosage to 14 units and found I wasn’t having any more hypos and my morning levels were better. I was having to have less insulin with food however on days when I was very active at work.

The downside I have now is that on my days off work or days when I am a bit lazier my bloods run high all day - I use to manage this with levemir as I would simply have more units on a morning and that would work fine! I can’t do that with the tresiba since it lasts for so long!

I don’t know if I’m not getting the balance right between basal and bolus but I am not seeing my consultant again until may so any ideas will be helpful!

 

[donnellysdogs]

So I have been on the tresiba for almost three months and and starting to feel that it is just not for me.

I upped my dosage to 14 units and found I wasn’t having any more hypos and my morning levels were better. I was having to have less insulin with food however on days when I was very active at work.

The downside I have now is that on my days off work or days when I am a bit lazier my bloods run high all day - I use to manage this with levemir as I would simply have more units on a morning and that would work fine! I can’t do that with the tresiba since it lasts for so long!

I don’t know if I’m not getting the balance right between basal and bolus but I am not seeing my consultant again until may so any ideas will be helpful!

That was one of my reasons for not liking tresiba. Days activities are so different for me that it didnt give me the flexibility I needed.
I still had to add in extras for mornings too so I didnt gain anything.. jyst frustration from different days and no flexibility.