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A very interesting question about basal insulin (Lantus/Tresiba/Levemir).

kzlorenz said:
I have collected a few more papers on the topic of Degludec and exercise.
If anyone wants them just drop me a line please.

Cheers
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I'd certainly be interested. I'm sure many others would. Is there any reason you can't post them in the public forum?

This one, http://onlinelibrary.wiley.com/doi/10.1111/dom.12588/full shows similar post exercise hypoglycaemia rates as that found with Glargine in a trial with more participants, which would be enough for me to avoid it.
 
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My own experience (with 56 years of T1D experience) is that any type of treatment choice (pump, any long-term insulin) will require some extra carb input after a good exercise session. The main reason being that whatever your "normal" levels of exercise are, your level bolus rate ultimately gets adjusted to that. If you exercise beyond those normal levels, it will require some additional carbs since the additional exercise is both burning whatever carbs you have and, I have noticed in myself, is going to process carbs more efficiently for several hours after the exercise. I don't think it would be possible to have a long-term approach that can get around it.
 
Hi, sorry for the delay.
Here the first 10 files.
 

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here some more (sorry if any double copy)
 

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I think my prob in last few weeks has been having to change my foods to soups and smoothies... And majority fruit and veg. It is s blooming hard guestimating carbs with real food...and I'm so tempted to get out the weighing scales but don't want to go OTT!!
Don't want to lose any more weight and therefore need to eat and not do basal testing!!
However, with truly OTT precision in last 24 hoursI have remained from 4.6 to 5.9 with one blip at 8.0 at an hour after breakfast which was an hour after getting up so may have underesteimated my waking phenomenon correction bolus....guess I may have to be OTT with weighing scales if I remain on smoothies and soups if this new drug doesn't kick ass with starting my colon working....
Tresiba today has been smooth.. Its my weighing fruit and veg that has to be fine tuned and that waking phenomenon correction....still much prefer it to a Pump though!! Even with the faffing around weighing it does not compare to what I used to faff around with on my pump!! Yaaaaay-still happy and fighting!!
 
A quick update on Tresiba and exercise.
So apparently Tresiba would not have given me any big problems after moderate-intense exercise.
I switched from 70 min fast walking/day to 2x 40 min fast cycling/day; this usually would have made me reducing Levemir about 20-30% in the first and second injection (i.e. same day and following morning) after exercise change.
I reduced Tresiba 33.3% (I probably wrongly assumed that if T half life is more than double I should have doubled my cut...). Anyway that did not work out well and I had a high night. I then the following day went back to a 90% prior switch dosage and the following night was much better. The third day I went back to 100% and did not have any hypos (still cycling every day now).
I'm now at the 4th day after exercise increase and everything seems OK.

Anyone who had similar/different experience ??

Cheers
 
robert72 said:
This was my Tresiba overnight last night. 15u taken at 10pm in one shot. I can't see that I could get it much flatter by splitting it across 2 or 3 doses. No, my Libre is not broken and yes, I did sleep in until 11am :)

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@robert72 do you find Libre helpful? Thinking to get one as i just put on insulin, so i would like to closely monitor my sugar level... but i feel sorry to my poor fingers with over 3 time tests per day
 
yycdordor said:
@robert72 do you find Libre helpful? Thinking to get one as i just put on insulin, so i would like to closely monitor my sugar level... but i feel sorry to my poor fingers with over 3 time tests per day
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Hi @yycdordor

Yes it's extremely useful if you want to keep a close eye on your levels. You'd still need to test occasionally to check for accuracy. I was testing around 10 times a day so a big relief when I first got it ;)
 
robert72 said:
Hi @yycdordor

Yes it's extremely useful if you want to keep a close eye on your levels. You'd still need to test occasionally to check for accuracy. I was testing around 10 times a day so a big relief when I first got it ;)
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I'd second this, I was up at about 10 checks per day as well. It gets your doctors off your back as well (although at a fairly high personal financial cost...)
 
staffsmatt said:
I'd second this, I was up at about 10 checks per day as well. It gets your doctors off your back as well (although at a fairly high personal financial cost...)
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My doctors never look at my Libre data/charts. They just look at my HbA1c and accuse me of having lots of hypos to get there ;)
 
robert72 said:
My doctors never look at my Libre data/charts. They just look at my HbA1c and accuse me of having lots of hypos to get there ;)
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Ha ha... same here! Even when I showed him the overnight Libre chart, he still gave me the speech about relaxing my regime & allowing my numbers to come up a bit. HB1AC at 5.1...
 
robert72 said:
My doctors never look at my Libre data/charts. They just look at my HbA1c and accuse me of having lots of hypos to get there ;)
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I actually meant them moaning about the amount of strips you use. Don't think the most paranoid of doctors would worry about my hba1c

Edit: don't know where the word liberal came from!
 
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yycdordor said:
@robert72 do you find Libre helpful? Thinking to get one as i just put on insulin, so i would like to closely monitor my sugar level... but i feel sorry to my poor fingers with over 3 time tests per day
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I find Libre very good especially during meals, my postprandial peaks got much better and consequently my hab1c.
:D
 
spanishavocado said:
Imagine that I have 18 units of Lantus or Tresiba at say 9:00 AM.

I can have the 18 units in one shot, or I could divide these large shot into three shots at the same time, same hour of 6, 6 and 6 units in diferent parts of the body (say belly, left leg and right leg). The three shots given at the same hour: 9 AM. No split afternoon dosing or anything like that. Split dosing is something totally different.

The goal would be to increase the surface of absorption and therefore make the insulin be more stable and work better. I've heard similar theories from Richard K. Bernstein, M.D.

Has anyone tried this technique with success? I may try it tomorrow for my Tresiba dose. Thank you.
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Given the mechanism of action and binding of the insulin within the body (The pharmacodynamics and pharmacokinetics of Tresiba) there would be no benefit at all in injecting yourself 3 times vs single dose.
 
Hi,

I wanted to say that I use Tresiba at 10pm every night. I used to use Lantus at a similar time and my BG would always tend to creep up from 5pm the following day. Now my levels are completely flat. It does take time to find your dose as the literature says it lasts for a long time so my advice is to allow 4 days maybe even 5 days for any dose change to take effect. I currently take 35 units and this has not changed apart from when I am lucky enough to have the inhalable insulin Afrezza. Then I get non-diabetic numbers. However we are not talking Afrezza here. Titrating Tresiba should be done with care as I increased too much way up to 44 units initially and by the time it all settled down I was going low all the time. 35 is perfect for me being 105kg. To address the exercise question earlier, I do BodyPump and spin classes and I do not go low after these during the night with Tresiba. IT was a constant problem for me on Lantus.

I hope this helps folks! That's all for now.....
 
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