Changing From Lantus To Tresiba

Kirbster

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Type 1
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I've been on Lantus for what seems like forever, but after reading lots of positive feedback about Tresiba I have decided I'd like to give it a try as it seems it is a lot flatter and more predictable than Lantus. I emailed my dietitian (as I have a great relationship with her) to ask whether I need to see my GP or a consultant about it, and she said because Tresiba is "off formula" I will need to see the consultant as he will need to recommend it.

I'm more than happy to do that, but I just wanted to know anyone else's experiences on trying to get Tresiba. Did you find it a battle to get it approved? Was it easy? I'm really not sure what "off formula" is but presume it means it's a drug that is prescribed only if there's a need, so I might need to build my case!

TIA,
Erin
 

porl69

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Hi Erin. My dietitian told me I was being moved from Lantus to Tresiba. I used to be on 22 units of Lantus in the evening but was getting odd highs around 6pm the following day. I am now on 13 units of Tresiba with a stable line (thank you Libre) thru the night and pretty good reading thru the day. I would totally recommend Tresiba. Apparently it stays in your system for 36 hours?
 

Kirbster

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Hi Erin. My dietitian told me I was being moved from Lantus to Tresiba. I used to be on 22 units of Lantus in the evening but was getting odd highs around 6pm the following day. I am now on 13 units of Tresiba with a stable line (thank you Libre) thru the night and pretty good reading thru the day. I would totally recommend Tresiba. Apparently it stays in your system for 36 hours?

Thanks for the info, much appreciated! I think Lantus is also supposed to stay in your system for about 36 hours (I'm sure I read that somewhere) but I think it has a peak period whereas Tresiba doesn't. It's great to hear you've had good success!!
 
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porl69

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Thanks to the Libre I could see the trend with my Basal insulin. At around 20 hours it definitely was starting to loose potency and I was getting higher numbers. Doesnt tend to happen since i have been on Tresiba, unless I have mis-calculation of my lunch carbs o_O
 
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"Stays in your system" and "remaining flat" are very different things.
When I converted from Lantus to a pump, it was explained that Lantus could "stay in my system" for up to 4 days so I had to be careful when starting my pump basal levels.
However, the levels of Lantus fall after 22 - 24 hours.
 
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Circuspony

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Are you in the UK? I got moved to Tresiba from Lantus. Initially my consultant told me to start taking Lantus in the morning when it was giving me overnight lows. That then meant I was waking up high as it wore off.

I definitely get a much flatter profile with Tresiba, but I'm not yet convinced it is right for me. I'm very active during the day time and I've had a lot more hypos / dropping low since starting on it. If I drop my dosage then my overnight levels go up. Got another appointment next week so we'll see what they say.
 

Kirbster

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Are you in the UK? I got moved to Tresiba from Lantus. Initially my consultant told me to start taking Lantus in the morning when it was giving me overnight lows. That then meant I was waking up high as it wore off.

I definitely get a much flatter profile with Tresiba, but I'm not yet convinced it is right for me. I'm very active during the day time and I've had a lot more hypos / dropping low since starting on it. If I drop my dosage then my overnight levels go up. Got another appointment next week so we'll see what they say.

Yes, I'm in the UK. I currently split my Lantus dose as I was getting overnight hypos too. I take 4 units in the morning, and 2 at night. I started taking 4 at night but had to reduce it further because I was still having hypos. Sometimes I still do on only 2 units! But I am also on the LCHF diet (keto) so I need very little insulin. I'll be interested to hear what your consultants recommends after your next appointment.
 

kev-w

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I'm booked to see the hospital consultant on Thursday for the same thing, but having been thinking about it and reading different views aren't as eager as I once was, in fact I'm reading up on Levemeir now too, I want a change as Lantus for me has quite a drop after 16 - 18 hours but if I reduce the dose my bloods run too high the following day, I also find Lantus to work differently some days, but I'm starting to lean to 'better the devil you know' kind of thinking.

Sorry :) no help whatsoever....
 
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Fairygodmother

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I changed from Lantus to split dose Levemir and after the initial period of discovering what doses to give I’ve found it’s definitely better than Lantus, for me.
The flat delivery of Tresiba is tempting as my Levemir split’s almost the same for nighttime as daytime. But it’s getting it that’s the problem. The GPS and the DSN don’t want to change anything without the Consultant’s say-so. Groan.
 

Draco16

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I'm booked to see the hospital consultant on Thursday for the same thing, but having been thinking about it and reading different views aren't as eager as I once was

@kev-w I often find myself agreeing with your posts and share similar approaches to T1 management... and spookily I also have an appointment on Thursday to discuss changing to Tresiba (though i'm coming from Levemir)!

I'm also becoming more and more uncertain about the switch. My main reason for switching was to reduce number of injections (I split Levemir), but now there is a thread about splitting Tresiba. Plus another Endo I bumped into on holiday said she thought it might not be suitable for me as i'm fairly active, but to an erratic schedule - Tresiba is less flexible.

I guess Levemir works well for me (only frustration is having to do 2 injections per day). I know there can be a thing with insulins eventually stopping working for people so having to switch them, so I think while Levemir still works well for me i'm going to keep going with it and have Tresiba in reserve for the future.
 

LooperCat

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I switched to Tresiba in March, and I’m beginning to wonder if I’ve made a mistake. It was to avoid the second injection of Lantus, basically. So while Tresiba is keeping me dead level overnight (good), I’m getting a big rise in the morning that I wasn’t getting before and have to take one or two shots to correct for it (not good), and then a slump late afternoon/early evening for which I have to take food, whether I want any or not (also not good). The other, biggest, issue I have is that one week a month I’m a little insulin resistant, and could do with a unit of extra basal for a few days - but Tresiba is so slow to react to changes that by the time it’s kicked in, it’s too late. So I end up with four days of highs followed by four days of lows (very not good). Admittedly that’s probably not a problem for half the population ;)

I’m going to give it until my next appointment in September, I’ve read it can take a few months to settle. At the moment I’m taking as many, if not more, injections and having to eat when it’s inconvenient or I just don’t want to. But then Lantus never kept me as stable during the night... I had quite a few night hypos when I was using it. Think I’ll hand them both back and have a functioning pancreas instead :D
 

Kirbster

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Type of diabetes
Type 1
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Insulin
I'm booked to see the hospital consultant on Thursday for the same thing, but having been thinking about it and reading different views aren't as eager as I once was, in fact I'm reading up on Levemeir now too, I want a change as Lantus for me has quite a drop after 16 - 18 hours but if I reduce the dose my bloods run too high the following day, I also find Lantus to work differently some days, but I'm starting to lean to 'better the devil you know' kind of thinking.

Sorry :) no help whatsoever....

On the contrary, it's a great help! It's just good to know that other people are going through the same thing. Gotta love this constant battle that is diabetes :banghead: What you've just said above sums up completely what Lantus seems to be doing for me.

I've also read some negative feedback on Tresiba which is making me wonder what the next step is. I know I definitely want to try something else but I'm just not sure what! Seems like different insulins work differently for different people (there's a lot of differences there!) and I guess it's just finding one that works for me. I might have to do a bit of trial and error.
 
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Kirbster

Active Member
Messages
41
Type of diabetes
Type 1
Treatment type
Insulin
I changed from Lantus to split dose Levemir and after the initial period of discovering what doses to give I’ve found it’s definitely better than Lantus, for me.
The flat delivery of Tresiba is tempting as my Levemir split’s almost the same for nighttime as daytime. But it’s getting it that’s the problem. The GPS and the DSN don’t want to change anything without the Consultant’s say-so. Groan.

I know what you mean about the GP's and DSN's! I don't mind seeing a consultant though if it means I can talk things through and change to something more appropriate. What worries me is that (as always!) those of us who live with diabetes seem to know more about our condition than they do, and I worry that I'm going to need to fight to get what I need. But hey, it's worth it.
 

Kirbster

Active Member
Messages
41
Type of diabetes
Type 1
Treatment type
Insulin
I switched to Tresiba in March, and I’m beginning to wonder if I’ve made a mistake. It was to avoid the second injection of Lantus, basically. So while Tresiba is keeping me dead level overnight (good), I’m getting a big rise in the morning that I wasn’t getting before and have to take one or two shots to correct for it (not good), and then a slump late afternoon/early evening for which I have to take food, whether I want any or not (also not good).

Oh God, I so get this! But what Tresiba is doing to you at the moment is exactly what Lantus is doing to me - both the big rise in the morning when I get up, plus the slump late afternoon/early evening. Maybe I just need to fiddle with my doses (currently 4 units when I wake, and 2 before I go to sleep) rather than change insulins. Oh it's all so confusing!!

Think I’ll hand them both back and have a functioning pancreas instead :D

I'm going for that option too!! ;)
 

LooperCat

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Oh God, I so get this! But what Tresiba is doing to you at the moment is exactly what Lantus is doing to me - both the big rise in the morning when I get up, plus the slump late afternoon/early evening. Maybe I just need to fiddle with my doses (currently 4 units when I wake, and 2 before I go to sleep) rather than change insulins. Oh it's all so confusing!!



I'm going for that option too!! ;)
Just goes to show how different we all are. Wouldn’t it be lovely if there was a one-size-fits-all treatment plan?
 

Barkingmad2

Member
Messages
14
I have found this very interesting. I have been on overnight Lantus for many years now but, I am up to 64 units now ! Morning bloods before breakfast are 10.
Think I might ask my nurse about a change.
 

Kirbster

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Messages
41
Type of diabetes
Type 1
Treatment type
Insulin
I have found this very interesting. I have been on overnight Lantus for many years now but, I am up to 64 units now ! Morning bloods before breakfast are 10.
Think I might ask my nurse about a change.

Are you Type 1 or 2? That's a lot of Lantus!