Tresiba dosing

[Zinadane]

I've been using tresiba and fiasp for about 4 years now. It's been really good to be honest. But I guess I'm always trying to fine tune and improve.
I find it really tricky getting the perfect tresiba base level that will not go high through early morning sleep hours and will not go low during the 3-6pm range.
Only ever used 1 first thing in the morning dose.
Are others using single dose tresiba or double dose. What is best to get the perfect base level?

 

[In Response]

If you are going high during the early morning, this is likely to do with Dawn Phenomenon.
As slow acting insulins attempt to have a flat profile, it is not possible to match it directly to the glucose drip from your liver.
There are times (such as during mornings when the liver drips more glucose) and there are times (such as after alcohol and during exercise) when your liver drips less.

The advantage of an insulin pump is that the basal insulin can be adjusted to closer match the body's needs.

 

[Zinadane]

Not the dawn phenomenon. The early sleeping hours 3-6am.
Really not keen on a pump.

 

[jaywak]

How do you know it's not the dawn phenomenon ?

 

[Zinadane]

Ok. Maybe then. How would I know.
Anyway, does double dosing tresiba day/night give better results. Anyone?

 

[Juicyj]

Anyway, does double dosing tresiba day/night give better results. Anyone?

Makes zero difference, tresiba is the most stable basal around, there's no mucking about with this, one injection is fine every day and it doesn't make any difference if you skip it for 12 hours either, as it lasts 36 hours.

Sounds like DP to me too - 3am is your lowest point during the night, from there on in levels can rise from the liver dump.

 

[searley]

I've been using tresiba and fiasp for about 4 years now. It's been really good to be honest. But I guess I'm always trying to fine tune and improve.
I find it really tricky getting the perfect tresiba base level that will not go high through early morning sleep hours and will not go low during the 3-6pm range.
Only ever used 1 first thing in the morning dose.
Are others using single dose tresiba or double dose. What is best to get the perfect base level?

because tresiba is a super long acting insulin there is little benefit in splitting the dose, there is very little spike in it action, and it lasts upto 72 hours.

some people with differing lifestyles don't suit tresiba as you can not decide the night before to take a little less as you'll have a busy day the following day... and the other way round you can not think i will have an extra unit tonight as im having a lazy day tomorrow as it can take 48hts plus to see the effect of a dose change

your best bet is to aim for the lower end of good control and use corrections with fiasp when needed... or if you continue to struggle you may have to consider the option of moving away from tresiba..

tresiba is great when you have a stable lifestyle

 

[jaywak]

I find if i'me going a little low in the early hours , not that low but say 4 the liver dump really kicks in , but if I can keep it about 6 I almost always wake in the normal range .

 

[Heathero]

Maybe have 5-10g snack before bed. Or 1 jelly baby5g if 4 ?

 

[Heathero]

Maybe have 5-10g snack before bed. Or 1 jelly baby5g if 4 ?

 

[DisFanJen]

I don’t know Tresiba but I am on Lantus which is a one shot Basal insulin so this may be relevant.

While Lantus gives a stable baseline my care team said there is a small drop off in the last 3 hours or so before the 24 hours are up and because of this I switched from injecting at night to injecting in the morning and that worked for me.

I don’t think multiple doses would be of any use but possibly changing the time of day you inject?

 

[jaywak]

DisFanjen thats exactly what I did several years ago , I was having nocturnal hypos quite regularly so I changed my tea time dose of Lantus to when I wake up in the morning and the problem was solved , I'me on Semglee now but it has stayed the same and only occasionally have I had a nocturnal hypo .