Changing From Levemir

[Antje77]

Hi I have been on Tresiba200 for 2 months, bear in mind that there is also Tresiba100. I was on 56 units of levermir split over 2 doses. Initially my suggested dose for tresiba200 was 48 units, however this caused many hypos and I was having to eat and drink a lot more sugary things and that was without taking any novarapid.

This is very interesting, as I'm looking into changing from U200 to U100 (because of refillable pens with a memory for last dose), and theoretically the dose should be the same, an insulin unit is an insulin unit, U100 is just more diluted than U200.
I'll have to be patient though. While my U100 will arrive next week, I still have a huge stockpile of U200 (due to a lowering insulin need) which needs to be used up first.

I'll keep in mind I may not need the same amount when switching!

 

[Tony337]

Hi
Just jabbed 14 units of Tresiba and my levimir is no more.
Feeling a bit odd actually but i think that is just because of a bit of nerves.
Last levimir was 14 units at 6pm yesterday 7/10.
First Tresiba 6am today 14 units and in theory should last over 24 hours.
Currently in the 5s and armed with a new libre sensor (accurate so far activated 4pm yesterday but stuck on my arm 48 hours ago) and caresense glucometer.
Currently 5.7 mmol/l libre and 5.8 mmol/l glucometer at 7.35am.

Sat at my desk at work supping coffee and waiting for something to happen lol lol ...

I have no idea whether posting this is of any use to anyone but i'm not precious about it and will stop if it starts to fade away as posts and threads do....

Tony

 

[Lily21]

Hi
Just jabbed 14 units of Tresiba and my levimir is no more.
Feeling a bit odd actually but i think that is just because of a bit of nerves.
Last levimir was 14 units at 6pm yesterday 7/10.
First Tresiba 6am today 14 units and in theory should last over 24 hours.
Currently in the 5s and armed with a new libre sensor (accurate so far activated 4pm yesterday but stuck on my arm 48 hours ago) and caresense glucometer.
Currently 5.7 mmol/l libre and 5.8 mmol/l glucometer at 7.35am.

Sat at my desk at work supping coffee and waiting for something to happen lol lol ...

I have no idea whether posting this is of any use to anyone but i'm not precious about it and will stop if it starts to fade away as posts and threads do....

Tony

Hi @Tony337,

Welcome to the Tresiba club (finally!).

I also felt pretty odd/out of sorts for a few days after starting Tresiba. I just chalked it down to my body being confused/thrown by the change. I'd been on Levemir for almost two decades after all!

I also found that my leg felt pretty weird/numb where I'd injected the Tresiba. This feeling has not gone away, however, and I still get a strange numbness every time I inject, even though I've been on Tresiba for over two months now.

I'm glad that you posted as I was wondering whether you had started Tresiba and how you were getting on with it. Do let us know how you get on over the next few days as the Tresiba builds up and reaches a steady state. I've found that although I can see the effects of a dose change within 3-4 days, it continues to build up for about 8 days before finally reaching a steady state.

 

[Tony337]

Thanks @Lily21
Currently 5.2 mmol/l stayed steady all morning with no food, 8000 steps.
Interestingly on levimir i would have needed around 10g of carbs by now and its impossible to know whether there has been any levimir floating about my system. I last took 14 units at 6pm last night.

This afternoon i will be more active but only in a steps sense and come 6pm i will gorge myself on a carb heavy meal and lets see what happens.I can't manage anything beyond 24 hours without food.

As far as jabbing i used my backside as i do for bigger injections as i'm in good shape for my age but don't have much fat on my legs or stomach.
1 jab a day instead of the usual 2 will be a bit of a novelty to start with.

My nerves have settled but adding carbs and novorapid into the mix might change that.

Thanks

Tony

 

[Tony337]

Had a poor nights sleep and poor readings.
4 hours after my evening meal i dropped that low i ended up shovelling jellie babies in.
It first looked like i had taken the wrong dose of novorapid however we have the same evening meal every thursday so took what i normally would take.
I reason i took the novorapid too near the food (that used to work nicely) spiked too high then the drop was a bit scary.

I got novorapid with levimir to work beautifully.

I upped the tresiba this morning from 14 to 16 and intend to take the novorapid 20 minutes before my evening meal providing i'm level then.
Currently 4.4 with around 20 g of carbs today.

Its only day 2 i keep telling myself lol

Have a top weekend

Tony

 

[Hopeful34]

Take care @Tony 337. Hope you have a better day today.

 

[Tony337]

Take care @Tony 337. Hope you have a better day today.

Thank you

 

[Lily21]

Had a poor nights sleep and poor readings.
4 hours after my evening meal i dropped that low i ended up shovelling jellie babies in.
It first looked like i had taken the wrong dose of novorapid however we have the same evening meal every thursday so took what i normally would take.
I reason i took the novorapid too near the food (that used to work nicely) spiked too high then the drop was a bit scary.

I got novorapid with levimir to work beautifully.

I upped the tresiba this morning from 14 to 16 and intend to take the novorapid 20 minutes before my evening meal providing i'm level then.
Currently 4.4 with around 20 g of carbs today.

Its only day 2 i keep telling myself lol

Have a top weekend

Tony

Any updates @Tony337?

 

[Tony337]

Any updates @Tony337?

Saturday perfect graph during the day not so night time.
Upped the dose to 20 units yesterday and whilst i struggled at 8pm going too low i ended up levelish going to bed i woke this morning on 6.5mmol/l.
I will stop with 20 units for the next few days.
Does tresiba peak i wonder if so i would say 12 hours in as it appears to alter the evening meal novorapid?
I had the levemir and novorapid mix to work beautifully am i looking at it wrong?

I do love the quote "never be certain of anything as its a sign of limited intellect"

Tony

 

[Tony337]

Again i was on my backside at 8 ish last night.
I cope well during low levels but even i struggled.
Took 18 units this morning and decided to cut back a bit on both insulins.
Luckily for me i am quite a determined individual and i will get to where i want to be.


toodle who...
Tony

 

[Lily21]

Again i was on my backside at 8 ish last night.
I cope well during low levels but even i struggled.
Took 18 units this morning and decided to cut back a bit on both insulins.
Luckily for me i am quite a determined individual and i will get to where i want to be.


toodle who...
Tony

Tresiba is meant to have a flat, stable profile with no pronounced peak. When the dose is right, I find that this is the case and my blood glucose level tends to hover at almost the same level for hours, only fluctuating by about 0.2 mmol/L on a basal test. Tresiba does build up in your body over time and takes a while to reach a steady state. Its lengthy duration means that each dose overlaps the other and I wonder whether it is the Tresiba overlap and frequent changes to your Tresiba dose that are to blame for the lows, or too much NovoRapid in the afternoon/evening, depending on when and what you're eating. Have you been doing any basal tests in the day? If so, how much has your blood glucose been fluctuating when you haven't got any NovoRapid or food in your system and you're just relying solely on Tresiba?

 

[Tony337]

Tresiba is meant to have a flat, stable profile with no pronounced peak. When the dose is right, I find that this is the case and my blood glucose level tends to hover at almost the same level for hours, only fluctuating by about 0.2 mmol/L on a basal test. Tresiba does build up in your body over time and takes a while to reach a steady state. Its lengthy duration means that each dose overlaps the other and I wonder whether it is the Tresiba overlap and frequent changes to your Tresiba dose that are to blame for the lows, or too much NovoRapid in the afternoon/evening, depending on when and what you're eating. Have you been doing any basal tests in the day? If so, how much has your blood glucose been fluctuating when you haven't got any NovoRapid or food in your system and you're just relying solely on Tresiba?

Hi and thanks.
I've been trying to avoid novorapid during the day but as i wake higher than i want i pop a drop in to get me lower.
Today is a prime example.
Up at 6am and 8.9 so took 18 units tresiba and 1 unit of novorapid.
Alot of walking first thing which is normal and i dropped into the fours but had to graze a little to countact the novorapid.
Thats normal for me too its the activity plus the odd bit of novorapid but the tresiba is too involved compared to levemir.

Then what keeps happening is...
6pm food and novorapid but need the novorapid 30 minutes before food......used to taking novorapid whilst eating.
Then at 8pm i'm on my backside with a low so obviously i have been adjusting my novorapid intake.

Taking food and novo at the same time ends in too high a peak for my liking.
Bedtime 10 pm ish and again a bit more food to help me relax enough.

Once the rapid runs out i end up in the 8s and 9s when i'm used to 4s 5s and 6s mmol.
Tresiba is fine for day but not for nights and as i had levimir Twice per day is my body craving for that?
Can that happen?
I keep thinking Tresiba is supposed to be stronger and longer lasting and i see the stronger bit but not the 36 to 42 hours i keep reading.

Please be mindful
Mdi and don't care how many jabs i need.
Simple walking works well with my insulin and always has.
Aiming for 5s and i've been running like that for years.
I don't fear a hypo and disagree alot with The NHS take on hypos.


Thanks and hope my post is not too long and boring.

Tony

 

[Garry fotheringham]

I loved Tresiba coming off Lantus, because the nearly 48h DIA was much more stable. Levemir is more 12h DIA, so you may need to make small changes to get the dose right, but Tresiba worked wondes for me.

I loved Tresiba coming off Lantus, because the nearly 48h DIA was much more stable. Levemir is more 12h DIA, so you may need to make small changes to get the dose right, but Tresiba worked wondes for me.

Note that Lantus is another popular Basal which can be split to two shots per day if needed.

Hi I have taken lantus last think at night ( it's a slow acting insulin 22 units for the last 20year ) I find it keeps my blood sugar under control well.

 

[Tony337]

Brief update.
2 weeks since changing and finding my way alot better but the relationship between tresiba and novorapid is completely different than my levimir with novorapid.
The mistakes i'm making are getting fewer so feel better in myself.

Tony

 

[Lily21]

Brief update.
2 weeks since changing and finding my way alot better but the relationship between tresiba and novorapid is completely different than my levimir with novorapid.
The mistakes i'm making are getting fewer so feel better in myself.

Tony

Excellent news @Tony337! I think it's important that we cut ourselves some slack when changing insulin. It's hard work dealing with a new insulin and it's going to take a while for it to become second nature. I'm so glad the mistakes you are making are getting fewer though. Long may it continue!

I'm almost three months in now and I'm feeling slightly more relaxed than I was before. It's still hard work but it's getting easier.

What percentage of your total daily insulin dose is Tresiba taking up at the moment? My total daily dose is currently around 30% Tresiba and 70% NovoRapid. Before I think it was more like 70% Levemir and 30% NovoRapid! I'm also having to take NovoRapid about 20-30 minutes before eating whereas before I took it at or just after mealtimes.

 

[Tony337]

Excellent news @Tony337!

What percentage of your total daily insulin dose is Tresiba taking up at the moment? My total daily dose is currently around 30% Tresiba and 70% NovoRapid. Before I think it was more like 70% Levemir and 30% NovoRapid! I'm also having to take NovoRapid about 20-30 minutes before eating whereas before I took it at or just after mealtimes.

I'm taking 40% less Tresiba than Levemir and when i take it is relevant...
I take Tresiba at 6am whereas levemir was taken at 6am and 6pm.
I eat at 6pm and on the back of me being physically v active and like you i took the 6pm dose of levemir and novorapid and oft injected whilst eating.
Now i have to take my novorapid 20 minutes before which is irritating as i'm forced to eat to insulin and i'm used to the opposte.
Percentage wise i cannot compare novorapid amounts as i'm still grazing during the day and not eating a square meal until 6pm.
Even then i'm heading off a high by going for a stroll instead of taking extra insulin.

It all sounds complicated when typing it out but it isn't and as i'm well known for saying my control was and is based on insulin carbohydrates and exercise.

Tony

Ps its 7.51am now with a new sensor yesterday and i'm 5.0 and had a flat line graph overnight...happy days

 

[ironf15t]

Good to read you’re getting the hang of it! I went from Levemir 34-36 in the AM and 24 in the PM to Humulin I 30AM 7PM before moving to tresiba where im taking 20u currently. It was 23 for the most part then i dropped to 22 as i was dropping alot during the night. But ive dropped to 20 to try and stop the sharp drop. All trial and error, but im loving it to be honest as most of the time it keeps me steady, other than if ive miscalculated my carbs/fiasp.