Can’t Get My Tresiba Dose Right At The Moment

[CornishKate]

Morning everyone,

I have been taking 9 units of Tresiba at about 8pm for a month or so (along with Novorapid with food) diagnosed 5 months ago. My readings have crept up to the 9s, 10s and 11s at meals so increased to 10 Tresiba. Then the 4am hypos for 4 nights so went back down to 9 units. But of course now the mealtime readings are back up!

Any help or advice please?

 

[Knikki]

Do you change Nova dosesage for meals?

Are you aware of Carb Counting?

If your running OK during the night at 9 of Tresbia then I would leave it alone for the moment, bear in mind that Tresbia is long lasting and has a 42 hour window so any change you make may take a few days to kick in (least thats what I am finding).

But if your runing high after meals, it sounds like your Nova is not quite right, maybe drop a unit of Nova at meal times.

The reason I ask about carb counting is that many of us match amount of insulin to carbs intake, so say for example you have a ratio of 1 unit insulin for 10 grams of carbs and you eat a meal containing 50 grams of carbs than you would only inject 5 units of insulin

I hope that sounds right, but I am not medically trained and as you are new to this game it could be worth a chat with your medical team

Hope things get sorted

 

[CornishKate]

Do you change Nova dosesage for meals?

Are you aware of Carb Counting?

If your running OK during the night at 9 of Tresbia then I would leave it alone for the moment, bear in mind that Tresbia is long lasting and has a 42 hour window so any change you make may take a few days to kick in (least thats what I am finding).

But if your runing high after meals, it sounds like your Nova is not quite right, maybe drop a unit of Nova at meal times.

The reason I ask about carb counting is that many of us match amount of insulin to carbs intake, so say for example you have a ratio of 1 unit insulin for 10 grams of carbs and you eat a meal containing 50 grams of carbs than you would only inject 5 units of insulin

I hope that sounds right, but I am not medically trained and as you are new to this game it could be worth a chat with your medical team

Hope things get sorted

Hi,

Yes do carb counting but my DN said a few weeks ago that if my reading at lunch was the same at breakfast and so on, my novorapid is right but the Tresiba is too low?

Thanks for your reply

 

[Knikki]

Must confess I am not familier with how LADA works, being a Type 1 thingy myself, but I would have thought even if your BSL is the same at Breakfast and Lunch but you say had 90 grams of carb for brekky but only 15grams of carb for Lunch and then have the same amount of insulin for both, it would make you hypo at some point after lunch?

Most people using Nova Rapid will alter the dose depending on how many carbs they eat at what ever meal time they are at, I certainly used to do before I changed insulins.

But in an ideal world it is not good to hypo during the night, which is why I suggest leaving the long acting Tresbia alone for the moment.

Hopefully some of the other LADA users around will chip in.

 

[CornishKate]

Must confess I am not familier with how LADA works, being a Type 1 thingy myself, but I would have thought even if your BSL is the same at Breakfast and Lunch but you say had 90 grams of carb for brekky but only 15grams of carb for Lunch and then have the same amount of insulin for both, it would make you hypo at some point after lunch?

Most people using Nova Rapid will alter the dose depending on how many carbs they eat at what ever meal time they are at, I certainly used to do before I changed insulins.

But in an ideal world it is not good to hypo during the night, which is why I suggest leaving the long acting Tresbia alone for the moment.

Hopefully some of the other LADA users around will chip in.

Oh no I mean I take the novorapid to match my carbs, 10:1 for breakfast and 15:1 for lunch my blood sugar readings are generally the same at each meal, 9s,10s and 11s so I am having to correct with each meal too.

 

[Circuspony]

Sounds like your novorapid needs to increase slightly with meals

 

[Knikki]

Oh no I mean I take the novorapid to match my carbs, 10:1 for breakfast and 15:1 for lunch my blood sugar readings are generally the same at each meal, 9s,10s and 11s so I am having to correct with each meal too.

Arh! I see sorry, teaching you to suck eggs was't meant that way.

I'm not sure, it could be other reasons why your BSL is going up but by the sounds of things you are doing all the right things to control it.

Its just one of those things unfortunatly that most of us, who are insulin dependent, go through, planety alinement wrong, weather BSL all over the place etc.

I would go back and quiz your medical team, but do bear in mind that Tresiba can take a while to change because it has such a long acting time frame and does build up.

I'm out of ideas sorry but do hope it gets sorted, night time hypos and not fun.

 

[CornishKate]

Arh! I see sorry, teaching you to suck eggs was't meant that way.

I'm not sure, it could be other reasons why your BSL is going up but by the sounds of things you are doing all the right things to control it.

Its just one of those things unfortunatly that most of us, who are insulin dependent, go through, planety alinement wrong, weather BSL all over the place etc.

I would go back and quiz your medical team, but do bear in mind that Tresiba can take a while to change because it has such a long acting time frame and does build up.

I'm out of ideas sorry but do hope it gets sorted, night time hypos and not fun.

Thank you, you’ve been so helpful

 

[donnellysdogs]

The very basic guidelines to determine if it’s basal or bolus to change...

If levels change up or down 2-3 hours after a meal then it would be your bolus that needs changing.

However..... basal testing would be better to determine which insulin needs adjusting.

Also the 2-3 hour adjustment for bolus does not take in to account your lifestyle as such. For example you may get up at 8am. Eat & inject but at 10am decide to go to the gym each day..... so that wouldn’t make it easy to determine which was responsible..... only basal testing would quantify which insulin in certain lifestyles....

 

[steve_p6]

Morning everyone,

I have been taking 9 units of Tresiba at about 8pm for a month or so (along with Novorapid with food) diagnosed 5 months ago. My readings have crept up to the 9s, 10s and 11s at meals so increased to 10 Tresiba. Then the 4am hypos for 4 nights so went back down to 9 units. But of course now the mealtime readings are back up!

Any help or advice please?

That was my experience on Tresiba with bloods dropping 8-9 hours after taking. I now split it 50:50 at 7am and 7pm which seems to have sorted things out.