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Did anyone need more Tresiba than Lantus?

P

pinewood

Well-Known Member
Messages
792
Location
London
Type of diabetes
Type 1
Treatment type
Insulin
Recently switched to Tresiba from Lantus and struggling with control using the same 12-unit per day dose; most reports I've read online see people REDUCING their dose but looks like I'll need to try increasing mine a bit. Anyone else ended up needing more insulin on Tresiba? It's only been 2 days so I should give it a bit longer but just curious.
 
Changing any medication in my experience takes time to get your body used to it,if your worried talk to your Doctor or Diabetes Nurse, Normally when you change your doc. should schedule a blood test to monitor the change much sooner than you would usually have one. Why did the doctor change from Lantus if thy did not explain why if you had good control why change ?
 
I tried Tresiba a while back and changed from being on a split dose of Levemir. At first I needed less but I think it was because there was still Levemir in my system that took some time to clear out. Once this happened I started to increase my Tresiba dose. My issue with it was it seemed like my dose was always too strong at night and then about 16 hours after injecting it would vanish from my system, as if I had no basal insulin in me at all. I don't know if this is due to absorption problems or my own biological basal needs - i.e. I need more less basal through the night and more in the afternoon, and a basal as flat as Tresiba doesn't work well for this. Either way I gave up after 3 weeks as my blood sugars were skyrocketing around dinner time and it was taking a toll on my mental health. I went back to Levemir and haven't looked back since. Maybe give it more time than I did and keep trying to find a dose that works for you!
 
As its only 2 days you cant draw any real conclusions just yet.......

if you need to adjust the dose to get the results you need then that the way to go.....
 
On this topic, I'm wondering what the experience of type 1s is who switched to Tresiba from a basal regime that was working well, and if you have stuck with it long term. I pumped for 11 years and have been using a split dose of Levemir for the last few moths except for my Tresiba trial, and I find it works pretty well. I'm wondering if there is an advantage to a basal like Levemir that isn't completely flat. On a pump a flat basal was great because I could extend boluses to cover protein spikes and slow digesting food, but since I can't do this on MDI I feel like the curve/slight peak of Levemir makes things easier - especially at night. I also like that I can adjust the dose for days or nights when I know I will need more, such as a stressful work day or a night where I ate a lot of food for dinner I know will hit me later. I'd be willing to try Tresiba again one day, but wondering if there are others who have good experiences with Levemir for the reasons I think I do, and how the transition to Tresiba went.
 
scotteric said:
I also like that I can adjust the dose for days or nights when I know I will need more, such as a stressful work day or a night where I ate a lot of food for dinner I know will hit me later.
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This is exactly why Levemir is good and especially why a split is good......I personally think all basal insulin's should be split for the reasons mentioned......

More specifically though its good for exercise or any other long or short term physical activity, as well as illness and alcohol.....

how come you don't pump anymore....?

a pump takes basal delivery to another level, a better level than injectable insulin.....
 
novorapidboi26 said:
This is exactly why Levemir is good and especially why a split is good......I personally think all basal insulin's should be split for the reasons mentioned......

More specifically though its good for exercise or any other long or short term physical activity, as well as illness and alcohol.....

how come you don't pump anymore....?

a pump takes basal delivery to another level, a better level than injectable insulin.....
Click to expand...

I agree, a pump is superior hands down, but only when infusion sites work. It worked great for me in the first few years but I had trouble getting consistent absorption after a while no matter what sites or infusion sets I tried. I was also getting red itchy welts. I tried switching to Humalog but it didn't work as well for me for some reason. Finally I realized I had never given MDI a fair shot and tried the same regimen I was put on at diagnosis - Levemir and NovoRapid. It worked great for me then and works great now. I may go back to a pump one day but right now I think it's more hassle for the same (or sometimes worse) control. Both methods have their pros and cons at the end of the day though!
 
This is a good reason for only going on the pump if you have gave the MDI your fullest effort.....

You can't really do anything about dodgy absorption though I suppose......same sites can be used on the pump as they can on injections....

What pump where you on...?
 
novorapidboi26 said:
This is a good reason for only going on the pump if you have gave the MDI your fullest effort.....

You can't really do anything about dodgy absorption though I suppose......same sites can be used on the pump as they can on injections....

What pump where you on...?
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Started on the MiniMed Paradigm 722, then used OmniPod for almost 4 years and last used the Paradigm Veo. I'm in Canada, not sure if the pump models are the same in the UK. OmniPod was definitely the worst but I put up with it living with worse control than I could've achieved. I was hoping it would help because I could use it on my arms, but I had more problems on my arms than my overused abdomen. I Iiked Medtronic and had far fewer problems.
 
scotteric said:
I tried Tresiba a while back and changed from being on a split dose of Levemir. At first I needed less but I think it was because there was still Levemir in my system that took some time to clear out. Once this happened I started to increase my Tresiba dose. My issue with it was it seemed like my dose was always too strong at night and then about 16 hours after injecting it would vanish from my system, as if I had no basal insulin in me at all. I don't know if this is due to absorption problems or my own biological basal needs - i.e. I need more less basal through the night and more in the afternoon, and a basal as flat as Tresiba doesn't work well for this. Either way I gave up after 3 weeks as my blood sugars were skyrocketing around dinner time and it was taking a toll on my mental health. I went back to Levemir and haven't looked back since. Maybe give it more time than I did and keep trying to find a dose that works for you!
Click to expand...

It's interesting you say that, because I found a similar thing! Was changed from Levemir 2x to Tresiba, and started getting huge spikes just before bedtime (11pm ish). The dose seemed spot on the rest of the day, but the nighttime spikes were driving me mental and I gave up after 2 months and went back to Levemir (and lo and behold, the spikes disappeared!)
 
Scotteric / Levy - your experiences are similar to my own - I switched from Levemir 2x as were needing increasing amounts over time (36 + 36units up from 18 + 18units ) suggesting I wasn't responding effectively and therefore changed to Treshiba 6 months ago. I was taking 30units Treshiba each evening and levels where fantastic to start, however recently found I was getting spikes from lunchtime onwards and needed to compensate this by taking more Novorapid. Like Scotteric it was perfect through the night so I was reluctant to increase Treshiba. After reading other threads I changed injection time to morning - so far the results have been greatly improved - just hope this will the case moving forward
 
That's interesting @LWA because I was taking mine in the morning and got the nighttime spikes. Be interesting to see how you're holding up on the change going forward because, unlike you, I didn't experiment with changing the injection time (partly because my DSN said it would make no difference as it's supposed to last 48h and shouldn't at any point be 'running out' of your system).
 
Clearly we have all experienced the same so perhaps it's not as flat as it has been portrayed -I will continue to stick with it and hope for the best - I would personally be reluctant to go back on the Levimir as despite great results for many years i unfortunately had to change given the eventual need for 72units in a day :(
 
Just to add something a bit different, I don't really find the spikes with Tresiba at all, and i take it in the evening. It seems to peak slightly at about 11 hours in. There is obviously something different from person to person, or something with other medications, or activity levels, because for me it has been a lot better. I was on Levemir before, and it was a nightmare. I've gone from 48 levemir (don't ask me how it was split, I can't remember) to 19 tresiba.

@pinewood it does take some patience to get tresiba sorted out - it was recommended to me leaving at least 3 days and ideally a week before making any changes, because of the 'overlap' effect. That said, it isn't right for everyone, particularly if you are a person whose activity levels vary significantly from day to day.
 
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