Type 1 HELP! Tresiba sending levels all over the place.

[Weinski]

Hi, iv'e just joined today so hello!
I am type 1 diabetic and was diagnosed exactly 2 years ago last week. I have been doing ok but am now struggling. I would be grateful for any help that anyone can give
I've been on Tresiba for 6 months now and am really struggling. Some days it keeps me very steady but most I'm all over the place 8-19. I've changed the dose in 1 unit steps from 8 to 11. I'm currently taking it at 11pm but have been told taking it at a different time wont change this.
Most days i constantly run at 12-13 no matter how much extra Novorapid I take. I'm really fed up and feeling increasingly unwell. My last HBA1c was 7.9 but with all this mucking about I'm expecting it to get worse next time round.
I am considering split dose Levemir?? My consultant says this wont work? not sure why!
I was on Lantus & Levemir both of which were running out by the evening but had great control on these aside from my levels creeping up in evening. I am unsure what to do for the best and i currently feel Tresiba is not working?
Has anyone else had problems with this new insulin/advice to share?
Thanks

 

[kzlorenz]

Hi, I'm actually going to switch to Tresiba very soon myself from 2xday Levemir

If I were you before anything else I'd:
Make sure you have no lipodistrophy on the injection site (maybe change area);

Make sure your insulin is not damaged or old;

How much do you weight ? What Long acting insulin were you using before and how many IU ?

Cheers

 

[Weinski]

@kzlorenz

Thank you for replying,
I have checked my sites for lipodistrophy and this is all clear. I've always been good at regulating my injection sites.
I have also changed my pen for a new one yesterday. Today have had no change but will have to wait another couple to maybe see if it is that?
I weigh 8stone 9 and take 11units tresiba and novorapid in in 1:25g ratio.
I used to use lantus at 8.5 then 9 on the last week before swapping to tresiba.
I've read so much that tresiba is working for so many people and can't seem to understand what's happening?
Thanks

 

[robert72]

Hi @Weinski

Have you tried going back to basics and doing some basal testing?

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007 (written for pumps but still applies to MDI)

I have been on Tresiba for nearly 2 years and find it very flat when the dose is correct.

 

[Weinski]

Hi@robert72
Thank you for the advice. I've never had to do a basal test? Is it easy! Does this normally give you a clear idea if this is the issue?
Thanks

 

[robert72]

Hi@robert72
Thank you for the advice. I've never had to do a basal test? Is it easy! Does this normally give you a clear idea if this is the issue?
Thanks

It's the best way to see if your basal is keeping you level through the day. Once you have got that right, then you can look at your bolus ratios - but without a solid basal you'll never be able get anything right. It's a bit of a pain but well worth the trouble.

 

[Weinski]

@robert72
Thanks ever so much. Looks like I shall be doing this

 

[kzlorenz]

@kzlorenz

Thank you for replying,
I have checked my sites for lipodistrophy and this is all clear. I've always been good at regulating my injection sites.
I have also changed my pen for a new one yesterday. Today have had no change but will have to wait another couple to maybe see if it is that?
I weigh 8stone 9 and take 11units tresiba and novorapid in in 1:25g ratio.
I used to use lantus at 8.5 then 9 on the last week before swapping to tresiba.
I've read so much that tresiba is working for so many people and can't seem to understand what's happening?
Thanks

Hi, I think you are on the 0.2 IU/Kg which might be right for you - many people need more than that (up to 0.4 IU per Kg) but I would NOT change your dosage that much without medical advice.
I think that sometimes just a few IU might change a lot - as suggested by robert72 it is indeed a good idea to figure out how much you need of basal.
I am going to do the same, just bear in mind that insulin Degludec has a long half-life and it might take more than 1 day to adjust (building up effect) so I think one should increase the dose every other day rather than every day.

Cheers

 

[kzlorenz]

This might help:
https://www.tresibapro.com/clinical-pharmacology/duration-of-action.html

 

[Weinski]

@kzlorenz
Thanks again & for the link.
I'm just very impatient and need to just put up with trying and waiting for this to adjust. I really appreciate all the advice.
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