Insulin Degludec ( Tresiba ), how does it works

[Pajazzo]

Hi, I' m newly diagnosed LADA. I' m doing 5 units of tresiba per day, plus other oral drugs.
I can' t understand the way injected insulin is actually released during the day. Does it reacts to glucose in blood - so that there is a proportional response in release depending on bg levels - or does it stays at steady state whatever it happens?
I want to understand it because in the first scenario a high BG level would result in a fast insulin consume, shortening its action time.
Now I have BG values around 11 at midnight and ~5,5 at 8 am, and I was wondering to increase units to 6 or 7 in order to decrease response to meals, especially dinner, but I' m worried of nighttime hypos.

 

[tim2000s]

Hi @Pajazzo insulin doesn't react to glucose in the blood, no.

Tresiba is made by adding proteins to the insulin molecules that the body's own mechanisms steadily breakdown to create a constant release of insulin. You absolutely shouldn't be trying to use Tresiba to treat meals as it has a release period that take 24-36 hours to run.

For use with meals, it sounds like you need one of the fast acting insulins. Novorapid, Humalog or Apidra, which are insulins that are constructed in such a way that the body quickly turns them into monomers so that they act fast!.

 

[DaftThoughts]

Hi Pajazzo!

I agree with tim, the insulin you're taking is consistently releasing a steady amount of insulin into your system. It's why we call it basal insulin, it is a baseline that keeps our values consistent between meals.

I had similar issues to you. I progressed from just oral meds to taking orals meds + Toujeo (same stuff as Tresiba but from a different brand). I woke up with good fasting values but my post-meal values were way too high. I was given another oral med that stimulates insulin production (gliclazide) but it turned my values into rollercoasters.

I've been on NovoRapid insulin since January. It's rapid acting and works after 10-20 minutes of injecting, and lasts for about 3-5 hours. We call that bolus insulin. I take it before meals and my values never go past 8-9 on average anymore except for on rare occasions where I miscalculated my food and insulin.

I highly recommend speaking to your GP/DSN as soon as possible and asking them if you can progress to rapid acting insulin. The bigger the swings in your values, the more lousy you'll feel.