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Issues with Tresiba? It seems like its not working.

V

viperguy212

Newbie
Messages
1
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

So a bit of background: I'm a T1 diabetic of 15+ years and have been on Novolog + Lantus for a good portion of that time. Not the very best but an A1C usually around a 7.

Last week after visiting the doctor and asking him about Tresiba and all the good stuff I was hearing I was prescribed Tresiba as a replacement for Lantus. In his words "its really amazing the effect it has with most people." Dosing was set to be 1:1. Great or so I thought...

It's now been a week of injections (once daily) and things have been horrible. My doctor told me to "scale back a little the 1st night" so I did 38u vs my normal 42 of Lantus. I then noticed a string of highs so the next day I upped the dosage. I'm now at 45u of Tresiba and this is still going like ****. Almost consistently high, all day. I've been dosing my Novolog as normal but something is up. I even (with supplies in hand to remedy the situation) purposefully overdosed my Novolog slightly at lunch today to attempt to force a low... 85. That's with a few extra units added on there! This was a controlled amount but enough Novolog that it should have caused a low.

Likewise, my body seems hyper-sensitive to carbs. Even the slightest amount and I'm through the roof in minutes. I'm a sworn Dexcom user and I've been keeping an eye on it... I eat and boom its up.

Has anyone gone through something similar? Maybe its my body adjusting in a way? I almost feel like it isn't doing anything at all.

Thanks!
 
My Toujeo300 basal is not been recognised as well either.
I've increased mine by a third due to stopping metformin. Increasing it again this morning. Starting a fast with forum group but not feeling well after doing too much yesterday. Although best time for me when not 100%.
Very tired and disrupted sleep due to stress. School run then bed for me today. I cannot fight exhaustion, all of the time.
Very swollen on tummy due to stress. I think, hoping not the huge amounts of insulin being injected in it?
 
Hi @viperguy212 Welcome to the forum.

Did your doctor explain the profile of Tresiba to you ? It's action lasts up to 36 hours, you start low and work your way up to your correct dose, however you shouldn't make any changes within 3 days of your last increase as it needs 2-3 days to adjust. I felt the same as you after a week as seeing high numbers on my meter was frustrating, it is unlike all other basals though and takes time to settle in, you will see it start to really take effect after 2-3 weeks but please be patient, it's stable and it really was the best basal I tried.
 
To add to the comments from @Juicyj , there is also the "Lantus affect".
When I changed to a pump, I ditched my Lantus but was told it hangs around for up to 4 days which may also be why you were advised to slowly adjust to Tresiba.
 

I've tried it 3 times and never had great success with it. Give it time, but if you are still struggling, try a split dose of Levemir. It isn't prescribed in North America as often as Europe for some reason (maybe because they think we don't want to take 2 shots/day instead of 1). It seems like a lot of people struggle with Lantus and are switched straight to Tresiba without exploring Levemir, a very good basal that is predictable and more flexible than Tresiba in my opinion (since you can adjust the dose every 12 hours as needed).
 
 
Hi , I started in January because I couldn't get control with Levimir. Tresiba is a bit finicky and takes a lot of work getting the background right. I took about 5 or 6 weeks but i found the 2 unit pen dose to much and ended up on the 1 unit dose pen so I could inject 23 u ... it takes at least 4-5 days for it to settle down then you'll get an idea of where you're base is then change if numbers are too high or lo leave it another 4 days then change again ..worth the trouble though I find it great.
 
Hi

I had awful time with Tresiba as it is so flat in its workings. Various consultants (from diff hospitals) have tried 3 times... and its horrendous for me. Same results everytime, but always have to prove it at each hospital.

However, I do still take it but with a second basal as well.

I have huge rises starting at 3.30 am. And increase even more when my feert touch the floor.

The consultants all started me of somewhere between 11 and 17 units of tresiba a day.. I now have 2 units at 4pm daily.

In addition though to cope with morning rises I have currently 10 units of insulatard at 3.30am.
I then have another 5.5 units at 7am with a 1.5 unit bolus.

I have played around a lot as consultants had no answers for me at all. Pump is ruled out.
Today so far I havent been above 7.0.

On tresiba only I was crucified. It messed up everything for me.
It could not cope with my morning rises at all, neither did adding in a bolus before getting up as by that time my levels were 15.0 or over andit then knocked on for the rest of the day.

Yes, its a pain and I hate waking at 3.30 each morning.

Additionally I have had a period where I had to stay in bed for an hiur for injections to start working.. consuktants and diabetes educators couldnt help me on that. Then my husband died and they again couldnt suggest anything to stop me having to stay an hour in bed.

The last two days I have upped doses of insulatard more, and lowered the morning bolus. I think I am now getting somewhere but this has taken me nigh on 12 weeks since I first asked hospital if they could suggest anything.

I saw consultant on Monday about the hour in bed and again, no suggestions at all other than me to play around. With him again insisting not to alter more than one thing at a time and allow time for changes to work..

However, in mirnings unless I balance the insukatard changes with the bolus... ie increase insukatard and decrease bolus, it cant be done.... so again consultant not realise the impact of changes... and how I have to do them.

So, yes, I have been someone that cant handle tresiba.... by itself.

Taking 2 units at 4pm though allows for a smaller basal dose running to 3.30am. I have the insukatard and bolus when my body needs it most and because of the time insukatard runs out with my timings then it is better like this... despite being a pain!

I am now hopeful that I wont have to stay an hour in bed now as my 3.30 dose I have been increasing from 8 units and this is kicking in well by 7/8am (depending if dog lets me sleep!).

Hospital staff did not agree to any of my changes or timings at all. However, this week with consultant saying its down to me only as they have no help to offer.... I think I have almost got what I need..

I cannot use a pump as my body blocks the cannulas but have you consudered a pump? Mine when it worked was superb for letting me adjust for my body..

Before going to tresiba once a day, did you have split doses of basal?
 
 
Tresiba is a super long acting insulin.. works very different to lantus

It takes 3 days to build up and work properly and changes you make in dose take upto 3 days to take full effect

When you stop taking it. It can still be working in your system for 3 to 4 days
 
I moved from Levimir to Tresiba last October and for the first 4 months it was horrible. Like others say any changes are not immediate my usual ratios were turned completely upside down.

I got to the point where i was ready to go back. Then i gave it one last try and really followed what my sugar was saying no matter how uncomfortable that felt. Best decision i ever made. It has helped stabilise my results and has made a big difference. My background is now almost flatline.
 
I have been using Tresiba for a couple of years now, and still can't get it right. In the day it seems I should have a higher dose, as if I miss a meal my blood goes high, but at night I have to be high in order to wake up at a normal range. Because I'm high at night I usually have to get up in the night for the loo, and because I now have arthritis in both hips, this is proving painful. I take my Tresiba at 7pm, In the morning my blood zooms back up, until I have my breakfast and rapid. I have told the diabetic nurse all of this, but I am told nothing helpful except that it is a very good insulin. They act like I am doing something wrong. I test morning, evening and every meal, and still can't sort it out. Any advice would be appreciated. I am thinking of going back to Lantus or similar. Cheers.
 
Hi,

T1 for 30yrs and was on Insulatard & Humilin S. Now apparently i was suffering from Insulin resistence, 29u Insulatard at 10pm every night and anywhere from 10-16u of Humilin s for meals. Swapped to Tresiba & Apidra a month ago, currently on 40u on Tresiba a night and increasing 2u every 3days, bm's anywhere from 15-22 on a morning. This means i am correcting with the Apidra. Was on Analog insulins before, Glargine & Novorapid, doses at the time were 72u of glargine and roughly 36-44u per meal of novorapid, could not get my bm's in range. Was swapped back to human insulins and doses were less than half and control regained. Mentioned this to the different specialists and am met with blank stares as they have no clue. Analog insulins do not work for everyone, they can even see this thatnsk to freestyle libre app. As mentioned above my bm's shoot up at 3am every morning, alarms for high glucose are turned off on a night due to having a cpap and not wanting to be woken.
 
The more I take the higher it goes
 
Hello @robg9 and welcome to the forum. So that people can reply appropriately to your posts, it would be helpful if you were willing to give us some more information eg type of diabetes, insulin regime etc please.
 
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