Just started Tresiba - bad experience

[bhk]

More than 95% of the reviews/comments that I read about the tresiba made me confident that it is THE basal to try as everyone appreciates its safety and efficiency. I started 3 days ago, but I seem to have lots of problems. I was at a 8 units daily dose of levemir, and I am injecting 8 units of tresiba daily now.

The problem is not only do I wake up with high blood sugar (but under levemir I wasn't), but my bolus (humalog) insulin seems not to work as well as before; I am taking 200% of the humalog doses I am used too, for every meal, and I am still almost always in hyperglycemia.

What does that mean? My body is now producing antibodies against all insulins? I have an infection due to the new insulin?

Did that ever happen to anyone starting tresiba? Any feedback would be soooo helpful!!

Thanks...

I will try to take 14 units of tresiba tonight and augment gradually the doses. If the situation fails to resolve, I give myself 3 weeks to get back to levemir.

 

[tim2000s]

Hi @bhk, what that says to me is that you need more Tresiba than you needed Levemir, and that your Humalog doses are having to act to counter the lack of basal. Once you have Tresiba titrated to the correct level, I suspect it will drop back into place.

 

[Juicyj]

Hi @bhk In all honesty 3 days is very little time to gauge a reaction on a new basal insulin, you need to start somewhere, then once you start adjusting over time and start increasing your tresiba dose it will still take a few weeks to settle in, considering that tresiba is active for up to around 36 hours you need to watch your adjustments carefully, so try not to adjust within a few days of each one. This was the best basal I tried out of Levemir and Lantus so I can definitely recommend it.

 

[M80]

Anybody have something to say about the Tresiba insulin? I did search for it but did not fins many threads talking about it in detail. My issues are too many hypos followed by spike.Currently use Levemir.I am quite "small" and because of this sensitive to the smallest variables of doses.Either way up or down. Also use Novorapid. Thanks!!

 

[M80]

Just saw this...I have just posted a thread about this basal asking questions.Just letting you know I have seen this now so you do not need to tell me in my thread

Mod edit to mention both threads have been merged together.

 

[Soplewis12]

Do you have have 0.5 unit pen?

 

[SnackoJ]

Anybody have something to say about the Tresiba insulin? I did search for it but did not fins many threads talking about it in detail. My issues are too many hypos followed by spike.Currently use Levemir.I am quite "small" and because of this sensitive to the smallest variables of doses.Either way up or down. Also use Novorapid. Thanks!!

Hi. I think we are quite similar, so here is my experience. I am still on low doses of both long acting (Tresiba) and short (Novorapid), having been diagnosed just over 2 years ago. I was on Levemir up until mid Dec 2016, when I was moved onto Tresiba. The problem I think with Levemir is that it only last for about 12 hours (no problem if you are injecting every 12 hours, but a big problem if only once per day, whereas Tresiba will last for 24 hours. My HBA1C and BG Ave readings were rising (for about a year) and I just could not get a handle on the why. Now I know why! Anyway, cut a long story short, I was invited to attend a SOCCER course (Type 1 diabetic training course) and it was quickly identified that I had no background insulin working from about midday through to 10pm at night. Now I have moved to Tresiba and have background working 24 hours a day its much easier to manage the rapid (providing you carb count). Everybody is different and no 2 people on the same insulin will be on similar doses, there are just too many variables. What I can tell you is that in my training course group, quite a few of us changed our background insulin (either the type or the quantity). It is fundamental to managing your diabetes that this is correct. IMHO Tresiba has been excellent for me. Would recommend you get NovoPen Echo Pens as these can dose 1/2 units and also keep a check on what has been injected and how long ago.

 

[SnackoJ]

More than 95% of the reviews/comments that I read about the tresiba made me confident that it is THE basal to try as everyone appreciates its safety and efficiency. I started 3 days ago, but I seem to have lots of problems. I was at a 8 units daily dose of levemir, and I am injecting 8 units of tresiba daily now.

The problem is not only do I wake up with high blood sugar (but under levemir I wasn't), but my bolus (humalog) insulin seems not to work as well as before; I am taking 200% of the humalog doses I am used too, for every meal, and I am still almost always in hyperglycemia.

What does that mean? My body is now producing antibodies against all insulins? I have an infection due to the new insulin?

Did that ever happen to anyone starting tresiba? Any feedback would be soooo helpful!!

Thanks...

I will try to take 14 units of tresiba tonight and augment gradually the doses. If the situation fails to resolve, I give myself 3 weeks to get back to levemir.

Thats a really big jump from 8 to 14 and I would caution doing this. 2 units change for a few days and gauge the results. If not moving in the right way try a further 2 units. Just my opinion, so sorry for jumping in.

 

[Peppergirl]

Hi, I switched from lantus (36u split dose 18u am & pm) three weeks ago today. First day was great at 30u then hypos each morning (which is different as I'm used to my sugar being higher). So I left it for 3 days, same hypos and then reduced it. Moved from injecting in evening to morning based on feedback from the forum. The switchover was interesting...anyway last week has been great, love tresiba, reduced to 29u, low in morning, not hypo, which is what I'm after. So I would persevere with it. I wasn't happy at first but seems OK so far. Good luck.

 

[M80]

Well I am very interested.Although I was not keen on Lantus.I used it for ten years.Found the two doses of Levemir more flexible.So I question if I will not like that it is in the system for so long.Even longer than Lantus was...It would give more hypos.But again,if it is a good basal dose (right) maybe it will be fine.

 

[drahawkins_1973]

Hi @bhk In all honesty 3 days is very little time to gauge a reaction on a new basal insulin, you need to start somewhere, then once you start adjusting over time and start increasing your tresiba dose it will still take a few weeks to settle in, considering that tresiba is active for up to around 36 hours you need to watch your adjustments carefully, so try not to adjust within a few days of each one. This was the best basal I tried out of Levemir and Lantus so I can definitely recommend it.

I'd second what juicyj has said. Particularly with tresiba it can take 2-3 days for the increased dose to take affect so personally I wouldn't increase it much, if at all, every day. I hope you find your right dose, I find it a very good basal.

 

[staffsmatt]

Moved from injecting in evening to morning based on feedback from the forum.

Hi @Peppergirl, could I just ask. Have you found much difference injecting Tresiba in the morning rather than in the evening? I was under the impression that as Tresiba lasted about 48hrs (supposedly) it wouldn;t really make much difference?

How did you do the switch? Half in the evening then half in the morning then skip the next evening?

Cheers!

 

[ElkBond]

Hey @bhk I also agree with @Juicyj

I found Tresiba takes a minimum of 48 hours to settle, and any changes won't be seen until another 48 hours. Do some basal testing to figure out how stable your basal is and adjust accordingly. I actually used less Tresiba than Lantus when I was on it.

 

[Peppergirl]

Hi @Peppergirl, could I just ask. Have you found much difference injecting Tresiba in the morning rather than in the evening? I was under the impression that as Tresiba lasted about 48hrs (supposedly) it wouldn;t really make much difference?

How did you do the switch? Half in the evening then half in the morning then skip the next evening?

Cheers!

Hi, just seen your message.
Fact is, I'm not 100% sure if I'd have stuck to evenings that my BG would not be as good as it is now. I kept changing dose every three days and after a week of morning hypos, thought I'd try a morning dose of tresiba. It's settled down now and my BG is normal in the mornings now (5.8 today!) rather than 3.2 which I'd been seeing each day. It is just trial and error. I've found really stable BG levels in the day. My issue was always on rising and I thought I suffered DP, but that seems to be corrected (?). But you're right, apparently tresiba lasts maybe 36 hours, so technically it wouldn't make a difference when it was injected. I just like having one basal shot rather than two (the small things...) and the mornings suits me. It's great having the libre to see what's happening too.

 

[Peppergirl]

Should also say, when I switched I missed the evening dose (9.30pm) and waited to the morning (10.30am)...it was OK until the afternoon, then I found I had to inject 3u of novorapid every 3 hours to reduce my BG, until the evening. It wasn't high (8-13) but much higher than I'm consistently seeing now I've switched to LCHF. Didn't have to correct much the next day. So, again waited three days and it settled down. As you mentioned, tresiba lasts much longer so I thought it would be OK for a gap of, well it was about 13 hours...anyway, I kept an eye on my BG and it has worked out well. Hope this helps.

Hi, just seen your message.
Fact is, I'm not 100% sure if I'd have stuck to evenings that my BG would not be as good as it is now. I kept changing dose every three days and after a week of morning hypos, thought I'd try a morning dose of tresiba. It's settled down now and my BG is normal in the mornings now (5.8 today!) rather than 3.2 which I'd been seeing each day. It is just trial and error. I've found really stable BG levels in the day. My issue was always on rising and I thought I suffered DP, but that seems to be corrected (?). But you're right, apparently tresiba lasts maybe 36 hours, so technically it wouldn't make a difference when it was injected. I just like having one basal shot rather than two (the small things...) and the mornings suits me. It's great having the libre to see what's happening too.

 

[staffsmatt]

Should also say, when I switched I missed the evening dose (9.30pm) and waited to the morning (10.30am)...it was OK until the afternoon, then I found I had to inject 3u of novorapid every 3 hours to reduce my BG, until the evening. It wasn't high (8-13) but much higher than I'm consistently seeing now I've switched to LCHF. Didn't have to correct much the next day. So, again waited three days and it settled down. As you mentioned, tresiba lasts much longer so I thought it would be OK for a gap of, well it was about 13 hours...anyway, I kept an eye on my BG and it has worked out well. Hope this helps.

Hmm I'll have a think then ta, at the minute if I have 6 I go really high the next day but if I have 7 I invariable wake up between 4 and 5 quite low.....

Thanks for the post!

Matt

 

[TorqPenderloin]

An important note: my doctor actually had me taper off Levemir onto Tresiba. I went from ~16u of Levemir on day 1, to 10u Levemir/10u Tresiba on day 2, 5u Levemir/15u Tresiba on day 3, and then 16u of Tresiba on day 4. It wasn't a perfect transition, but it was about as easy as it could be.

Another important note: it took me a solid month before I felt comfortable making a judgement on Tresiba. 2 weeks after switching, I had briefly considering moving back to Levemir. However, I gave it a chance, got my Tresiba dose correct (I now need 10-11u/day), and it's been awesome for the last ~3 months.

 

[Kbarbaracollins_]

Should also say, when I switched I missed the evening dose (9.30pm) and waited to the morning (10.30am)...it was OK until the afternoon, then I found I had to inject 3u of novorapid every 3 hours to reduce my BG, until the evening. It wasn't high (8-13) but much higher than I'm consistently seeing now I've switched to LCHF. Didn't have to correct much the next day. So, again waited three days and it settled down. As you mentioned, tresiba lasts much longer so I thought it would be OK for a gap of, well it was about 13 hours...anyway, I kept an eye on my BG and it has worked out well. Hope this helps.

 

[Kbarbaracollins_]

I switched from Levemir to Tresiba about three months ago. I split my dose morning and evening as suggested by Dr Bernstein. I find my overnight blood sugar very stable with no more hypos and the dawn phenomenon appears to have disappeared. I can really recommend it

 

[smidge]

Hey! Not been on here for ages but saw this thread and thought I'd respond. I was on Insuman basal and changed to Levemir as it was supposed to be a 'flatter' profile basal insulin. I had an absolute nightmare for the 2 - 3 years I was on it. For me, it was not 'flat' I took it twice a day morning and evening 12 hours apart 6am and 6pm at 7 and 8 units respectively. My basal needs kept rising and I put this down to being LADA and not yet settled. My bolus needs were all over the place - different ratios at different times of day. Eventually, when the Libre came out, I finally proved from the data collected that Levemir only works for about 8 hours for me in the doses I was taking, but any more resulted in frequent hypos. I had been using my bolus to correct my basal - more during the troughs and less during the peaks. I swapped to Tresiba and had about 2 months of real difficulties in getting the doses right. But it has been miraculous once it settled down. I take one 9 unit dose at night (10pm). My bolus needs have risen, because the basal is no longer peaky and troughy. My numbers are now really good most of the time and I rarely get hypos at all - although I get the occasional high. I feel like my life has returned to pre-diabetes day - except for the jabbing. I still low-carb as I believe it is the best way to maintain good control, but when I do want to eat some chips or roast potatoes I can - with Levemir, I couldn't eat any carb without wild fluctuations. For me, Tresiba has been life-changing - but for the first few months I wanted to flush it down the toilet. Stick with it for a few months and then reassess.

Good luck.

Smidge