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Lantus to Tresiba?

New2T1D

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66
Location
Somerset
Type of diabetes
Don't have diabetes
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I do not have diabetes
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Things that are unfair.
Diabetes nurse advised me to consider changing from Lantus to Tresiba yesterday, to take account of fact that Lantus doesn't last the full 24 hours. She said that it takes 7 days for Tresiba to be fully in its groove/ pattern, whereas with Lantus is it 3. It's also less flexible when one has active vs non-active days (relevant for a teenager: my son)! That said, he can be more flexible about when in the day he gives injections (no dead set time), which would be a positive. It's only recently been licensed for under 18 age and seems harder to get hold of for pharmacists than Lantus is (consultant's prescription needed) as a downside and I also hear it can cause crashing headaches. So I'm slightly worried about the newness of the drug - what do people think? I don't want to cause any risk to my son. That said, I read that Lantus is potentially carcinogenic, so what do you do? I have to be honest, I'm also nervous of changing the drugs. We've been living with T1 since November 2016 and so are relatively new to it. I'm a bit anxious about disturbing the status quo....any advice or thoughts from people. Thank you

Also, how do you give it, when it's a 42 hour lasting drug???? A set number of units every 24 hours for example?

And how do you change over/ transition from Lantus to Tresiba? Thanks again.
 
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Hi the DSN's should give you advice on how to make the transition, I've been on it since I was diagnosed nearly 9 months ago and I haven't suffered any side effects from it, I take a certain amount of units every night at around 10pm but obviously times will differ etc x
 
Hi @New2T1D . You say DN as asked you to consider changing from lantus to tresiba, no one has said you must change. I can't advise on tresiba, never used it, but I've been using lantus for longer than I can remember.
I was on a once a day injection which looking back did lead to some slightly high readings. I changed my injections times from last thing at night to early morning , which just seemed to move the slightly higher readings to a different time of day.
On signing up for DAFNE course I was asked to split lantus approx 12 hrs apart ( 6 am. 6 pm ). Since doing this a few years ago my basal levels have been far more stable and predictable, it also put an end to nighttime lows ( almost )
There's always options open to us. Hopefully you will find one that best suits you and your son.
Remember not all the experts work for the NHS there's a wealth of advice on the forum for you to consider.
 
Hi @New2T1D

I changed over from Lantus to Tresiba about three years ago and can confirm that it lasts well over 24 hours. I have gone over 30 hours between injections and seen no drop off in basal levels. I can't say that it's given me headaches at all though. If you do decide to change you should work with your DSN to adjust doses. It's normal to take 30% less to start with and then titrate upwards until you find the right dose. It will take a few weeks to get right. I would also agree that it's not ideal if you are very active as you can't drop your dose to compensate. If that's an issue then you might be better considering Levemir, which you can take twice a day and adjust quite quickly if your basal needs change.
 
just started degludec recently myself, personally after a few days of using it ive not gotten any headaches or side effects, i think its amazing, my control has improved 10 fold, although you do have more flexibility with it, you are advised to keep the injection times close together each day, i give my self 20 units around 10/11 am each day and it keeps my levels steady consistently through the day, due to the long lasting effect topping it up each day keeps my levels constantly under control. again the amount of units will be different for everyone so i would suggest for a week constantly monitoring levels and making sure any meals are perfectly calculated so that the correct amount of novorapid is given so that any abnormal levels can give you better incite as to if you need to increase or decrease the daily dose. again my personal opinion is that is a great drug that can give mush better control, saying that i cannot compare it to lantus as ive never used it myself
 
I started on Tresiba about a month ago an I love it. I used to take 40 units of Lantus before bed. When swiching I took 36 units of Tresiba at my usual time. The next day I was a bit nervous about taking my Tresiba, as I didn't understand how it wouldn't stack and give me a hypo if it works for so long, but it worked out fine. Still don't understand how it works, though
I had better numbers with Tresiba from the start and take 40 units now, as I did with the Lantus.
 
Does anybody out there get problems with it not working? I have had major issues with it not working. I was advised it was where I was injecting.... my bum, I changed this and still get intermittent problems.
 
Rainey said:
Does anybody out there get problems with it not working? I have had major issues with it not working. I was advised it was where I was injecting.... my bum, I changed this and still get intermittent problems.
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It alone does not work effectively for me but I have huge DP and waking phenomen to deal with. I also have to have additional insulatard shot at 4am and I take my treaiba and a getting up Correction bolus as well without any food.

It cannot handle my intermittent days of stress at all. As stress cannot be planned for then I end up fire fighting and correcting.

However, now at least I do not have lows over night so thats better and makes starting the day easier for me.
 
Thank you. Interesting. Many people have posted massive uptake in requirement & Im sure its due to its failure to work. I know when it works its 'fine' but...
 
Rainey said:
Thank you. Interesting. Many people have posted massive uptake in requirement & Im sure its due to its failure to work. I know when it works its 'fine' but...
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Interesting... tbh, never thought if its failure to work..

Been a long time with pump previous to tresiba and I know 100% from pump days that my basal needs triple at 4am and gradually then reduce after I get up. Then rise again at 4pm.

I also know all the stress day reactions..

Not saying otgers dont realise this, but when you can actually see your hourly basal changes on a pump then its easier to think that "its stupud body again"...

I would still say its my body to be honest. Novody can judge what changes are occuring inside. Cancer had huge effect on my body, and it would have been very easy to constantly blame insulin when it was growing inside etc. At least insulin is all manufactured in same way and standards.
 
Based on what I've read online, most people find that their daily insulin needs DECREASED on Tresiba. While I'm aware of a handful of people who were less than happy with the change, the overwhelming majority are extremely happy with it.

I switched at the end of 2016 from Levemir and have never regretted the change. Levemir had a small benefit of allowing me to customize my dose a bit more but that was ultimately related to its much shorter absorption profile.
 
You should give a hefty amount of consideration to Levemir if your son is extremely active some days and sedentary the next. I have little in the way of routine when I'm not working (2 weeks on/off) so a flexible "twice daily" insulin like Levemir suits me well.

I've had instances when friends have contacted me late in the evening with plans for a last minute endurance cycle the following afternoon (50+ miles). With Levemir, I simply took less in the morning - job done. Likewise, if I had a call saying it was cancelled - I could just take my usual dose.

MDI regimes are very much dependent on the individual and their lifestyle. For me, Levemir is the basal insulin that matches my lifestyle best. My days are unpredictable, my plans often change last minute and my exercise intensity can vary from very light to intense depending on how I feel. If your son is anything like that; then Levemir may be worth considering
 
I agree with activities affecting basals and stress too.

For me tresiba is less flexible than levemir / lantus for enabling spur of moment activities.

I only dog walk but even this is planned. If unplanned extra walk or even 30 min dog training lessons can throw my levels out. Wasnt so bad with levemir.

I do have an extra shot of insulatard at 4am. If I know my morning activities are going to be different I can alter this or my 8am pre getting up bolus.

However with tresiba although flatter at night I am more limited with unplanned activities.

Also, although tresiba will keep me flat whilst dog walking in afternoon afterwards it can still throw me low. My bolus would be out of my body by that time and also the insulatard peak acting would be completed.. and I dont eat till 5/6pm so its still tresiba and I do not want to eat extra pre walk just for the sake of it..
 

Thanks for replying. What is insulatard? Thanks. G
 


Wow, your HbA1c results are amazing.
 
Thank you all for responding. Much appreciated
 
New2T1D said:
Thanks for replying. What is insulatard? Thanks. G
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Insulatard is an extra basal injection. I take it at 4am as its gently starting to work for my DP and stops it rising too much. Then at 8am when I have my morning correction bolus it helps as its kicking in at full strength between 4-8hrs after taking it the Insulatard at 4am. So. Again it helps the ruses from 8-midday for me. I still have to bolus though at 8am as the Insulatard in larger doses will affect me with liws for the rest of the day uf I take too much of it.

Its been a fine balancing act for me as my hospital wanted low doses of tresiba and high doses of insulatard. They were under tge imoression insulatard out of ourr bodies at 16 hours. It isnt with me.

Now I am much better doing 12 units of tresiba and 1 -2 unit of insulatard. Its given me a headache along the way with hospital telling me to do things I know have been wrong for me. Having a cgm funded means I need to be compliant to their advice.....

Insulatard for me, just a little shot at 4am really calms my mornings down a lot. Not perfect but cping is easier than having a bolus at 4am that acted too quickly and too strong.
 
I changed from lantus to tresiba and it has been a god send for me, I've been on all the other basal insulins and none of them have helped with my dawn phenomenon like tresiba. Not only am I on less basal now than I have ever been, I've also been able to cut down on my night time metformin, my carb to insulin(humalog) ratio has surprisingly stayed the same during the day and I'm no longer waking up in the night having to give myself extra insulin. I did have a honeymoon period where I was having hypos for a few days whilst my body adjusted but other than that there have been no side affects. Is there any reason the DN suggested the change? High morning sugars?
 
The only thing I find with tresiba on Friday nights and table tennis from 5-7pm and my levels even on tresiba for over night will drop. And if I was on a different shorter basal I could have lowered dose but tresiba needing 3 days to change its a case of now eating at midnight on Fridays and thats hard for me.
 
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