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levemir to tresiba

Discussion in 'Type 1 Diabetes' started by Alexsalter47, Aug 23, 2019.

  1. Alexsalter47

    Alexsalter47 · Well-Known Member

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    hi all, I'm on levimir 48units , 24 morning, 24 evening, been on this for 10+ years

    night hypos? probably sometimes.

    been told tresiba is newer and better.

    doc says , inject 40units to start with once a day and titrate up.

    my A1C is 5.6 without much trying.

    to be fully honest with you all , im on MDIs, and dont actually know too much about what my long acting does lol. dont wet yourselfs though, ive had it for 16 years and doing great , as per the results. but im just a little unsure of changing and the dangers. im prepared and would no doubt just be testing more, just looking for little guidance. Tbh I've never titrated or edited my long acting . I mean I could easily just start injecting 40units at 6pm but what would I be looking out for? And then what adjustments would I need to make? Thanks
     
    #1 Alexsalter47, Aug 23, 2019 at 8:28 PM
    Last edited: Aug 23, 2019
  2. MeiChanski

    MeiChanski Type 1 · Well-Known Member

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    Hello,
    Tresiba is more flat insulin profile compared to levemir, it doesn't have a peak so less hypos. If you start at 40 units, give it a try and if you find patterns then adjustments need 4 days to settle before another adjustment.
     
  3. Alexsalter47

    Alexsalter47 · Well-Known Member

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    I always thought my hypos were only from too much fast acting. But it would make sense if levimer is less flat and I'm waking in the night with sleep disturbances from low bloods. Thanks. I guess I try 40 from tomorrow and see how my readings are. Then increase if I'm seeing highs all the time or in the nights. Thanks for the fast response.
     
  4. kaylz91

    kaylz91 Type 1 · Well-Known Member

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    Tresiba is good but not as flexible as others

    Like say if your on a split basal like you are now, if you did a little more exercise than usual you could probably take less of one of the basal doses to allow the effect the exercise has had, with Tresiba it's not that simple and generally means for me at least a day off reducing bolus's the day after a bit more activity, I was told 3 days to leave between adjustments though not 4

    I've been on Tresiba since I was diagnosed almost 3 years ago (very lucky apparently as it only started being prescribed in Scotland a couple of months before I was diagnosed) but I don't have any complaints about it xx
     
  5. Alexsalter47

    Alexsalter47 · Well-Known Member

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    I'm sat waiting for th chemists to open and pick it up.

    Going to inject 40units this evening and see how it goes. He says start on 40. Previous long acting 48 in total. I don't quite get it. But I guess 40 it is... It's my bolous injections that make the big changes. So have no idea really what changes an inaccurate long acting could do. But we ll see...

    Yeah your right. I train hard , and even on the split long actings I use, I still find myself nearly halfing my bolouses for 24+ hours after training lol. But never have altered the long acting . Probably could have in the past and not hypoed so much in the night but nevermind. I'd prefer managing the fast acting more tbh. Best I just get it started and see. I've had type one for 16 years now.
     
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  6. kaylz91

    kaylz91 Type 1 · Well-Known Member

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    I have a cross trainer/exercise bike in my room and love hitting it, I was hugely into going to the gym before I was diagnosed but the unpredictably and anxiety was rotten so I never went back, since getting the Libre I bought that and can walk for miles now as its given me SO much more confidence being able to see what's going on

    As I said I'm not even 3 years in and have went through a lot of **** with it already, eye problems, eating disorder, but I'm determined I can overcome it, hell I almost cried just cause I managed dessert after Christmas dinner lol but it was a huge step for me

    I was started on 8 units at diagnosis but had to cut it down to 1 and was on that until the end of last year when my honeymoon came to an abrupt end lol, now up to 14 units at the moment
    xx
     
  7. MeiChanski

    MeiChanski Type 1 · Well-Known Member

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    I would like to add that Tresiba lasts a lot longer (like 36hours or so) than levemir despite it being inflexible. When levemir runs out your BG will start climbing, like in cases where I do sleep in. Tresiba being flat profile and when you're able to get the perfect dose, all you need to do is focus on your fact acting insulin. It took me 2-3 months to get the perfect dose and it has shift my focus on just my fast acting. I've been quite happy with it but it was frustrating at first.
     
  8. Alexsalter47

    Alexsalter47 · Well-Known Member

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    yeah ive been advised its best to move onto it. ive only been splitting my levimir per 12 hours the last few months, for the last like 15 years its been 48 units once every 6pm lol, i just cant help but think that 40units of tresiba will be too little and i ll suffer highs somewhere some how, cant i just start off at 44? lol surely if its right or righter then i ll see more single figures if not hypos . the pharmacy told me it would be in today, but it turned up and they said come back tuesday, so annoying
     
  9. Alexsalter47

    Alexsalter47 · Well-Known Member

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    im glad you exercise, it really is a wonder for type 1s, im glad your gaining control too.

    i powerlift 3 times a week which averages 2 hour punishing sessions, and then 30mins heavy sweat bike work 6 days a week to finish each day/session off to control fat% and increase heart health. so my in general i hypo more than have highs, i dont mind that at all, but i hate seeing 16+ blood. in some cases i only have to inject 1-2 units if any before training.

    how are you finding the libre? do you think the sensors stick easy for good periods of time? im working on getting one, as im a bit bored of 15+ tests a day on average lol
     
  10. kaylz91

    kaylz91 Type 1 · Well-Known Member

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    I absolutely love it, I tend to stick a Tegaderm patch over it but I think that's just become more habit as when I got it on prescription I was in and out of a dog cage with our poorly cat so didn't watch to catch it on my way in or out lol

    I still finger prick 4 times a day to judge bolus (some do frown on that thinking that people who don't trust it to bolus it shouldn't have it in the first place) but even the rep at the education session said to confirm with a finger prick, it's great to see where spikes are happening and being able to get your pre bolus just right

    I've been on them since 15th April and only needed 1 replaced as it became widely inaccurate 8 days in but replacement was sorted with a 10 minute call and I received it 2 days later

    Are you working to get it on prescription? If so good luck!! :)
    xx
     
  11. Alexsalter47

    Alexsalter47 · Well-Known Member

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    i love the blood readings, i know for a fact its going to take a long time for me to trust it. and i doubt i will fully. but we'll see, as time goes on, i ll be able to observe and compare. yeah i'm working on getting it through nhs. my local diabetes nurse said i could get it and refereed me to secondary care. so i went to that consultant appointment, and he said i could get it but couldn't give it to me then as it was a small hospital, so he refereed all my info and notes to my gp and the main hospital of which im waiting for the appointment for at the moment, where i ll then be issued it; probably with some training. i can see sensor already put on my prescription, so the gp has had my notes from the consultant. just need the rest. so waiting for main appointment i guess lol
     
  12. helensaramay

    helensaramay Type 1 · Expert

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    I have the Libre and exercise 5 or 6 days a week. I am also on the pump.
    The pump has been brilliant for exercise. When doing cardio I suspend my basal and when doing resistance training (such as climbing) I increase my basal.
    I still experience some exercise related fast bg drops. As the Libre is 15 minutes behind finger pricks, I do not use it during cardio. However, the Libre is great the rest of the time. I find it great overnight (when nothing is affecting my bg) and for spotting daily trends to adjust my pump basal profile.
     
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  13. Scott-C

    Scott-C Type 1 · Well-Known Member

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    Basal should hold your bg steady when you're not eating or injecting bolus insulin.

    It's worth playing around with basal amount - get it right, a lot of the rest if it falls into place and makes it much easier.

    If basal is too high, you're going to get slow glides down which will take you gently but still nastily into hypo land.

    If basal is too low, bg will rise way too high when the last bolus shot wears out.

    If you get basal right, it means you don't have to mess around sorting out drops/rises with dextro or fast acting.

    I'll sometimes just have a really long lie on a Saturday or Sunday till about 3pm, basically because I'm lazy, but the idea is that because I've had no fast acting or food since the pub closed at about midnight, my basal should hold me steady +/- 1.5 till 3pm. If it doesn't, it needs tweaked.

    Good luck!
     
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  14. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    Hi, I was on Levemir a year ago, but then doctor changed it to Tresiba. I was on 10 units of Levemir and exactly the same on Tresiba and I haven't noticed any big changes.
     
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  15. Scott-C

    Scott-C Type 1 · Well-Known Member

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    It took me about 3 months before I was confident enough to bolus from libre. It's always going to be a personal decision on this, but I found that just through using it for a long time I reckoned I'd figured out it's (many) quirks and how to adjust for those, so decided to go for it.

    If you're on script for it now, I'd highly recommend buying ($139 one off cost) a MiaoMiao transmitter, it gets stuck onto libre, reads it every 5 mins and bluetooths it to an android app, xDrip+, turning it into "proper" cgm - hypo alerts and you can feed bg results into it to make the readings much more accurate, which always helps with bolusing decisions.

    Here's some links if you're interested in that route:

    https://miaomiao.cool/

    https://github.com/NightscoutFoundation/xDrip/releases
     
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  16. Alexsalter47

    Alexsalter47 · Well-Known Member

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    Thank you! Amazing reply. I should have known that. I'll start at 40 and see how it goes. I ll have to run the bolus dry and see what my bloods do. I thought libre updates every 3-5mins?
     
  17. Alexsalter47

    Alexsalter47 · Well-Known Member

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    Well on my script atm appears to be one libre sensor. Is that normal? I think I ll need to ask for more tbh.

    I will do the the off purchase. Their website pic looks like it's a bit bulky/unsecured, what's your exp with it? Do you tape it down or anything?

    Thank you for those links, I think I'm nearly there!:)
     
  18. Scott-C

    Scott-C Type 1 · Well-Known Member

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    Depends on the area you're in. I'm in Scotland, the NHS here is devolved so it has it's own rules compared to England, the general rule here is that each script has 4 sensors on it to give us a couple of months supply and save us bothering the GPs each fortnight.

    Nah, it's fine. Stuff like this always looks bigger than it is in photos, I notice it about as much as I do the llbre, which is not much at all.

    When you order the transmitter, also order about 30 or so of the adhesive patches. Each patch has 4 double-sided sticky bits on it, you peel one of those off, stick it onto the MiaoMiao, and then stick it onto the sensor/skin. To be fair, some folks have had allergic reactions to the sticky, but, hey ho, there's never any guarantees with this sort of Wild West stuff. I've been fine with it for about 8 months now.

    The double sided adhesives have been fine for me, but I don't spend a lot of time doing gym or swimming or anything. Others have tagged Tegaderm, vetwrap and other wraps on top for a bit of added protection.

    Another link to jamorhams's home page, which shows some screenshots of xDrip+:

    https://jamorham.github.io/

    The backstory is that when the dexcom cgm first came out, T1s liked it, but felt it could have some more useful features, but dexcom weren't interested in adding them as it would be too much hassle getting them past the FDA, so the open source community, in the shape of the Nightscout group, reverse engineered it and came up with dexdrip, and that has since evolved into xDrip+, with jamorham and several others doing the main work on it.

    It isn't authorised by any medical authority on the planet, your docs will probably never have heard of it, but it has been widely tried and tested by thousands of experienced T1s, and we trust it.
     
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  19. Alexsalter47

    Alexsalter47 · Well-Known Member

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    Massive help thank you. I'm gonna need to have a chat with gp and up the prescribed amount,cba handing a script in every week or two

    I ll order the full lot when my scripts sorted and I've got them. I forgot, how longs a sensor last roughly? I'm looking forward to it and setting it all up finally. It's about time I got updated, it's been long enough
     
  20. Scott-C

    Scott-C Type 1 · Well-Known Member

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    Good luck, mate, libre gives a lot of good information, but when you get it set up with MM and xDrip+ and those first few blue dots appear on your phone, it's always good.
     
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