1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Moving to Triseba

Discussion in 'Type 1 Diabetes' started by Aknitty, Dec 23, 2018.

  1. Aknitty

    Aknitty · Active Member

    Messages:
    35
    Likes Received:
    5
    Trophy Points:
    28
    Hello
    Have recently been moved to Triseba, on same dose as Levermir (38u).
    Have been taking it for a week now and am finding my bloods are far more erratic than they were on Levemir? I thought it was supposed to be stabilising - is this the case for everyone? Have increased by one unit tonight as I know changes should be gradual.
    Am not seeing team for three weeks and am eight weeks pregnant too (second pregnancy) so feel quite scared of the current fluctuations. And vulnerable too.
    Estimated a1c on libre has changed from 41 to 44mol in the last week and I have been working SO hard to keep it low.
    Thanks for reading and for any words of advice.
    Anna
     
  2. kitedoc

    kitedoc Type 1 · Well-Known Member

    Messages:
    4,788
    Likes Received:
    3,337
    Trophy Points:
    198
    Hi @Aknitty, From my experience as a T1D, not as professional advice or opinion:
    Why the change from levemir? Just because Tresiba is newer does not mean is is necessarily better?
    (And doctors do like to try out new things).
    From looking at the profiles of both insulins including their length of action: in terms of altering and adjusting doses, Tresiba is like an ocean liner, a change in the rudder (dose) can take 4 to 6 days to show a change in course (effect), Levemir is more like a Navy boat, 48 hours to show change, Being on an insulin pump, even quicker.
    You should have very quick access to your health team and waiting 3 weeks is unsatisfactory.
    Please ring them up and speak with them.
    You are pregnant so need to be afforded the most immediate care.
     
  3. Aknitty

    Aknitty · Active Member

    Messages:
    35
    Likes Received:
    5
    Trophy Points:
    28
    Thank you Kitedoc.
    Their thinking is that I have no coverage of Levemir in the evenings as it doesn't last as long. They feel I am too high in the mornings and want me around 4 or 5 so have moved me. I already hate this team and think they are incompetent so this doesn't help as I feel like I am paddling totally on my own. I might try adjusting my Novorapid ratios and see how I get on. Thanks for help.


     
  4. kitedoc

    kitedoc Type 1 · Well-Known Member

    Messages:
    4,788
    Likes Received:
    3,337
    Trophy Points:
    198
    Hi again @Aknitty, But that is why levemir is usually prescribed for twice daily use and can be tuned to cover the less insulin need at night and the more insulin required during the day.
    And as they have probably mentioned the peak BSL for after a meal is to be measured at 1 hour (60 minutes) after meal (not 90 to 120 minutes). So what short-acting insulin are you prescribed ??
     
  5. Aknitty

    Aknitty · Active Member

    Messages:
    35
    Likes Received:
    5
    Trophy Points:
    28
    Thank you again. Am on Novorapid, 1:4g at breakfast, 1:6 at lunch and 1:7 at tea.
    Yes my one hour post prandial readings are always a bit too high but I think they felt I was starting most mornings too high (around 6, they want me at 4 or 5)

     
  6. kitedoc

    kitedoc Type 1 · Well-Known Member

    Messages:
    4,788
    Likes Received:
    3,337
    Trophy Points:
    198
    Hi @Aknitty, I have heard and tried it myself to give my Novorapid say one hour before a meal, to allow more time for it to reach its peak effect and better match the rise in BSL after the meal.
    Not sure if that has been suggested to you and yes there is some risk of a hypo if the timing is not right but perhaps your health team might have some views on that as a way to keep keep those BSLs down.
    Best Wishes. :):):)
     
    • Like Like x 1
  7. hodders

    hodders Type 1 · Well-Known Member

    Messages:
    105
    Likes Received:
    58
    Trophy Points:
    88
    Hi
    When I began on treshiba I was advised to lower my dose. I too used levemir 10units for day and 12 for night. I now only use 15 units of Treshiba. Even a change of 0.5 makes a big difference. As I see it with treshiba you are constantly topping up the tank due to its longevity with levemir for me anyway the tank was constantly running out of fuel. Like others have said treshiba does not respond quickly but takes about 4days for changes to make a difference. If you want a basal that changes quickly then stick to levemir. If like me this word off then treshiba will even things out eventually but like everything type 1 it's trial and error.
    No more rambling. Good luck
     
    • Like Like x 2
  8. 22nw22

    22nw22 Type 1 · Well-Known Member

    Messages:
    314
    Likes Received:
    41
    Trophy Points:
    68
    I was moved to tresiba some months ago, thinking I wouldn't, because the doctors are still working on why my sugars aren't stable and my Levemir wasn't doing what it should. I am 14 nearly 15, dx at 20 MONTHS. Why aren't they stable? I have been approved for freestyle libre funding (deemed eligible, thats what I mean)

    I am testing, I am doing insulin, I do have the occasional sweets...but other than that... I am doing what I need to do. It's odd? The Libre shows patterns on a graph every time the sensor gets scanned and gives you an arrow that will tell you what the sensor thinks the glucose is doing!
     
  9. kitedoc

    kitedoc Type 1 · Well-Known Member

    Messages:
    4,788
    Likes Received:
    3,337
    Trophy Points:
    198
    Hi @22nw22, I was diagnosed at age 13, many years ago. What happened to me over the 13 to about 18year age interval was a series of ups and downs in BSLs and insulin requirements. My BSLs would go up and insulin requirements rise to 2 x or greater than usual and then after several weeks the bsls would get lower and I had to reduce my insulin doses quick smart to stop the hypos.
    Some weeks or a month or so later the same thing would start again.. This was back before glucose meters and whilst there were only regular and NPH insulins to use.
    What I was told by my doctors, which made a lot of sense, is that I was growing and that when the growth spurts would start up that meant the growth hormones were surging. Such hormones would antagonise the insulin, so I needed larger doses. As the growth spurt settled my insulin requirement went back down again. Then another growth surge would start etc etc.
    I cannot truly believe that your doctors have not thought of this as a possible cause of your BSL troubles.
    And why would moving from Levemir to Tresiba necessarily be advised if they do not have a clue about what the underlying cause of your trouble was?
    Of course your doctors may have thought of growth spurts but if so, why not explain that to you and give a reasoned answer about how best to cope with them.?
    And doctors sometimes seem to like trying out new things without necessarily having a good reason to do so.
    My personal view on Levemir vs Tresiba (I have only used Levemir in the past) is that the ability to change insulin doses to meet a change in insulin requirements is much easier with levemir than Tresiba.
    It takes 3 to 4 days sometimes longer for adjustments to Tresiba to reach a steady effect, but only 24 to 36 hours hours or less with levemir. (and even less than either with an insulin pump). See Nordisk monographs on Tresiba and levemir and also www.researchgate.net/publications/2770871008/Analysis_of_insulin_in_pump_settings_in_children_and_adolescents_with_Type_1_Diabetes/ - Pediatric Diabetes 2015 Sept 1
    Now you may wonder why there are to head to head comparisons of Tresiba and Levemir? - my guess - they are made by the same drug company.
    Perhaps see if your doctors are amenable to explaining whether it is the start of growth spurts that could be the cause of your troubles or not and how Tresiba is the better insulin if that is the case.
    If you meet blank looks and receive no help perhaps you need new doctors ???
    Best Wishes.
     
    #9 kitedoc, Dec 29, 2018 at 5:19 AM
    Last edited: Dec 29, 2018
  10. 22nw22

    22nw22 Type 1 · Well-Known Member

    Messages:
    314
    Likes Received:
    41
    Trophy Points:
    68
    Oh yeah, but the NHS will give me a Libre
     
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook