Stress and Tresiba

So I was wondering if anyone could help with this. In the past two weeks, I’ve had two acutely stressful episodes. Not the most stressful events of my life by any stretch, not the most stressful events I’ve been involved with since using Tresiba, but stressful nonetheless.

However in the past two weeks these episodes have essentially switched my Tresiba off. For a period of over 48 hours I was having to take Bolus constantly for blood Sugars to just stay at 12. At just over two days the effect “wore off” and my control went back to normal.

I’m in the middle of the second episode of this type and I’m a bit shocked. Like I’ve never had any Insulin react so poorly to stress before. Tresiba itself has not reacted this badly to stress before.

Stress is the only unifying factor between these two episodes.

Why would my Tresiba suddenly be so unable to handle stress? If it’s not Stress what else could be causing this issue?

In Response said:

I don't think the problem is the Tresiba - Stress causes our blood sugars to rise.

Being on a pump, I would just increase my basal to manage it.
The advantage of Tresiba is that it has a flat profile for a long time. The disadvantage is the "long time" means that you cannot make changes as they can take 3 or 4 days to take effect by which time the stress may be over.
This is why Tresiba is not great for women who experience monthly hormonal changes.

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I do understand what you're saying however, like I say, I've had more acute cases of Stress which haven't resulted in problems this bad before using this Insulin.

Also, in each case, the stress lasted approximately two hours and resolved. Having blood sugars out of control for two days in response to that seems disproportionate in the extreme.

Juicyj said:

Hello @StewM

Sorry to hear you've been experiencing this - hope things are getting resolved. I see where you are coming from with tresiba, however I would look at other reasons as to why you are taking so long to bring down those high levels, could you of hit a wall of resistance with your bolus corrections, could the stress in fact still be the factor even after these events have passed ? the hormones could still be present despite the event having passed. Also are you using fresh insulin to correct with.

Some thing I would try in your position is some gentle exercise, so head out for a long walk, nothing strenuous though.

Our bodies do change and our responses can change too, what worked once could be different another time, however it's unwise to make any basal adjustments over a temporary event, only when a pattern occurs.

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Thanks Juicy!

"Could you of hit a wall of resistance with your bolus corrections, could the stress in fact still be the factor even after these events have passed?"

This is an interesting question, and not something I'd thought of. How would I know if that was or wasn't the case? Are there signs other than the high blood sugar to look out for?

I have been using a Fresh Pen, in both cases, yes, as it seemed like a factor worth eliminating from the equation.

Gentle exercise isn't something I tried, as I felt like s*** when my blood sugar started climbing relentlessly, but I'll give that ago and see what happens.

Yeah, I did do a Basal Test 72 hours after the first incident began, but the Tresiba seemed to be doing its job perfectly at that point.

Struma said:

Have you wondered if the tresiba is being absorbed a little erratically, perhaps something to do with the sites?

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Oh good question! I’ll have to give my sites a little examination. They feel fine, but sometimes the signs can be quite subtle once a problem’s beginning to start.