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Switching Insulin

T

Tracie1212

Well-Known Member
Messages
138
Type of diabetes
Type 1
Hi
I changed insulins last night from Toujeo to Tresiba. Told by DSN to take same dose of 22 which I did.

Went to bed higher at 16 by morning level dropped by 12. Nurse said not to adjust dose and stick with it. Feel completely wiped out this afternoon and shaky although levels not hypo.

Just wondered if anyone else has had similar experience. To be honest going to put 21 in tonight. Every nurse I speak to seems to have a different view which doesn't help.

Thanks
 
Didn't get on with Toujeo find unpredictable levels up most nights on sofa trying to sort out highs and lows plus various symptoms with.

Used to be on Lantus but switched to Toujeo after I came off pump and back to mdis.

Felt great earlier knew I would but as the insulin doses take hold not so good. Will I ever feel OK again or is this it?
 
Tracie1212 said:
Didn't get on with Toujeo find unpredictable levels up most nights on sofa trying to sort out highs and lows plus various symptoms with.

Used to be on Lantus but switched to Toujeo after I came off pump and back to mdis.

Felt great earlier knew I would but as the insulin doses take hold not so good. Will I ever feel OK again or is this it?
Click to expand...
I have only had type 1 for 3 months and so am about as far from being an expert as possible. Pretty much most of what I have learned I found out here. Have you spoken to your doctor about this? The other members are way more knowledgeable than I am. I asked because 3 months ago my HbA1c was 17% when I was diagnosed and then earlier this week my endo said my lastest result was 4.5%. They thought this was too low and wanted to put me on meds (I said emphatically NO) and then they wanted to change the type of insulin (I said NO to that too) and then they said to reduce my insulin dosage by one unit each injection (I haven't done that either). My current regime (insulin and lower carb intake) is working for me (perhaps too well) and my secondary symptoms like blurry vision have reversed so why would I change? I will raise my HbA1c for the next test in 3 months by gradually and carefully eating more (I am skinny anyway). My top priority is to keep my BG in range.
Hope you feel better really soon. Pay attention to your doctor. I have had some bad experiences with doctors and so am skeptical.
 
Hi

I'm under care of hospital but speak to DSNs regularly I'm due to see endocrinologist end of November. I did speak to my GP yesterday but find surgery tends to leave the decision making to hospital and nurses. However they did send out a prescribing nurse last night who was brilliant So glad you have found something that works for you. I'm carb counting trying to adjust my ratios. Agree this forum is brilliant I get a huge amount of support in here . I continue to challenge certain medical professional decisions they are not always right!
 
TBH every switch is going to be hard work.
I went from levimir to tresiba ..the hard work is getting the basal right once youve changed cos each insulin has a slightly differant mechanism . Just test test give it a couple of days ....no problem
 
Hello @Tracie1212 I moved from Lantus to Tresiba a few months ago mainly because I was splitting my Lantus, not recommended said the DSN ~shrug~ because I wanted a one a day long acting insulin.

When I first started using it, for me, I did find that it took 4 or 5 days before it started to build up and have an effect and was told that it can last up to 42 hours in the body, so any changes made would take a while to take effect.

I found that over night, round about 6 hours in, that my levels were dropping a fair old bit and would spend a fair bit of the night in the high 3's or low 4's and I am tacking roughly the same amount as you.

I have just changed now and started taking it first thing in the morning, and finding the lows easier to deal with mainly because I am awake and can deal with it :)
 
Hi@knikki

Thanks for your reply.

How did you move your dose from night to morning. I was thinking along the same lines as you try moving to morning can deal with lows better if awake. Were you eating anything before bedtime?

Weird that DSN recommended against splitting your Lantus as my consultant told me to do just that. Why oh why are we being told different ways of managing medication. I don't understand surely the training should be consistent.
 
annliggins said:
TBH every switch is going to be hard work.
I went from levimir to tresiba ..the hard work is getting the basal right once youve changed cos each insulin has a slightly differant mechanism . Just test test give it a couple of days ....no problem
Click to expand...

Thanks yes I know will be hard work hope it's worth it.
 
Tracie1212 said:
Hi@knikki

Thanks for your reply.

How did you move your dose from night to morning. I was thinking along the same lines as you try moving to morning can deal with lows better if awake. Were you eating anything before bedtime?

Weird that DSN recommended against splitting your Lantus as my consultant told me to do just that. Why oh why are we being told different ways of managing medication. I don't understand surely the training should be consistent.
Click to expand...

Over the years I have seen many DSN's all have been very nice and all have slightly different view on things, you get used to it after a while.

I think the reason that Lantus should not be split, based on what I found out, is because it is meant to last 24 hours in the body. However, like many have found it would only last say 15-18 hours, so towards the tail end of it things were starting to go bit wayward :) hence the reason I decided to split it.

Tresiba is long lasting like 42 hours and I have been informed that, if you say, missed a night time inject, you would have enough around the body not to make it a bad thing and just to inject same time the following day.

So, one night I was running particularly low and I knew from the Libre graphs that I would very likely go lower round the 2-4am mark and thought, "Arh! why not see what happens if I don't inject and do it in the morning"

Which is what I did and so far things are working out. Yes I run low but that is just me and the way I handle this wonderful thing called T1D.

As for the "eat anything before bedtime" I could be running as high as 8-9 as I went to bed and it has been known on more than one occasion for me to wake up below the 4 mark ~shrug~
 
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My tresiba is due at 10pm feel all shaky think I'm going cold turkey although never done drugs but imagine this is what it's like. (not hypo) not sure if Toujeo is completely out and body is asking for Tresiba. Dilemma is background insulin controls my Ketones already feeling like will rise. Or take 22 units and deal with hypo . I'll be monitoring through night so likely go for 22 units . I have my plan in place with drawer full of goodies. Wish me luck.

Thanks for your help.
 
Hi Knikki

As predicted I'm running low find as soon as I inject Tresiba my levels drop. I'm eating 6/7pm and fast acting then get to 10pm. If I don't use novorapid feel unwell so having to push levels up to 12 before bed to stop immediately fall in levels. Last night I had finger of brown bread with tiny tiny bit of jam. This carried me through to 4am then Cereal bar. Woke up on 5 but a few lows this morning plus yesterday lunch time ate but no fast acting injection. . This is my 3rd day on new dose would like to move it to morning dose to test behaviour pattern. Don't think my body will tolerate big jumps as in 6 hour gap between evening to morning switch. Thinking of smaller steps maybe 1 hour each night. Thinking of adjusting dose to 21 tonight as I've proved what I knew from night 1. Plus reducing my fast acting tm breakfast. Appreciate it takes few days to settle in. Still a little way to go but pleased I've got this far and changed my insulin. Feel a lot better fingers crossed it behaves
 
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