Tresiba and NovoRapid Advice Please

Hi fellow Type 1 Battlers,

After many years on Novorapid bolus and Levemir basal, I have today started taking Tresiba instead of Levemir. I was advised to make this change due to overnight problems during the last 6 months or so with my blood glucose level when in bed.

I used to take 9 units of Levemir last thing at night (usually around midnight) and 9 units when I got up (usually around 9am). I would always try to ensure that my level was stable around 4.5 - 5.5 when going to bed, but frequently was awake between 4am and 5am with a rising level of 6 which meant a small dose of Novorapid was needed or I would get up with a level of 9+ and sometimes 12+

In an attempt to avoid a poor night's sleep I would sometimes take a unit or two of Novorapid before going to bed. My doctor thought that my high level at 9am may have been due to counter regulatory hormones taking effect due to me going low during the night. I think I know when I've gone low during the night by the unpleasant confused thought patterns which occur and usually wake me up, but my doctor may of course be right.

So due to these problems, I have changed basal insulin, and this morning took 16 units of Tresiba, as my total dose for today.

Anyone with any thoughts or advice or common experience please? Living on my own, and not knowing anyone who is a Type 1 diabetic, means that some dialogue will be very welcome and appreciated.

Circuspony said:

I take Tresiba and take full dose in the morning. My starting dose when I came off lantus was a bit low so I'd run with a dose for a week and then pop it up a notch if I was waking up too high.

I had a load of issues with lantus but Tresiba has always been pretty stable with me overnight

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Well 2 days into Tresiba, and this morning no dawn phenomenon! I hope this continues!

oldgreymare said:

I switched from Levemir to Tresiba a few years ago. Started at a single dose of 80% of my twice daily Levemir dose. It does last at least 24 hours for me - I take it once mostly in the am but sometimes not until afternoon.

But I do suffer from dawn phenomenon as my BG tends to start rising from 4-5 am. When I've tried to adjust Tresiba to cover I had too many nighttime hypos, so now just inject a small Novorapid dose when I wake up.

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I'm 2 days into Tresiba, and this morning no dawn phenomenon! I hope this continues!

Juicyj said:

Heya @Tracker???

Has your team offered you a Libra sensor as you should be able to access one now ? Quite useful to see what is actually going on during the night. I am on a pump now but prior to that I was on tresiba and once i'd got the dosing right it was the best long acting insulin i'd used compared to lantus and levemir which I didn't cope well with so brace yourself for adjustments as you settle in but it's worth it - let us know how your getting on ?

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Hi, 5 days of Tresiba use and I love it! So far it is working so much better than Levemir, and I hope it continues to. Yes, I have a Libre 2.

Two days later, and Tresiba is not working as well - this morning and yesterday morning my level was around 7.5 and rising, even though my level was around 4.5 when I went to bed. Should I up my dose a little?

And two days later from my last post, same problem. Tresiba now seems to be as **** as Levemir. For the first 5 days it was wonderful, and then for the next 4 days it has been far from wonderful. Very similar carb intake, and amount of exertion, and amount of Novorapid everyday.

There was talk of "bracing myself for adjustments", can anyone offer any help with this please?

Male. Fairly active - similar exertion most days. How can I find / get help from Tresiba users please?

Thank you for your help.

I think I have worked out the explanation for what is going wrong - it's exactly as my diabetes doctor suggested - I'm going low in the night and due to counter regulatory hormones taking effect my level is too high by 8am or earlier. I think I need to take less Novorapid with my dinner. Do you think I should also reduce my Tresiba?

Last night I took less Novorapid than normal, but I was still low in the night (4am), complete with horrible confusion. When I got up I was 4.0, so my level was rising, and I was 7.9 at 9am, and I only had a few grapes at 4am. The last 2 days have been awful though, due to the sudden unexpected death of a much loved pet. Does stress like that, make hypo's more likely?

Is there anywhere that I can read up about Novorapid and Tresiba please? I hoped that my posts would attract a lot more response than they have. The lack of response very much surprises me. Whilst I realise that many T1 diabetics don't use Novorapid and Tresiba, I thought there might be quite a few that do.

I need to know the usual response times for Novorapid - is it about half an hour? And for Tresiba - I'll take a guess at 2 hours? For both types of insulin, when is full effect and how long does full effect usually last for? Is there usually effect of any significance after full effect? I know there won't be exact figures, hence I'm requesting usual or average ones.

In my opinion, use of insulin is easily the most challenging part of being a T1 diabetic, so I have always been very surprised and disappointed regarding the lack of info provided by the NHS. I would have thought that use of such a potent and potentially dangerous medication would mean that there was a lot of information given to users.

One last question - is there anywhere else on this website / another website that I may get more response?

Thank you for your help.

Rokaab said:

I'm afraid the answer is it can very very very much depend on the person, I finally gave up with Novorpaid about 5 years ago as for me, I could see on my Libre that it was kicking in after 4 hours or so - well fat lot of use that was, and for breakfast at least I had to pre-bolus by a good half hour to stop my sugar level going monstrously high (it still went high mind just not so high if I pre-bolused) - whereas for some people it can work a lot faster.

I changed to Fiasp which is faster acting and definitely improved things for me, but quite a few have reported it just starts acting like water after a while.

Tresiba I was on this for a couple of years before I got my pump, it can take a good 3 days or so for changes to take affect as its very long lasting, so I found no effect after injecting on a daily basis as it all overlapped anyways - I found it far better than Lantus which definitely did have a kick after about 3 hours for me causing hypos, Tresiba didnt seem to - at least not for me.


Unfortunately everyone is different so there cant really be an all-encompassing guide to it, only vague suggestions which may be why there is nothing really in great detail.
For example If I took the same amount of insulin as some users on these forums I would be dead

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Thank you very much for the reply. I understand that insulin effect can vary a lot between people, but I would still like to have an idea of the experience of others who are successfully using Novorapid and Tresiba.

It's looking like my low's at around 4am are due to Novorapid (I think), so any tips from users for avoiding these lows? I go to bed around midnight, which is usually 3 - 4 hours after I've had my Novorapid and my evening meal, and I try to make sure that my level is 5+.