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Diabetes Discussion
Type 1 Diabetes
Tresiba, Dawn Phenomenon, Split Dosing
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<blockquote data-quote="kitedoc" data-source="post: 1802026" data-attributes="member: 468714"><p>I cannot speak for Tresiba dosing etc but with Levemir I used to split it 2/3 total dose for am and 1/3 total dose pm and adjust further from there. Because it was of 12 to 14 hour duration I would take the am dose about 8 am and pm dose about 10 pm. The slight peak of the 10 pm Levemir seemed to help deal with the Dawn phenomenon without over duly causing a low BSL near breakfast. Of course that may vary between individuals.</p><p>The problem I foresee with Tresiba is the overlaps. In theory, if the first two doses were taken say 12 hours apart, the level of Tresiba's action might almost double at the 12 hour mark and at regular further dosing this effect would keep stacking up.</p><p>The other thing is that Tresiba action is flat and pretty reliable in its absorption but a body's basal insulin need varies over the day and night, as the Dawn phenomenon exemplifies. Yes, an insulin pump with programmed basal profile can deal with this.</p><p>I assume you take the Novorapid at 2 am along with the protein meal. Have you tried the Novorapid taken a bit earlier, say start with 11 pm one time, 12 mn another and see if that works any better and whether a protein meal is still needed? Would a slight reduction in Trsiba by say 1 unit help as well. Just suggestions for you and your doctor !</p><p>Best Wishes and fingers crossed !!</p></blockquote><p></p>
[QUOTE="kitedoc, post: 1802026, member: 468714"] I cannot speak for Tresiba dosing etc but with Levemir I used to split it 2/3 total dose for am and 1/3 total dose pm and adjust further from there. Because it was of 12 to 14 hour duration I would take the am dose about 8 am and pm dose about 10 pm. The slight peak of the 10 pm Levemir seemed to help deal with the Dawn phenomenon without over duly causing a low BSL near breakfast. Of course that may vary between individuals. The problem I foresee with Tresiba is the overlaps. In theory, if the first two doses were taken say 12 hours apart, the level of Tresiba's action might almost double at the 12 hour mark and at regular further dosing this effect would keep stacking up. The other thing is that Tresiba action is flat and pretty reliable in its absorption but a body's basal insulin need varies over the day and night, as the Dawn phenomenon exemplifies. Yes, an insulin pump with programmed basal profile can deal with this. I assume you take the Novorapid at 2 am along with the protein meal. Have you tried the Novorapid taken a bit earlier, say start with 11 pm one time, 12 mn another and see if that works any better and whether a protein meal is still needed? Would a slight reduction in Trsiba by say 1 unit help as well. Just suggestions for you and your doctor ! Best Wishes and fingers crossed !! [/QUOTE]
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