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Tresiba Insulin & High Readings

A

atatton

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6
I have just started Tresiba and take 20 units in the morning. My blood sugar has gone from 7 this morning at 8:00 and is now 21 at 18:00. I am not too sure what I can do to lower my sugar. I previously took Insulatard and my blood sugar were a bit low but ok. Any help please???
 
atatton said:
I have just started Tresiba and take 20 units in the morning. My blood sugar has gone from 7 this morning at 8:00 and is now 21 at 18:00. I am not too sure what I can do to lower my sugar. I previously took Insulatard and my blood sugar were a bit low but ok. Any help please???
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Hi @atatton , welcome to the forum!

Can you tell us a bit more?
What type of diabetes do you have? Are you only on Tresiba or do you use a mealtime insulin as well?
Are you taking the same amount of insulin units with Tresiba as with Insulatard?
What did you eat in the hours before 18:00?
Are you newly diagnosed or have you had diabetes for a longer time?
What kind of numbers were you seeing on insulatard in the evening Did you see numbers as high as this?

I'm sorry for all the questions, the answers will help though.

As for advice, 21 is rather high. If you feel unwell or are unsure, call 111 for advice!
If you don't feel unwell, what about seeing what your blood sugar will do in the next couple of hours, and call 111 if they don't drop?
 
I have type 1 and have just been changed to Tresiba today is my first day. Fast acting insulin has to come once I am stabilises on Tresiba according to my consultant. I took 40
Units Insulatard and I am taking 20 units Tresiba to increase by 3-4 units daily until sugar is ok. Today I have eaten I slice of white toast with punt butter, tomato soup and a roll for lunch and some
Beef jerky this afternoon. I am about to have my dinner of pasta and salad. I have had diabetes for 50 years but very seldom had sugar above 14 on insulatard they were usually on the lower side between 4 & 8 that’s why insulin was changed. Do you think I should skip having dinner?
 
atatton said:
I took 40
Units Insulatard and I am taking 20 units Tresiba
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I would expect to go high if you halve your daily dose of insulin.
Tresiba isn't meant to deal with mealtime spikes, so that makes things even more difficult while you're still working out your doses with your consultant.
atatton said:
Do you think I should skip having dinner?
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What about eating something but skipping the carbs for tonight, seeing as you're this high? So have some more meat and veggies or such?

Can you test for ketones?
If your blood glucose doesn't drop you run the risk of developing DKA with those numbers, which you don't want.
I'd ring 111 for advice and not wait until tomorrow if your sugars won't drop.
atatton said:
Fast acting insulin has to come once I am stabilises on Tresiba according to my consultant.
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Is your consultant an endocrinologist?

Wish you all the best, please don't take chances on things improving by themselves if you don't come down!
 
Sugar now 19 so waiting to see what happens. Will go for a walk and see what it is in another hour. Thank you for your help. I will see how it goes tomorrow and up the dosage by 4 units to see if there is any improvement.
 
atatton said:
Sugar now 19 so waiting to see what happens. Will go for a walk and see what it is in another hour. Thank you for your help. I will see how it goes tomorrow and up the dosage by 4 units to see if there is any improvement.
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Do note that since Tresiba is one of the longer lasting ones, it can take a good 2-4 days for any changes to become apparent
 
atatton said:
I have type 1 and have just been changed to Tresiba today is my first day. Fast acting insulin has to come once I am stabilises on Tresiba according to my consultant. I took 40
Units Insulatard and I am taking 20 units Tresiba to increase by 3-4 units daily until sugar is ok. Today I have eaten I slice of white toast with punt butter, tomato soup and a roll for lunch and some
Beef jerky this afternoon. I am about to have my dinner of pasta and salad. I have had diabetes for 50 years but very seldom had sugar above 14 on insulatard they were usually on the lower side between 4 & 8 that’s why insulin was changed. Do you think I should skip having dinner?
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Hello. Welcome to the forum.

50 years T1. Wow.
Just over 45 years for me.. Looks like diagnosis around the same age?
When did you start the insulatard?
I was put on an "Actrapid" too as an MDI regime in the late 1980s after initially being on porcine?

I'm a little concerned you may have slipped through the net with regards to a more appropriate & flexible insulin regime prescribed?

Best wishes.
 
I was diagnosed at 8 yrs old in Scotland and was put into Monotard and Actrapid. I then moved to South Africa, which was very far behind medically and I was kept on this insulin until I came back to the UK in 2005. I then saw a diabetic consultant and he put me in the Insulatard which I have been on since then. I have not had very many problems at all but my sugar is usually quite low 4-8. In the last year I have had 2 hypos and my doctor told me to see the consultant who has put me on to Tresiba. I have been injecting with a hypodermic needle and vials of insulin and this is also the first time I have had a pen. Sugar is now down to 16 so coming down slowly and I won’t be in bed for another couple of hours so hopefully should be ok. Thanks for your concern it’s nice to have someone to chat to.
 
Hi @atatton and welcome to the forums. Are we diabetic twins? (I was diagnosed in 1970 aged 8 :)). Given that tresiba lasts several days I'd expect you to be high while you wait for the dose to build up but I'm slightly confused by the rationale of delaying the fast acting till you're stabilised on the tresiba? I would have thought you'd need it from day 1 unless you are on a keto diet? Do you already have fast acting insulin in your fridge or do you have to wait for another appointment?

It's good that your levels are coming down slightly but do you have a way to check for ketones? (You probably never needed it before if you never ran high.) I only got a meter that checked for ketones recently when I told my consultant that I'd never had a DKA and didn't think I needed to check....:)
 
Hi Ellie definitely diabetic twins I am also confused as to why I can only have the fast acting after I see my consultant the next time (23 Nov) I sometimes wish consultants were actually diabetics themselves!! I have no way to check for ketones, maybe something I can ask him next time I see him. I woke up this morning and my sugar was 11 so I took 24 units instead of the 20 I took yesterday and I will wait and see what my readings are like today. I will drop you a note later to let you know.
 
atatton said:
Hi Ellie definitely diabetic twins I am also confused as to why I can only have the fast acting after I see my consultant the next time (23 Nov) I sometimes wish consultants were actually diabetics themselves!!
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That's a long time to go without any bolus insulin. Unless you are on a keto diet? Is there someone you can contact to double check this advice? eg a diabetic nurse at the hospital or your GP? Otherwise there is an NHS diabetes helpline run by the diabetes.org.uk website.

NHS Diabetes Advice Helpline for patients with insulin-treated diabetes - Health Innovation Network

And there is also 111

My understanding of a basal/bolus regime is that the basal is supposed to cover your insulin needs when you are not eating, the bolus covers your food. If you are having to cover both with your basal, then you are going to get a lot of hypos and spikes, unless of course you are keto.

You absolutely need to be able to check for ketones, particularly if you are running in the teens and higher for long periods. You can get urine testing strips from a chemist but you are entitled to a ketone meter and strips from the NHS (I think, I'm a bit out of date with UK practices.)
 
When I was prescribed Tresiba, I was warned erratic readings were common in the first 2-5 days and extremely common in the first 24 hours.
 
I would try and contact your diabetic team again. I find Tresiba a really stable background insulin but it might as well not be there when I eat - Novorapid is essential for allowing me to have anything with even moderate carbs in it and bread would spike me into huge blood sugar figures with just Tresiba
 
Hi all it seems to have settled down a bit and I called my consultant on Monday and he prescribed Novorapid to take before meals. Sugar readings are a bit better today, average 14 so not too bad but need to get average to about 8-9. I have to call them again on Friday to check and see what they think. Thank you all.
 
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