Type 1 Tresiba & spiking blood sugars

Nanaclaire

Active Member
Messages
42
Hi I wonder if anyone can help me. I changed over to Tresiba a few months ago but having a few issues:
I seem to be spiking after my evening meal between. 14. & 20+. Between 6 pm and & midnight
I am up to 70 units at bed time at time I was advised to take it.
Through the day my blood sugars are normal but dinner time they can be 5-8 range then shoot up to spike whatever I eat
Taking between 28-32u of Humalogue at main meal but just keep raising
I am taking the Tresiba at wrong time of day
I also go low more through the day than I used to. Then it’s trying to sort low & highs at same time

Any advice would be grateful

Claire Fleming
 
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JAT1

Well-Known Member
Messages
562
Type of diabetes
Type 1
Treatment type
Insulin
Hi I wonder if anyone can help me. I changed over to Tresiba a few months ago but having a few issues:
I seem to be spiking after my evening meal between. 14. & 20+. Between 6 pm and & midnight
I am up to 70 units at bed time at time I was advised to take it.
Through the day my blood sugars are normal but dinner time they can be 5-8 range then shoot up to spike whatever I eat
Taking between 28-32u of Humalogue at main meal but just keep raising
I am taking the Tresiba at wrong time of day
I also go low more through the day than I used to. Then it’s trying to sort low & highs at same time

Any advice would be grateful

Claire Fleming
Do you count carbs and dose your short-acting, mealtime, insulin on the basis of an insulin to carb ratio, or, are you on fixed doses? When my blood sugar behaves more unpredictably than usual, I carefully record the food I eat, how much it weights and its carb count. I compare that to the amount of insulin I injected before the meal and reconsider my personal insulin to carb ratio to see if it needs adjusting. I avoid correction doses if possible because it seems that my short-acting insulin has a very long tail with insulin activating up to 6 hours after injection and hardly working at all for the first 3 hours. I'd rather deal with a high in the teens than a sudden, swift, scary low because I unknowingly stacked.
 
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eventhorizon

Well-Known Member
Messages
442
Type of diabetes
Type 1
Treatment type
Insulin
Hi Claire.

Try missing out on your evening meal for 1 or 2 nights. If your blood sugar still rises then you'll know it's a basal insulin problem. If it stays reasonably flat then it's likely a food or bolus dose that needs work.
 

LarzAttax

Newbie
Messages
2
Type of diabetes
Family member
Treatment type
Other
Hi I wonder if anyone can help me. I changed over to Tresiba a few months ago but having a few issues:
I seem to be spiking after my evening meal between. 14. & 20+. Between 6 pm and & midnight
I am up to 70 units at bed time at time I was advised to take it.
Through the day my blood sugars are normal but dinner time they can be 5-8 range then shoot up to spike whatever I eat
Taking between 28-32u of Humalogue at main meal but just keep raising
I am taking the Tresiba at wrong time of day
I also go low more through the day than I used to. Then it’s trying to sort low & highs at same time

Any advice would be grateful

Claire Fleming
Hi, Claire,

Has your Dr ever suggested testing a different regular insulin? Perhaps the Humalog and Tresiba aren't getting along so well? Also, are you counting your carbs? And what kind of diet are you on?

Humalog is quick acting and short living, but has a peak of 1-2 hours. I would really like to know how many carbs you're having with the amount of insulin you're taking. Insulin/carb ratio, again, very important. Humalog can live as short as 2 hours in your system, so if you're still processing or releasing sugar from your meal after 2 hours, naturally, you will need more of that insulin. If you're eating a high carb, high fat, high protein meal, you are absolutely going to struggle with balancing those glucose levels. Remember, simple carbs act fast, but complex carbs act slow and over time. So, if you're combing them in excessive amounts, you are going to have multiple spikes spread out.

Not to mention, once you get above 200 mg/dl (11.1 mmol/L), it is increasingly difficult for the body to properly process the insulin and thus requires even larger amounts of insulin to correct the issue. Unfortunately, once the insulin finally starts working, it can hit all at once and cause glucose to crash. So, steady monitoring is also essential here. Do you have a CGM? Constant glucose monitoring device. These are highly beneficial.

Our bodies do interesting things during the evening/sleep time. One of those is releasing stored glucose. My husband and my son are both type 1 diabetics. My husband does better on an insulin pump that can actively pump small doses of regular insulin into his body throughout the night, so he isn't waking up with high glucose levels and having to inject himself at 2 or 3 or 4 in the morning. My son had to switch his long acting insulin dose from night time, to morning, because his glucose would drop dramatically at night after taking it.

There are multiple things to consider and discuss with your Dr. Hopefully they listen to your concerns? Based solely on the information you've given us, I'd personally suggest being more strict about the meal you have at night - keep it lean and low carb, count the carbs and adjust your quick acting insulin dose based on that. Eat earlier in the evening. Consider going for a walk or implementing some other workout routine in the evening - exercise does wonders for diabetics. Wonders. Oh, and don't forget to calculate your protein. A lot of diabetics don't know that protein must also be accounted for, just like carbs. For every 20g of protein, consider counting 10g as it were carbs.

Diabetes is tricky. There is never going to be a set standard for what needs to be taken. You have to literally consider every detail of your routine and try to decide what is going to work the best for you, personally, because no diabetic experiences the same routine or the same reaction as another. This is hormones in a nutshell. Best of luck!
 
Last edited:

LarzAttax

Newbie
Messages
2
Type of diabetes
Family member
Treatment type
Other
Hi, Claire,

Has your Dr ever suggested testing a different regular insulin? Perhaps the Humalog and Tresiba aren't getting along so well? Also, are you counting your carbs? And what kind of diet are you on?

Humalog is quick acting and short living, but has a peak of 1-2 hours. I would really like to know how many carbs you're having with the amount of insulin you're taking. Insulin/carb ratio, again, very important. Humalog can live as short as 2 hours in your system, so if you're still processing or releasing sugar from your meal after 2 hours, naturally, you will need more of that insulin. If you're eating a high carb, high fat, high protein meal, you are absolutely going to struggle with balancing those glucose levels. Remember, simple carbs act fast, but complex carbs act slow and over time. So, if you're combing them in excessive amounts, you are going to have multiple spikes spread out.

Not to mention, once you get above 200 mg/dl (11.1 mmol/L), it is increasingly difficult for the body to properly process the insulin and thus requires even larger amounts of insulin to correct the issue. Unfortunately, once the insulin finally starts working, it can hit all at once and cause glucose to crash. So, steady monitoring is also essential here. Do you have a CGM? Constant glucose monitoring device. These are highly beneficial.

Our bodies do interesting things during the evening/sleep time. One of those is releasing stored glucose. My husband and my son are both type 1 diabetics. My husband does better on an insulin pump that can actively pump small doses of regular insulin into his body throughout the night, so he isn't waking up with high glucose levels and having to inject himself at 2 or 3 or 4 in the morning. My son had to switch his long acting insulin dose from night time, to morning, because his glucose would drop dramatically at night after taking it.

There are multiple things to consider and discuss with your Dr. Hopefully they listen to your concerns? Based solely on the information you've given us, I'd personally suggest being more strict about the meal you have at night - keep it lean and low carb, count the carbs and adjust your quick acting insulin dose based on that. Eat earlier in the evening. Consider going for a walk or implementing some other workout routine in the evening - exercise does wonders for diabetics. Wonders. Oh, and don't forget to calculate your protein. A lot of diabetics don't know that protein must also be accounted for, just like carbs. For every 20g of protein, consider counting 10g as it were carbs.

Diabetes is tricky. There is never going to be a set standard for what needs to be taken. You have to literally consider every detail of your routine and try to decide what is going to work the best for you, personally, because no diabetic experiences the same routine or the same reaction as another. This is hormones in a nutshell. Best of luck!
My apologies, I just realized "Type 1" is in your header, which makes a lot of what I said pretty much common knowledge for your average type 1 diabetic. I'm going to leave it in case it is useful for a non-diabetic, student, or newly diagnosed.

I will reiterate what I said about the regular insulin possibly not being a good match with the long acting insulin, though, and the importance of carb counting. Once more, best of luck.
 

Nanaclaire

Active Member
Messages
42
Hi, Claire,

Has your Dr ever suggested testing a different regular insulin? Perhaps the Humalog and Tresiba aren't getting along so well? Also, are you counting your carbs? And what kind of diet are you on?

Humalog is quick acting and short living, but has a peak of 1-2 hours. I would really like to know how many carbs you're having with the amount of insulin you're taking. Insulin/carb ratio, again, very important. Humalog can live as short as 2 hours in your system, so if you're still processing or releasing sugar from your meal after 2 hours, naturally, you will need more of that insulin. If you're eating a high carb, high fat, high protein meal, you are absolutely going to struggle with balancing those glucose levels. Remember, simple carbs act fast, but complex carbs act slow and over time. So, if you're combing them in excessive amounts, you are going to have multiple spikes spread out.

Not to mention, once you get above 200 mg/dl (11.1 mmol/L), it is increasingly difficult for the body to properly process the insulin and thus requires even larger amounts of insulin to correct the issue. Unfortunately, once the insulin finally starts working, it can hit all at once and cause glucose to crash. So, steady monitoring is also essential here. Do you have a CGM? Constant glucose monitoring device. These are highly beneficial.

Our bodies do interesting things during the evening/sleep time. One of those is releasing stored glucose. My husband and my son are both type 1 diabetics. My husband does better on an insulin pump that can actively pump small doses of regular insulin into his body throughout the night, so he isn't waking up with high glucose levels and having to inject himself at 2 or 3 or 4 in the morning. My son had to switch his long acting insulin dose from night time, to morning, because his glucose would drop dramatically at night after taking it.

There are multiple things to consider and discuss with your Dr. Hopefully they listen to your concerns? Based solely on the information you've given us, I'd personally suggest being more strict about the meal you have at night - keep it lean and low carb, count the carbs and adjust your quick acting insulin dose based on that. Eat earlier in the evening. Consider going for a walk or implementing some other workout routine in the evening - exercise does wonders for diabetics. Wonders. Oh, and don't forget to calculate your protein. A lot of diabetics don't know that protein must also be accounted for, just like carbs. For every 20g of protein, consider counting 10g as it were carbs.

Diabetes is tricky. There is never going to be a set standard for what needs to be taken. You have to literally consider every detail of your routine and try to decide what is going to work the best for you, personally, because no diabetic experiences the same routine or the same reaction as another. This is hormones in a nutshell. Best of luck!
Hi thank you for advice I’m having chat with my diabetes nurse on Monday , I’ve got quite a few points to bring up with her.As I have said I am Type 1 & have been for over 25 years now, I went on to the freestyle Libra in March this year and I love it . It’s great & now I’m getting my blood sugar reading almost perfect the good thing is you get alerts when blood sugars are up or down where as with meter you were only doing meal time tests. I do carbs & really watch what I eat I’m trying to lose weight as well due to having to have a knee replacement hopefully in the new year, I’m finding it very difficult to exercise due to severe pain. I have Osteoarthritis in my spine & knee But I do what I can on crutches due to it.
only seemed to have started this problem since I went onto Tresiba at the moment I’m juggling with my insulin trying to get it right obviously not all at once I’m still spiking on some evenings but getting a high 1st thing in morning. This morning I was 13:5
but today almost perfect sugars & no spike so far (8.9). Hoping I don’t spike .i don’t eat after my evening meal unless I have gone low. Hoping I get this sorted / corrected as I know if this continues they won’t do the operation & fed up of feeling so tired & having a what feels like a permanent headache.
Thanks again for your advice much appreciated.
Nanaclaire
 
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