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Tresiba

D

Diatribe-T1

Member
Messages
20
Type of diabetes
Type 1
Treatment type
Insulin
Would it be better to take Tresiba in the morning to stabilise daytime glucose readings ? Night readings are holding steady, if somewhat low at times. Perhaps it’s just a case of eating fewer carbs to allow the Novorapid to stand a chance ? Any advice welcome.
 
it shouldn't make a difference if injected at the same time each day. there have been a few people in the forum which have tried splitt dosages. you'd need to speak to your dsn for dosage advice. I found fiasp worked a little faster than novarapid.

heres some info on active time/peak times for various insulins.


Would be worth sharing CGM data with your diabetes team, if not already doing so. insulin to carb ratio can change over time, perhaps that has changed? if using fixed doses instead, carbs would need to be very simular for meals and would recremmend course such as DAFNE if not already done, depending on how long ago could be worth refresher.

how are between meals looking on the graphs?
 
tresiba is effective for 36 hours, no matter what time of day it is taken. Due to the looping of tresiba's action, it is safe to even forget to give an injection and remember about it after 10 hours
 
grantg said:
it shouldn't make a difference if injected at the same time each day. there have been a few people in the forum which have tried splitt dosages. you'd need to speak to your dsn for dosage advice. I found fiasp worked a little faster than novarapid.

heres some info on active time/peak times for various insulins.


Would be worth sharing CGM data with your diabetes team, if not already doing so. insulin to carb ratio can change over time, perhaps that has changed? if using fixed doses instead, carbs would need to be very simular for meals and would recremmend course such as DAFNE if not already done, depending on how long ago could be worth refresher.

how are between meals looking on thgraphs?
Click to expand...
I’ll have a look at the link, thank you. Ratios have definitely changed. Still quite sensitive to insulin but evening ratio has changed. I’ll be going to the appt with diabetic team in January. I was to attend in November, but for some reason it was cancelled. That has never happened before. I have done the DAFNE course, which was v good. Between meals are ok. I’d just love to have a glorious stable line like I do at night. Sometimes the carbs in the evening seem to get a second wind and bld glucose rises again after its initial rise. It could be the fat content ?
 
Zhnyaka said:
tresiba is effective for 36 hours, no matter what time of day it is taken. Due to the looping of tresiba's action, it is safe to even forget to give an injection and remember about it after 10 hours
Click to expand...
Goodness gracious that’s incredible. I’ll read up a bit more on Tresiba. Thanks Z.
 
Diatribe-T1 said:
Ratios have definitely changed. Still quite sensitive to insulin but evening ratio has changed

I have done the DAFNE course, which was v good. Between meals are ok. I’d just love to have a glorious stable line like I
Click to expand...

it could be that the bolus may need changed due to activity levels, and your muscles able to use the glucose in a much more efficient manner as the day progresses. eg couple of wheatabix in the morning spikes me to 10+ if same at evening meal 8+.

what are your mealtimes 2 hours afterwards ? big advantage of cgm able to see that easily. i'd hazzard guess that your recording your exercise through the day, alongside made some notes of various meals had (inclusive of carbs) have also found some foods very little difference in the first hour or so, then could creep right up for extended periods of time (depending on whats in the foods, eg mac n cheese is a no no for me now) :)

some people have found requirement to inject for just protein if a meal without carbs.
 
You’re very good to give such a thoughtful reply. I find that I’m more resistant to insulin in the evening. Not much activity atm because the weather here is quite wet, so no gardening, I’m afraid. I do make notes on various meals, with carb content. So, after meals in the evening it goes like this mostly, at 5pm - 5.2 mmol, 7pm - 6.4. Jumps up to 10mmol or even 13mmol inbetween this timeframe. I take 4 Novo for 40g carbs. Only fats I use really is butter, which I am a tad heavy on. Hope this makes sense G.
 
I often wondered about when to take Tresiba, too. I used to take it am, however changed to bedtime. I started Keto when I was first dx'd in 2017 (at 69) as T2. Serious DKA in 2019 (at 71) and was actually T1. This past two plus years I have gained 30 lbs. It's probably too many low carb sweets and not enough protein. This has been the story of my life. I don't know how to lose this weight because it definitely isn't healthy for me, and I feel terrible, too. ICK! Even if I eat the same food at two meals, my BG either shoots way up or way down. I just never know which way it's going to go. It's very difficult to rein it in again. Any tips would be appreciated.
 
DKA very hard thing to go through. I have the jumping Jack sugars as well but only when I eat bread and the like. Luckily I love salads, even in the middle of winter. Only exercise I do is gardening. I think the best we can do is take detailed notes of our food intake, exercise and all the other things which can affect our glucose, stress, illness and the like. Others here on the forum have more knowledge than I. Keep trying. It’s good to be engaged with diabetes. Gorgeous dog btw.
 
Diatribe-T1 said:
I take 4 Novo for 40g carbs.
Click to expand...
1:10 ratio then which appears to be starting dosage. i've used several ratios (under medical advice) ranging from 1:10 shifted to 1:12 then 1:15... amongst other ratios.

It could be worth while trying a fast for the first few hours of the day.

if you use libre check out https://www.libreview.com/ on page2: Considerations for the Clinician¹ : there should be considerations for clinician: might be worth checking if anything is listed there then discuss with said clinician.

mealtime patterns you can ask dsn/consultant if they see any correlation to differing insulin requirements, if so could they either work out new ratios, alternatively give some extra education to allow you to work it out yourself. if they are unable to do, part of dafne course was on corrective dosages. usually given standard info based a little on averages (bmi etc) 1unit would likely decrease sugars by X. remember if doing correctional dosages has to be Y hours before correcting to prevent insulin stacking which can cause sugars to drop very quickly. You can call dsn to request a refresher or ask for advice on dosages (forum rules don't permit dosage advice directly) we can signpost.

there is a ton of things which can effect glucose levels.

dka isnt nice :( lots appear to be diagnosed via dka like myself
 
Ratios do change. Morning it could be 1:6. Tend to just drink tea during the day as I prefer to eat in the evening. Thanks for the libre link. I’ll look up more on Dexcom, as that’s the CGM I’m using. I unit Novo usually drops me 6mmol, depends on how active I’ve been. Been ages since I did the DAFNE course, so I’ll ask about that at next appt. One person I met told me that stress lowered her sugars. Strange ! Mine are the opposite with stress. One more question, sorry, is it ok for sugars to hit 13 mmol after a meal, even if they’re back down within two hours ?
 
grantg said:
1:10 ratio then which appears to be starting dosage. i've used several ratios (under medical advice) ranging from 1:10 shifted to 1:12 then 1:15... amongst other ratios.

It could be worth while trying a fast for the first few hours of the day.

if you use libre check out https://www.libreview.com/ on page2: Considerations for the Clinician¹ : there should be considerations for clinician: might be worth checking if anything is listed there then discuss with said clinician.

mealtime patterns you can ask dsn/consultant if they see any correlation to differing insulin requirements, if so could they either work out new ratios, alternatively give some extra education to allow you to work it out yourself. if they are unable to do, part of dafne course was on corrective dosages. usually given standard info based a little on averages (bmi etc) 1unit would likely decrease sugars by X. remember if doing correctional dosages has to be Y hours before correcting to prevent insulin stacking which can cause sugars to drop very quickly. You can call dsn to request a refresher or ask for advice on dosages (forum rules don't permit dosage advice directly) we can signpost.

there is a ton of things which can effect glucose levels.

dka isnt nice :( lots appear to be diagnosed via dka like myself
Click to expand...
Sorry you had to go through DKA, it’s awful.
 
Diatribe-T1 said:
Ratios do change. Morning it could be 1:6. Tend to just drink tea during the day as I prefer to eat in the evening. Thanks for the libre link. I’ll look up more on Dexcom, as that’s the CGM I’m using. I unit Novo usually drops me 6mmol, depends on how active I’ve been. Been ages since I did the DAFNE course, so I’ll ask about that at next appt. One person I met told me that stress lowered her sugars. Strange ! Mine are the opposite with stress. One more question, sorry, is it ok for sugars to hit 13 mmol after a meal, even if they’re back down within two hours ?
Click to expand...
Even non diabetic sugar levels after a hefty meal could be +13 theirs will usually come down faster. General advice I was given was 2to3 mmol difference within a couple of hours.

Depending on type of stress can go down in rare circumstances. Stress depending on cause can either make mine go up (eg getting blood taken needlephobic) some other stress has caused lower numbers everyone is different

Regards to dose correction how active are makes lots of sense. Something like 25 percent or 50 percent of ratio on activity type/length which can be unique to that individual. Eg swimming for me appears to be moderate level with large impact on levels even at slow breast stroke pace and indeed back crawl very slow around minute to minute and half per length usual time pool 30to50mins max

You could try a fasting test to see if levels remain stable which would soon tell you if enough basal. See below link for some info on that which might be worth discussing with your dsn should you find the graph isn't relatively flat when testing basal.

www.diabetes.co.uk

There are many different types of insulin delivery devices available including syringes, pens, jet injectors, oral insulin and pumps which are detailed below.

There are many different types of insulin delivery devices available including syringes, pens, jet injectors, oral insulin and pumps which are detailed below.
www.diabetes.co.uk www.diabetes.co.uk


Other thing you could ask for is referral to diabetic dietician if they are unable to offer Dafne refresher. They work via Dafne usually a little more leeway in advice they can offer than regular dsn
 
Biggest issue with dka is that if don't get treated fast can lose cognitive ability of reasoning which can make treatment exceptionally hard.
 
Your advice is invaluable. I’ll have a look at link, thanks. Find it difficult at times to have stable sugars while gardening. Sometimes get carried away and do more work than I had planned for, ending with a hypo. I tended to run sugars a bit high to avoid this. I’m not the most accurate when it comes to figuring out ratios and the effect exercise has on me. Just going to continue taking notes. Great idea about dietician. Thanks again. It’s good to be able to talk to others who deal with the same issues. Sorry to hear you’re needlephobic.
 
Zhnyaka said:
tresiba is effective for 36 hours, no matter what time of day it is taken. Due to the looping of tresiba's action, it is safe to even forget to give an injection and remember about it after 10 hours
Click to expand...
Going to have a look at more info on Tresiba. Thank you.
 
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