I switched from Lantus to Tresiba about three months ago. Initially, the first few days, the transition appeared to be seamless. However, after about one to two weeks I started to have bad lows in the night. I did an even conversion of 11 units of Lantus to 11 units of Tresiba per my doctors suggestion. Starting at this point I tried everything under the sun to prevent the lows which would come about three or four in the morning. I took the Tresiba at different times of the day which did not seem to help.Initially I was taking the Tresiba at about the same time I took the Lantus (about 8 or 9 in the evening.) I also noticed I was much more sensitive in the morning to my mealtime insulin and had to drop my usual dose by one or two units. However in the evening I became much less sensitive and required about a third more insulin with my dinner. Long story short, it has taken me three months to figure out how to use the Tresiba effectively for me. I now take 8 units of Tresiba at about 7 in the evening. I take a delayed dose of insulin for breakfast and prebolus for dinner a good 20 to 30 minutes before I eat with a one or two unit correction 2 hours after dinner. Sometimes I need one unit at about 11 to prevent an early evening high. All in all I like tresiba and I like the fact it has 48 hours coverage and missing a dose can be corrected at any time. But, it is not in my opinion an equal switch from Lantus to Tresiba. I feel like I had to completely learn how to use insulin again.Anyhow I wonder if anyone else has had a similar experience or I am just an anomaly.
Some people have to take a lot lower dose and some can take exactly the same dose like me. Everyone is different. I’m glad you got it worked out though. I too like the longer lasting in case i forget and take it later in the day.
We switched 1:1 from toujeo to tresiba. In the end lowered it by one unit. We love it. Much better coverage for full 24 hours. Only slight drawback is it has a small tendency to pull blood sugar a little low at night. Nothing dramatic and much preferred to waking with a high blood sugar as with toujeo.
She takes tresiba at 7:30 am and we too feel like our mealtime insulin (Afrezza) is stronger with tresiba. We tried to drop back on tresiba by a unit then trended high at night. It’s almost as if she needs 24.5 but of course pen doesn’t deliver half units. In the end she just tries to be at 120-130 at bedtime and that puts her right around 100 in the morning. She never had a dramatic low in the high to mid sixties was the lowest we got. Good luck!
It’s better every day. I feel I finally have a handle how tresiba works in my body, the timing and the bolus ratio.
i had to eventually cut my tresiba dosage into half!
i was on 12 units levemir morning and evening before the switch and am now down to 12 units tresiba at bedtime. crazy, but i love it a lot.
I am finding this as well. I have been having to drop my Tresiba dose to avoid hypos during the day.
I think doctors need to warn patients that there is a trial and error period when switching over. At first I was very frustrated and almost gave up but with persistence I FINALLY was able to figure it out. I am glad I stuck it out!
My guess is for the first ten days or so you don’t get full tresiba effect until it’s fully integrated into your fat pad. It’s likely for first few days you have effects from both your old basal and tresiba which likely makes it a bit erratic.
Actually it went on for three months. Some of the erratic patterns were due to the effect of the Tresiba and my novolog. I had to redo my entire bolus profile, including timing, amount etc.
Ahh that makes sense. I’ve often wondered what it’s like to combine tresiba with older RAA’s I’m not surprised it’s more erratic. Afrezza compliments tresiba very well, for us. Good luck! Glad you figured it out! Amazing how much trial and error is still involved after all these years isn’t it? One size never fits all.