I learn so much more on this site than through my endo. Here’s my ponder:
Better to take a dose of tresiba ( now on 10 at bedtime) and experience lows in the am OR
drop to 9 tresiba and treat highs w novolog during the day? Following a low carb diet. The usual 15 grams carb to treat lows takes longer ( up to 1-2 hours) then explodes my bs to Uber highs. Been type 1 for 58 years. Any suggestions will be greatly appreciated!!!
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Assume you are using pens?
If so, you could switch to syringes that have 1/2 unit markings, and you could try 9.5 units.
I also have been T1 55+ years, but using insulin pump for over 30 years. So have never used pens, but keep syringes on hand for backup.
There may be Tresiba 1/2 unit pens, often called ‘junior’ for kids with lower dosages.
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Never knew! Thank you…
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I too use Tresiba and Novolog. I have been a type 1 since 1959. Tresiba pens should definitely have 1/2 markings, and it is frustrating that they don’t.
I give 10 units of Tresiba at night most nights, although sometimes I need 11 units. I am not willing to go back to using 1/2 unit syringes,
I once watched a YouTube video that explained how to take the cartridge out of a Tresiba pen and put it in a pen with 1/2 unit markings, but I can’t find the video again.
I try to stay between 65 and 130 so I am always either trying to stay out of hypo territory or not go too high. When I am giving 11 units of Tresiba I make sure that my glucose level is over 110 at night to make sure that I don’t get woken up with a low alarm. When giving 10 units, I like my glucose level to be about 90 before bed, so I am not dealing with a high alarm. Sometimes I still get woken up by a low alarm or need a bit of insulin.
I take about 10-11 units of Novolog and eat about 265 low fat plant based carbs.
I think about trying a pump, but I like the simplicity of pens, and I think I would have a hard time wearing a pump.
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Thank you for your response. I too like shots vs pump. I looked at the plant base Neal plan yet what scares me is the amount of insulin needed to compensate the carbs. Dr Bernstein’s diet theory is less carbs equals insulin equals less unpredictable ranges in blood sugars. Remember the days when low carb veggies were free foods? Even protein needs dose compensation. I’ll look into 1/2 dose of Tresiba…
I followed Dr Bermstein for 11 yrs and ended up with heart stents and other severe problems. Extreme low carbing is not healthy for many people. For the last 5 yrs I have been following the two type 1, extremely well educated guys, at Mastering Diabetes. When low carbing, a piece of fruit would send me sky high, but by following this program the body can change so that it becomes much less insulin resistance. I can now eat almost 10 times the amount of healthy carbs on the same low amount of insulin. My last A1c was 4.8, and my TIR is excellent. I take a total of 21 units of insulin and eat about 265 carbs daily.
I love it, but being a low fat vegan isn’t for everyone.
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Here is link to video. Seems like an easy solution, but requires purchase of pen that allows certain pen cartridges.
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Thank you so much MM1! This time I wrote down the pen I need to order. This will really help me out!
Marilyn
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Thanks MM1!!! I’ll check this out!
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It took me 20 years to decide that I’d try a pump.
I will never go back.
Although, the Dexcom was a bigger change than the pump even, in terms of better glycemic control and less frustration.
And WAAY better A1C.
@MM1: Yep, syringes are easy, but that video’s a great low tech solution for half-unit Tresiba! I got a Luxura pen a long time ago from my endo as a freebie, which I used with Humalog cartridges. Never hurts to ask. And I do miss the days when a half unit one way or the other really mattered for me…
Also, regarding the “tradeoff” that @Tbk led the discussion with: If you, like me, are using pens, overnight will always be weird because until about 4am, whatever basal insulin you use will be doing fine, but then you’re coming up on dawn phenomenon and waking up (“feet-on-the-floor”) time, both of which will increase your insulin requirement - sometimes by a lot - even without addition of carbs. You can definitely accommodate this with bolus insulin, but you can’t expect your flatline Tresiba to handle it alone.
But not obvious, which is why its great to have forums and share experiences!
As mentioned, I have never used pens, but I did a quick search and found video that Marilyn mentioned. Forums are great for this kind of collaboration!!!
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Truenorth, I take my Tresiba shot around 7:00 am. I never have dawn phenomenon or FOTF which I know is odd. We are all different.
Thanks for the idea of getting a new pen from my endo. I don’t have an endo and my GP never has any diabetic freebies unfortunately.
If a pump could improve any of my glucose statistics, I would get one, but my numbers are already quite good.
I still might try a pump eventually. I am glad that you like yours!
For myself, taking Tresiba in the morning works better for avoiding overnight hypos. However, the dawn phenomenon was worse. After seeing several accounts of splitting Tresiba doses for improved coverage, I tried it and discovered that my 24 hour blood sugar control improved. I currently take either 8 units in the AM, 2 in the PM or alternately, 7 units AM and 3 PM. An endocrinologist (I forget which one) suspected that the duration of action for smaller doses of Tresiba (like 10 units) might be less than 24 hours and that splitting the dose AM and PM might be beneficial. No more hypos and dawn phenomenon improved.
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If you can figure a bg change/carb ratio, you might try calculating the carbs you actually need and add a little according to how fast bg is falling. For those with an insulin pump, the number is the insulin sensitivity factor divided by the carb ratio. Its not foolproof and I have no idea how well it might work without CGM, but it beats the heck out of getting into the bg yo-yo.
Walmart Pharmacy also sells 1/2 unit insulin syringes - ReliOn 31 gauge, 6mm needle (‘short needle’) , 3/10ml syringe …
I had been buying pen needles and syringes from Amazon. I have not been able to for 2 years. Reason: Amazon will not ship to my address (a house). Georgia does not require a prescription for these either. I would love to know why.
It appears Amazon has restriction settings, by state and others have commented on Amazon. May be legitimate for your state or mistake in Amazon setting.
I have never used pens, and has been many years since last purchase of syringes. 30+ years using pump.
Here is a comment from one Amzn product:
"We already contact Amazon and ask them to remove those “restriction”.
However, this is the initial response from Amazon:
“This product has been identified as an insulin pen, needle, or similar insulin device product that that is subject to regulation in the states of California, Connecticut, Delaware, District of Columbia, Georgia, Guam, Illinois, Indiana, Massachusetts, Minnesota, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Puerto Rico, Rhode Island, South Carolina, Tennessee, and Virginia. Although permissible for listing on Amazon, such products cannot be sold into the above states based on state law and Amazon policy.”
I thought the same way, Marilyn, so from 1966 - 2009, I took MDI. I will NEVER go on a tubed pump, but I have found that my transition to a tubeless Omnipod DASH system to be a life-changer. I started with their first version of pump, switched to DASH, and now am contemplating going to the OmniPod 5 closed-loop system. Please take a look at the OmniPod website to learn how easy it can be to use a pump, and seriously think about it. Your life could be even easier with a pump, and you might have even better control.
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