Dose once or two times a day with tresiba?

Hum, I don’t know where you’re getting this 1% from. The pancreas has two main functions: an exocrine function that helps in digestion and an endocrine function that regulates blood sugar. T1’s don’t make amylin or insulin, cells within islet are destroyed. I have no clue how much of pancreas has any function at all, I didn’t give a percentage…nor do you know.

maybe for some, YMMV. As I said, if you actually READ the clinical trials of splitting vs. one dose levemir, there is no significant advantage; one whom takes small doses of basal (myself), splitting a dose creates possible stacking, then ones just taking smaller doses to try and achieve the same thing. Often, when we switch different insulins, basals…our patterns will remain the same, our bodies have patterns, too…it’s not always the basal, thus the pump.

Yes, YMMV, but splitting Levemir is the norm. It is heavily dose dependent and you would need to take a significant amount for it to work effectively for 24 hours. Again, clinical trials don’t matter. There are clinical trials saying there is no difference between using analogues and human insulin to treat diabetes - and I’m sure for people with an A1C of 8 or 9, it doesn’t make much of a difference.

1 Like

A simply basal rate check will show if the levemir is lasting 24hrs. some find splitting is better. Mysugr basal rate test is ok and will give accurate results.

In general they find splitting has better A1c

Your posts come across as outright belligerent. If you’d like to adjust your tone and have a reasonable conversation instead of just barking at everyone that they have no idea what they’re talking about—- people might be far more likely to be willing to listen to and exchange with you.

6 Likes

So, I was trying to figure this out with a brand new diabetic here: BS dropping after eating during the day - #55 by mohe0001

Sorta just for the purpouse of discussing how stuff works. Its NOT a flatline activity curve for 48 hours. Thats not true. Its flatline for around 12 hours, then tapers off. Personally, I find this activity curve pretty confusing and difficult to work with…

Really? I wonder how you know what I know and what I don’t know when we are strangers on the internet?

I learned that islets (where beta cells and other endocrine cells are located) make up about 1-2% of the pancreas when I took a basic anatomy and physiology course during my undergraduate degree. Within our islets, beta cells do not work, but all other endocrine cell types do work. This is not obscure information, and likely it would be in any basic anatomy and physiology textbook or could be verified with a single Google search.

3 Likes

That’s the whole point though is that when it’s overlapped every day it becomes perfectly flat for all practical purposes… with minimal peaks and troughs. There is effectively no “curve” to work with… this picture illustrates its profile well when used daily.

This allows for an essential state of equilibrium, whereas meds like Lantus are constantly wearing off and recharging even if taken 2x daily…

Tresiba is truly a breakthrough to me.

3 Likes

Following this thread as I have been considering splitting my dose. I was having reactive lows when taking 15u once per day of tresiba. I had worked up to 22u since diagnosis. Now I Am down to 5u once per day and running GREAT in the afternoons but high overnight.

I was wondering if splitting may help as it seems I need more insulin at night than the day, probably to the nature of my highly active day job.

Lantus and Levemir are well known to not last for 24 hours, especially at smaller doses, which are what type 1 diabetics typically use. They last less (Lantus about 20 hours, Levemir less), resulting in a lack of basal for a few hours during the day. So, splitting them does make sense. In fact, this is marketed as one benefit of Toujeo over Lantus (even though both are the same insulin glargine) - Toujeo does last for 24 hours. Splitting Toujeo or Tresiba doesn’t make much sense to me though.

I had more success splitting Tresiba than taking it in one dose when I tried, but there was overlap which caused very bad hypos approx. 9 hours after injection. You can try it, but I’d also recommend trying Levemir if it doesn’t work well for you, which lasts 10-14 hours at smaller doses and so is more conducive to splitting without overlap.

I don’t think it works uniformly for everyone as advertised. At least when I tried Tresiba, it was way too strong in the first 6-8 hours after injection, but if I lowered the dose enough so it wasn’t driving me low for hours it wouldn’t last more than approx. 16-18 hours (so no better than 1 dose of Levemir, really). Splitting it made sense to fix this, but the problem is the overlap since it still does last longer than Levemir. Like everything, it’s probably magic for some people and a nightmare for others.

1 Like

Thats a nice picture, @Sam19 . Super helpful. Thanks.

1 Like

I sense a lot of hostility in your responses here and it truly puzzles me.

Just to be clear, let me rephrase this; “FOR ME, waking up with 120 IS too high.”
I aim for non-diabetic numbers as non-diabetics do not develop complications. There are now studies that show that an A1c greater than 5.4, even in non-diabetic population, is a predictor of cardiovascular diseases. Here’s one study.

I choose to not take any risks, especially being T1 for 33 years, I want to minimize any damage possible so I choose to be very tightly controlled and have an A1c below 5%. I feel great and my life quality has improved tremendously as as result. I was even able to reverse some previous complications. I do take relatively small amounts of insulin, and splitting Tresiba has helped me (after lots of trial and error with one dose then split but taken at different times) I was finally able to overcome dawn phenomenon.

I find your criticism very odd, @Sarah97 and unnecessary. I found something that works for me and I’m here to share my experience. I did not ask for your opinion about it. This is an open forum and everyone chooses different ways to handle their diabetes, I was only sharing mine.

4 Likes

This.
I’ve had great success with MDI, but dawn phenom is probably the biggest reason I still consider getting a pump. I have long thought Tresiba dosing did not need splitting or really have much concern about timing, but this makes me think about that again. Is the reason for your split success due to low overall insulin need, specific timing, or some combination of those with other factors … ?

I guess I can’t just separate this one method I use (splitting Tresiba) from everything else I implement in order to tightly control my T1. This month I celebrate my diaversary of 33 years and I have no beta cell function of my own (though I suspect my alpha cells still function somewhat). I eat very low carb (under 30 grams a day), exercise regularly and follow Dr Bernstein’s recommendations in his book Diabetes Solution overall and doing all of this has helped me get a much better handle of my control over time. I have many “tips and tricks” in my arsenal, like not eating 5 hours before bedtime and limiting protein for dinner, but they all go hand-in-hand with eating the way I do and following Dr Bernstein’s regimen.

2 Likes

no, taking more levemir doesn’t make it last longer, it lasts as long as it lasts. Say you take 1 tylenol, it lasts 6 hours, if you take 2 tylenol, it still only lasts 6 hours, take more does not make it last longer. Also, the reason MOST people need to split their dose is…with large doses, typically type 2’s who need a lot of insulin, it pools underneath the skin a big pocket of insulin and does not all get absorbed, thats typically why doses are split it works better. the whole concept of spliting a normal basal smaller dose makes no sense…say you take 6 units, that keeps you flat overnight but let’s say doesn’t last long enough, how does splitting that 6 into 3u am + 3uPM even work…you’re getting less insulin, they certain don’t just stop at exactly 12 hour increments.

That’s not at all how it works. Its duration is dose-dependent. All insulin though, even Regular insulin and rapid-acting insulins will last longer at higher doses. If 6 units kept me flat overnight but didn’t last long enough, I wouldn’t split it into 3 and 3. I’d take 6 and probably take another 6 or whatever I needed in the morning as well. It doesn’t have to be an even split, the beauty of Levemir is you can take more during the day and less at night or vice-versa to meet your basal needs. The UK NHS recommendations are for Levemir to be taken twice/day. I can tell you through personal experience that one dose will not last past 15-16 hours for me, unless I took enough of it that I would be extremely hypo all day and night. I’m not sure what your opposition to this is, it is well-established that Levemir’s duration is dose-dependent and that splitting it makes sense for most type 1s.

2 Likes

Incorrect. This graph shows how the duration and peak of levemir increases with an increased dose.

levimirspeeddose

Hilarious, what an audacious response! Seriously who are you to tell anyone how to speak or what to say. SMH!