I made the switch to Tresiba from Levemire on April 27th. My A1c was 6.7. My new A1c is 5.8!!! I have never, ever been this low. The other great thing is I have not had 1 nighttime low, not 1 which is amazing to me. It is so nice to go to bed and not have to worry about lows. The only negative. I seem to have is extra fat around the belly. Not sure yet what the real cause of it is. Overall, I love TRESIBA!
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Awesome, I love it too. Iād encourage everyone to at least get a couple free samples and if they like it but insurance doesnāt cover they can have their doctors document the medical necessity to go out of formulary. I suspect soon it will totally replace lantus and levemirā¦ Itās just way better stuff.
In order to keep the cost down, you can download a coupon for Tresiba which, when used with insurance, your co pay is only $15. This discount is ok to use for 2 yearsš I agree, Tresiba is the basal insulin of the future.
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The discount can be found on the Niorvo Nordisk website or google itš
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Thatās great Gail, Iām glad it has worked out for you so well. My cde mentioned my doctor was switching people to that but due to my lows and other issues Iām afraid to even try tresiba. I would still be on the pump for bolus anyway If were to ever try it.
An āuntetheredā approach with Tresiba as basal along with fast-acting insulin in your pump may be ideal for you. If youāre afraid of lows, just start with a very low dose of Tresiba (and be willing to do a lot of corrections for awhile) until you dial in your dosage. Or you could just use an āon-purposeā low dose of Tresiba and utilize variable temporary basals with your pump if you have frequent and significant variability in your BG levels due to digestive issues, etc. Just a thoughtā¦
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Why? It seems would defeat the purpose? The whole concept of 1x daily long acting super-basal is that it essentiallly eliminates the advantage of a pump, for those whom it works wellā¦
I know a handful of folks (primarily parents of children with Type 1) who use this āuntetheredā approach for one or more of the following reasons: 1. Their child was already in extremely serious DKA when first diagnosed (weāre talking hours from death) and they are predisposed to experiencing DKA at the slightest misalignment of the D-stars (including but not limited to forgetting to correct or bolus, miscalculating doses even slightly, site failure, pump failure, growth hormones, viral pre-illness, menstrual cycle hormone fluctuations, etc.) even with very close management; 2. Constant, ongoing pump setting adjustments, including temporary basal rates, and close and frequent monitoring does not eliminate enough unpredictable āstickyā highs; 3. Frequent swimming and other water activities, especially during the warmer months, which necessitates repeatedly disconnecting the pump (unless one utilizes the almighty OmniPod), results in pesky highs.
One could argue that MDI (even with Tresiba) might be a better option in these situations, but the peeps I know have tried this, and have found that, at least for them, the combination of using a long-acting insulin for all (or part) of their basal needs plus utilizing a pump with its not-available-with-MDI options of using variable basal rates and temporary basal rates works significantly better than using either MDI or a pump by itself.
I may very well end up trying to convince my daughter (whose BGs are currently under about as good control as can be expected with A1cās in the high 5ās to mid-6ās despite the fact that her body is currently a cauldron of raging puberty hormones) to adopt a Tresiba + pump regimen when she goes off to college because there is no way in hell when she is own her own for the first time that she will be capable of the neurotically constant 24/7 (I sleep through the night only 5 nights per year while she is at D-camp) monitoring/correcting/adjusting I currently do.
Addendum: Donāt get me wrong; I am light-years away from being a helicopter D-mom. My daughter started doing her own injections on Day 2 after diagnosis, and she currently does at least 75% of her own pump and Dexcom changes (and used to do even more). But I want to avoid her getting Complete Diabetes Burnout. After all, she has the whole rest of her life from 18 onwards in which to deal with her D essentially solo. As a parent, I consider it my responsibility to shoulder as much of the D-burden whenever and wherever I can while I still can. I donāt expect that, even with the incredible D-tech currently at her disposal, that she will be able to endlessly maintain the extremely close monitoring that I currently perform. But, in general, the more time spent in good control, the better the long-term outcomeā¦
I get what youāre saying, but to me pumping bolus and injecting basal seperately seems like the worst of both worlds. I agree that MDI is safer especially when there might not be immediate access to replacement pumps etc, like in my own caseā¦
Iād encourage everyone to just try MDI as a primary option. Insulin like tresiba had changed the game. I think the prevalent understanding that pumping is superior could really be reevaluated in many cases with new generation insulinsā and itās not a one-way streetā people can always go back to pumps if they preferā¦
But one will never understand the potential benefits of going pump free and mastering MDI as long as theyāre still using a pump.
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The āuntetheredā regimen definitely isnāt for everyone, but essentially it provides a consistent basal dose while still taking advantage of the pumpās features. It makes for less risk of ketones and/or DKA while still having access to the rapid dosage adjustments and greater flexibility that a pump provides.
I have some Lantus (I donāt think Tresiba has been approved in Canada yet, and given that many things take years to get here, Iām not holding my breathā¦) and am seriously considering doing the āuntetheredā regimen myself.
āUntetheredā seems like quite a misnomer for keeping a pump on your body 24 hours a day but not using its primary featureā¦ (Basal)
I have to have 4 hours in between most significant corrections and meals. I know everyone says Tresiba is more stable but Iām terrified to have the mdi type lows I have and no pump to shut off basal. It could happen. Also I am waking up with high bg and ketones still too. I donāt know I will ask about a low dose but I think they will say no due to my weird lows. A few weeks ago I took a nap at 180 with a .4 correction and woke up at 47 an hour later. Today it looks like I almost flatlined while sleeping after being high for hours and hours.
I donāt know what their reasoning was but I need tiny and pretty specific doses for my meals- the pump does all of that for me. mdi wouldnāt work for me at all. And due to lows I had on mdi I would be very scared. With the pump I can just shut off for lows and it helps a great deal. The pump keeps all my records, it figures most things out and I donāt have to inject or carry tons of pen needles around etd. I hate injecting and all of that.
You do use the pumpās basal, you just replace a portion of it with injected basal insulin. You do 50-75% of your basal as a shot, but the other 25-50% is the pumpās basal. The reason for the name is that you can disconnect from the pump for hours at a time and still have a reduced basal rate on board. Otherwise, when using a pump, you canāt disconnect from it for more than 30-60 minutes without checking BG and taking insulin to cover the gap.
That makes some sense, I really just donāt grasp what significant advantages the pump is providing at that pointā¦ i get it if people need to take ultra tiny doses, like fractions of units even when eating significant amounts of carbsā¦
Iād love to see some more people try 1 or 2 week trials with tresiba without a pump and see what they think. Everyone whoās done so on this forum has had pretty great results, although some eventually opted to go back to a pumpā¦ I donāt think weāve seen anyone say they wish they hadnāt tried itā¦
The pump provides lots of things besides small dosing. My primary reason for going on the pump was to deal with dawn phenomenon, which Lantusā flat profile just couldnāt handle. Also, being able to rapidly adjust basal insulin when monthly hormones change is invaluable. But I do have issues with sites failing (even though I use metal sites). I also swim where it would be handy to disconnect my pump (which Iāve tried, but end up feeling sick with super high BG and ketones a couple hours later). So those would be areas where the untethered regimen would help.
If Tresiba was in Canada, Iād try it. I get so sick of my pump at times. I tried a short pump vacation with Lantus a few weeks ago but gave up after only a few days because I couldnāt deal with the extreme swings. I am doubtful a flat basal insulin would work for me long-term, but it would be interesting to try, since Tresiba seems somehow better than Lantusā¦
I agree with you, Sam19. I once asked a mom who manages her two daughters with Type 1 untethered why it is called āuntetheredā because, in my way of thinking (which is, of course the right way to think) you still remain tethered to an insulin pump (or at the very least tethered to a set). If memory serves, people refer to this combination of basal insulin + pump as āuntetheredā because some people disconnect the pump from the tubing and reconnect it only when correcting or bolusing via the pump.
Iāve thought about it for my son for a few reasons. a) Heās such a rough-and-tumble toddler that I feel like he dislodges or bruises or just messes up his infusion sites at least once every few weeks, leading to unexplained highs. If those happen at daycare, he can reach the 300s before I figure out whatās going on, but giving him shots for his many many snacks would be impractical. b)He uses such tiny increments that thereās no perfect basal, even with a pumpā¦itās either too much or too little. So I can imagine that you might be able to get to that just right basal rate if you supplemented with some tiny diluted amount of long-acting insulin.
Still, for me itās not quite worth the hassle yet, and the downside is that if heās trending low you canāt just temp basal 0. But itās an option Iām keeping in my back pocket if all the mysterious site failures donāt subside.
Since I have been on Tresiba my blood sugars stay level in the morning. I have skipped my breakfast and morning coffee and tested every two hours till noon ( Iām an early riser ) and stayed at 121! I used to have to take Humalog upon waking daily. Not any moreš
Interesting. On Lantus I can go to bed at 100, be at 100 at 3:00 AM, and if I donāt take a few units of Humalog, I can wake up at 7:00 AM at 250. In fact, before I got the pump, if I didnāt wake up at 3:00 AM every morning to take a shot, I rarely ever woke up with blood sugars below 180-200. I sometimes have to take insulin when I wake up if I donāt eat (or donāt eat carbs), but itās mostly the pre-waking dawn phenomenon that Lantus couldnāt touch.