My son has more stable blood sugars with Afrezza and Tresiba than he did with OmniPod and Humalog. It reduces highs more quickly and eliminates lows. His A1C had been running 7.0-7.2 and declined to 6.6 after two months on Afrezza. It requires a different mindset, but we learned a lot by watching videos at AfrezzaDownUnder.com. The learning curve was a tough week to two, but was greatly aided by our CGM. Son’s quality of life much improved. I can be more specific on any particular aspect if you are more curious. We absolutely love Afrezza.
No, I reduced the dose by 1/3 in the end which seemed to be the perfect setting for me. You MUST reduce the dose, maybe even by 40% at least during the first three days in order to avoid long term hypos.
The dose should then be adjusted by 1 unit up/down each 3 days as it takes 3 days for Tresiba to reach its full effect.
Also once you start, reduce your Toujeo by 1/3 each day, meaning that on day 3 you will have full Tresiba effect and zero Toujeo in the system. Same is to be done with the pump basal.
Just to clarify- if you are using 30 units of Lantus, you will most likely need 20 units of Tresiba.
Now I’m super confused. So I take toujeo and Tresiba at the same time?
I take 25 toujeo now.
I understand your confusion with @BK1112’s suggestion for changing from Toujeo to Tresiba. It seems that he suggests ramping your Toujeo dose down as you ramp up your Tresiba dose in a complemtary step up/down fashion. I think that’s more complicated than it needs to be.
I would simply use Toujeo one day and then swap in your best guess for an equivalent dose of Tresiba the next day. Keep your emergency glucose handy and check your BG more than usual to see how things are going. I think it’s reasonable to set an overnight alarm to check at say 3:00 a.m.
Don’t be too quick to change your Tresiba dose. Let it ride for at least a few days before increasing or decreasing. Keep some records so that you can make a good adjustment when it’s needed.
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You can either go my way or Terry’s way. With my way you are minimizing the risks to almost zero, BUT it’s a bit more complicated. With Terry’s way, you will most likely go high during at least the 2 initial days, but it’s more simple.
Here is how I did the switch:
Calculation: My pump basal (or your Toujeo) was e.g. 30 units. I know that there should be a reduction by 1/3 when switching to Tresiba. That means that my Tresiba dose should be 20 Units. I deduct one additional unit just to be on the safe side, i.e. better high than low. So I start with 19.
Day 1 11 am: Inject 19 u Tresiba and decrease the basal/Toujeo by 1/3 or 33%, i.e. inject 20 units. Day one effect of Tresiba will be 33% of it’s actual power.
Day 2 noon: Inject 19 u Tresiba and decrease Toujeo by another 1/3 or 33%, now injecting 10 units. Day two effect of Tresiba is now up on 66%.
Day 3 10 am: Inject 19 u Tresiba only. Now the Tresiba effect should be on 100%.
Measure the blood sugar. If high, increase to 20u on Day 4, if low decrease to 18u on Day 4. Then measure the sugar and adjust again Day 7 if needed, but by 1 unit only.
You may also have noticed that I injected at different hours. This is because Tresiba gives you the possibility not to be exactly on the hour when injecting thanks to its long lasting effect. I have tested the range of +/- 3.5 hours without any negative effects on the bs stability.
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I switched directly from lantus to tresiba without any complex transition plans… It was easy for me, same dose, stopped lantus one day and started tresiba the next… Worked fine for me
I switched same dose of Levemire to Tresiba. It worked for me😊
Thanks for everyone’s input it helps greatly. I decided to do the kiss principal since I’m lazy and just do a few under my usual dose. I figure if I get lows then I get to eat a lot of delicious candy and cokes all in the name of low bs and my wife can’t say anything about it. 
I’m very excited for the new medication, I feel like I got a new toy. Speaking of toys, I bought a new roku3 for the first time off my favorite shopping place, Amazon prime. Random fun fact.
If Tresiba sucks I blame all of you.
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It sounds a lot like Apidra but an inhaled version. I hated Apidra as it never lasted long enough for my meals. It sounds very interesting. I’ll do some searching on this site for more info on it. I’m curious to try it but if it’s like Apidra then probably wont be for me. Never know until I try though!
Afrezza provides great flexibility. For a quick acting meal, one cartridge will do the job. But for a fatty meal, like pizza, my son will use one cartridge, then inhale another one 20-30 minutes later. He has learned what works best through experience. So you needn’t worry that Afrezza won’t last long enough. It’s flexibility to accommodate any meal is one of its advantages. Also, the cartridge units, 4, 8, and 12, are NOT equivalent to injectable insulin. We think of them as S, M, and L. Good luck!
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It’s all in the timing with afrezza… I take it about 20-30 minutes after I eat, which allows a tremendously more flexible life… But I agree if you’re a super slow digester it would be less advantageous and more often require follow up doses
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I was just reading through your posts sam19 when you first started on it. Your numbers are impressive, makes me realize what a lazy diabetic I am, I don’t count carbs, I just guess.
I already called my dr and told them I want to try it and I set the ball in motion to get the dexcom G5. I’m revamping my entire regimen. Day 2 of Tresiba and so far so good!
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@LADA_lady My insurance does not cover Tresiba, but what I do is use the GoodRX discount card first, then the NovoNordisk discount card which takes up to $50o off each prescription. This reduces the co-pay to $15 for three 3ml pens of 200u/ml. Not sure how much you need, but that covers my entire monthly prescription and then some.
Thanks… I hope you like it… Just remember it’s all about timing with afrezza that really is the key… If you have a reasonable handle on the timing, wild guesses as to the carbs are more than adequate
With these 3 concepts in mind, I believe perfect control is possible with afrezza
- take enough
- don’t take way, way too much
- figure out how to time it right— this is the only part that actually required paying attention
Once I got a handle on timing I pretty much stopped carb counting altogether, and my results stayed the same…
Good luck and please share your experiences with it.
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Hi Jane -
My 15 year old son has T1D. We have been looking for a doctor to prescribe Alfrezza. Can you recommend a doctor? Everyone I have asked has said no since it’s not FDA Approved for pediatrics yet,
Thank you,
Julie Husic
Hi everyone,
I started Tresiba on August 2, and so far it is not working at all, at least it doesnt give me a headache like regular insulin. In the paperwork that comes with the Tresiba it also says it lowers your potassium, which I normally have low blood pressure, but since taking the Tresiba my blood pressure has gone up. So I started taking potassium with the Tresiba. Normally any insulin doest work for me, my doctor is suggesting a gastric bypass…so I dont know where to turn now, I do not have any problems like retinopathy, or neuropathy, just high blood sugars, from 209 in the morning to 518 in the evening. Does anyone else have this problem? Thanks for listening
From August 2 until now is not enough time to adequately determine if it’s actually affecting your blood pressure (seems unlikely) or if you’re just happening to have higher blood sugar those couple days. It’s also not enough time to figure out a proper dose… Maybe it would be good to mention to your doctor the sugar levels you just mentioned here and ask about increasing your dose? Also, are you only taking tresiba or are you taking a mealtime insulin as well? Clearly some adjustments are needed.
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Is there a way to “private message” you on this website?
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Hi Sam,
I have had diabetes since 1994, last 5 years sugars have run 300 to 600 and above, no insulin works on me, only gives me bad headaches so I cannot function. My new primary care just started me tresiba, which amazingly does not give me a headache…yay, now if it will just lower my bg, I am going to mention to him about Dr Berstein thinks it should be given twice a day, I think that might work better for me. I am allergic to metformin and nothing natural works either. My sister also has the same problem. She has high blood pressure, and I have low blood pressure. One of the side effects of Tresiba is low potassium.which would raise blood pressure and my blood pressure has gone up since taking the Tresiba. I go back to my primary care on Aug 9th and I will address these questions with him. I also have an appointment with a new endocrinologist on the 17th of August. However my experiences with endos is that they think I am a conudrum…so their suggestions are gastric bypass even though I am not obese. I have all the symptoms of gastroparises but no one seems to address the vomitting I have had off and on for 3 years now. Thank you for your kind response. I have also tried the afrezza and it did not work, just a headache.
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Just click on the icon image of the person you want to private message. Then click on the message icon and that will open up a screen to enter your message.