From pump to Tresiba

Since I’m using an Animas pump and want to explore all my options before choosing what to do, and since I’ve heard so much hype surrounding Tresiba, I’ve decided to give it a try. (I also intend to try the OmniPod and Medtronic pumps, if I can. Unless of course I love Tresiba and decide not to return to the pump!)

I took my first dose yesterday afternoon, using the total of my pump’s basal rate as the starting dose.

Since then, I’ve been running high non-stop, even with numerous corrections with Fiasp. My lowest reading has been 13 mmol/L.

I’m just wondeirng if others who have transitioned from a pump to Tresiba can share their experiences. Did you run this high for the first days? If so, did you adjust the dose of Tresiba early (prior to three days)?

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Men, sorry no one experience with going from pump to Tresiba but wow, have I talked with many pumpers who have made the change. I have talked with many who rave about the change. They all said that the first week is challenging trying to find the right dose, but once they find it, it works like a dream. I hope for great success for you. I think about it every once in awhile but I think i’ll Keep pumping. I like the fact I can turn the insulin off or way down if needed. Keep us posted on your pump vacation!

I’d also heard people rave about it and stories of people coming off pumps, which is why I wanted to give it a try as part of my evaluation of all options. :slight_smile: To be honest, I use basal adjustments on my pump a lot and will also miss discreet bolusing, so I’m skeptical that I’ll actually give up my pump long-term…but you never know what might happen!!

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I am very interesting to see how it goes for you. As I think we have both been pumping for a long time. I have never taken a pump vacation and honestly don’t know if I could handle it. But I have learned over the years, trying something new or different might be the answer. And I know you know this, but you have to give it time. Good luck and I’ll be very interested in how it plays out.

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I’m interested too, esp how the dosing worked out for those making the switch. I don’t want to leave my pump, but I may have to.

I went off of my Animas pump to try Tresiba and MDI. My pump total daily basal insulin was right around 14 units. I started Tresiba at that dose but found I had to bump it up to about 19 units/day eventually to find the spot that controlled my BGs reasonably well.

I think it’s good practice to allow at least two days to pass before changing your Tresiba dose again.

I was off the pump for five months last year and although I’m back on the pump, I feel good that I have a recent MDI experience to fall back on if the need arises. Prior to that pump break, I had used infusion pumps continuously for 29 years.

The thing I missed most with using the pump is the ability to inquire of the pump’s memory whether I took my insulin or not. I used my Google calendar to aid my memory but I was not 100% with making my calendar entries.

Good luck with your Tresiba trial. I’m interested in how you get along with it.

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Theres a new pen for Novolog/Huamlog that keeps track of IOB etc. InPen…I tried a vacation but did not try Toujeo (Tresiba not formulary). Lantus did not work for me. So I got a new Ping (sigh sigh).https://www.companionmedical.com/InPen/

Apparently we only have Tresiba available in FlexTouch pens in Canada. Which is too bad, because the NovoPen 5 and NovoPen Echo are both far superior, and I’d much rather use Tresiba in those pens (they also have built-in memory).

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For Tresiba, I recommend getting the Timesulin cap of Amazon. It’s not as good as the built-in memory pens, but it does the trick for “when did I last use this?” which is all you usually need for a basal pen.

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We found tresiba needs a full 3 days to show it’s full capability. I would think this especially true going from no “true” basal with a pump to tresiba.

yes I did , iI was on medtronic pump for three years which caused me big issues of redness, itching, I tried everything including sureT but it did not work at all>>> although I had very good control of BS with the pump but this problem was a nightmare for me.
So I switched to Triseba and yes it took me two weeks to reach the right dose and timing and now I am in a dose 10% less than pump and once in 24 hrs (I was earliet in twice a day with Lantus) with flat line of bs if not eating (Which I do most of the time following intermittent fasting pattern) and I am free and not attached with A1C of 5.6

Thought I’d update this thread and let people know that after two and a half weeks of major struggles - I almost gave up several times - last night I decided to try splitting the dose as Dr. Bernstein recommends, and it’s like night and day. I went from a rollercoaster of rarely staying in range day and night (standard deviation of 5.1 mmol/L) to so far today hitting a 12-hour flatline. I have no idea why a split dose would work SO dramatically different from one dose per day, but so far it seems to be. Next week will be the real test when my holidays end and I go back to work and taking an evening course, and then hormones, and exercise sessions (which I’ve been avoiding), so we shall see how all that goes.

When I was on Lantus years ago I had to split the dose and experienced dramatically improved results with the split, but it was nowhere near this dramatic. And I don’t think Tresiba is wearing off like Lantus did, but there’s something about its profile that makes some people benefit greatly from splitting it into two shots a day.

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Let’s hope that trend continues! I know with other insulins, the onset, peak, and duration are all affected by the relative volume of the dose. Since you’re essentially cutting each Tresisba dose in half (or there about), perhaps the smaller volume dose works better for you.

When you were taking Tresiba once per day, did you try to split the dose but take both doses one after the other and use different locations?

In any case, it’s hard to argue with success.

Yes, I did try this. My main problem was that I was experiencing huge drops overnight (6-11 mmol/L) and huge spikes in the evening. I was taking an evening dose of Tresiba, and I felt like the drops could be due to Tresiba being slightly stronger when it was ramping up in the hours after an injection compared to later on (and even the next day) when it was wearing off in the evening.

(I’m taking 2,000 mg of metformin a day, so it’s been suppressing my DP overnight, which used to be a big problem.)

So I’m not totally sure of the exact reason. All I know is that my CGM (set to 4.0 - 7.0 mmol/L) has not alarmed in over 12 hours. :slight_smile:

Of course, this is just one day, so here’s hoping it continues and isn’t just some sort of fluke.

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Wow, that seems unusual, but as @Terry4 says, definitely hard to argue with what works!

Your descriptions of Tresiba activity remind me of when I used Levemir, 2x or even 3x a day to get an “even” baseline. I’ve had no such concerns with Tresiba, but as always YDMV. I wonder also if the metformin could be part of what’s creating the unexpected diurnal response.

Best wishes for the next week – work life always adds a few more variables to the mix.

Jen - that is great news about the split. I had posted earlier last year about my experience going from the pump to Tresiba, it took a while to dial things in, but ultimately I had to go back on the pump. I need to really up my basal in the evening. However I will bring up the split with my doc tomorrow (happen to have an apt). Again great to hear about the approach and the difference you experienced, I never gave it a try but might in the coming the days. On a side note when I was on Tresiba I noticed I needed to keep things stable for five days prior to making a change in the dose, I know they say three but five worked for me. Again keep us posted on how things progress!!