Lantus will run out soon, so I can try Tresiba

Type 1 and LADA
#1

… and I want to be prepared.

From an earlier posting, I know that adjusting Tresiba can take a long time, which make me a bit nervous. Furthermore, it is unclear to me if I should rather be taking Tresiba in the evening or in the morning.

And, I am honeymooning. Currently my basal is higher, 9 units Lantus daily, because I was under stress and could not sleep much, but when I sleep better, it can drop down to 8, or even 6 if I move around a lot. Given these small amounts, I was told here that not even Tresiba might last 24 hours … does this influence the time of injection? Should I split it?

Any other suggestions and tips for my transition to Tresiba?

#2

I think you will do fine on any basal. Even though you take small amounts, you are honeymooning and it’s likely your pancreas is producing enough insulin to compensate for when the basal runs out. I took around 10 units of Levemir once a day when I was diagnosed and don’t remember having a problem. Today I need around twice that amount and I don’t think 1 shot of it would last 24 hours. On my experience with Tresiba it was much stronger a few hours after taking it, would peak around 6-9 hours after injection, and then fade away. It definitely made a difference if I took it morning or night. For other people it’s flat and lasts, so I think you just have to try it, see what happens and experiment. If you don’t like it try Levemir, I think it is a very consistent basal that doesn’t get enough attention.

#3

Yeah Levemir is another choice I have been looking at. It seems to be a good option for those who have irregular activity levels, because you inject it twice a day, so adjusting basal is easier with it.

Also, Levemir and Tresiba both work by binding the insulin to the albumin in the blood, which means no “Lantus Lows” (these are another reason why I am tempted to switch … the stories about these lows are really scary).

I think I’ll inject Tresiba in the evening for now, and gradually move it towards the morning. It would be ideal as part of the morning routine you know. But what you describe - it being stronger a few hours post-injection - makes me wonder if there’s an optimal time to cover the insulin resistance in the morning which is typically elevated in people (dawn phenomenon and all that jazz).

#4

I take my Tresiba at about 9:30 in the morning and I have the oddest occurrence every day. At 6 am or so I experience a very sharp drop in my BG (100 mg/dl) that lasts for a couple of hours. Now keep in mind that this is at about the 20 hour mark and by all rights Tresiba shouldn’t be peaking at that time. I know it isn’t a matter of too much Tresiba because when I’ve done basal testing during the day my BG’s are usually very stable and if I do try reducing my dose I’m high all day and all night.

So, either the Tresiba is peaking at 20 hours or my body gets extremely insulin sensitive at 6 am. Just thought I’d give you one of the quirks I’m experiencing even though I think it’s a really good insulin. Oh, those Lantus lows I do not miss those. I was on Lantus for almost 15 years and no Dr. ever explained why I was having unexplained lows and highs.

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#5

Odd. I’ve never heard of anything like that. Diabetes is just weird :slight_smile:

The Lantus lows are another reason why I want to try out Tresiba now, because currently, I only need very small dosages, so if a Lantus low happened now, it would be bad, but not so bad. However, if I had to for example inject 16 units instead of 8, it would be a very different story.

#6

It’s likely the Tresiba. I experienced this too, though after taking it at night instead of mornings, and it is the opposite of what happens to me on a pump or Levemir. I wonder if in certain body types the supposed 24 hours of pure flat basal fun just doesn’t work. I know some people are completely stable on Tresiba, but this wasn’t the case for me or for a lot of others based on comments I read.