I don’t envy you this challenge. I guess I’m lucky in that I don’t suffer the same side effects. Trulicity makes me nauseous, pretty regularly, but it’s getting better. I don’t know if nausea is also a side effect of Tresiba, but I would assume it is.
I can certainly understand your hypo-phobia. I also had some scary lows pretty soon after my diagnosis, and at the time I didn’t really know what to do or how to respond. Luckily I made it through the night without issues. And like I said before, with time I got used to the lower-on-average numbers.
I’d say that waking up at 92 and then returning there after eating is a pretty good place to be. The nausea, however, sucks. Have you asked your doctor about this? Also, have you asked your doctor about a Dexcom or other CGM? It makes figuring out things like insulin dosing so much easier. I know it’s cliche to say that it’s a game changer, but in this case it certainly is.
75 to 120 mg/dl does not seem off to me, that’s about my target range. I also use Tresiba as basal and I also had a bad episode with Lantus. That led me to Levemir, and then now to Tsba.
But I don’t feeel nauseous when I am low (or ever), even when I am in the lower part of my “in range”.
I hope you figure it out!
I’m not sure what the nausea is from. I’ve always had chronic nausea, but it’s been controlled. I haven’t had many issues, it really has just popped up when I’m running below 100 for an extended period of time. If it continues, I’m bringing it up to my doc; could be Tresiba, but then I would think it would be constantly, so I’m really not sure. It’s just not fun! And unfortunately, my insurance doesn’t cover a GCM or anything, and I can’t afford it out of pocket. Luckily, they cover my insulin pens pretty well but that’s about it. I use a Kroger brand meter and test strips because insurance just doesn’t cover any supplies; not even pen needles. It sucks!
Thanks! I hope so too. And I know 75-120 doesn’t seem off, but my issue us dropping from something like 120 to 75 within 15 minutes for no said reason. It’s just being difficult. Luckily today was a lot smoother and steady! I cut back a little on my bolus amounts and am trying to really figure out my insulin to carb ratio. Used to be 1u per 10 carbs but I’m aiming more towards 1u per 15g, and that seems to work a lot better, thankfully! but I also ate a snack before bed last night without a shot. 18g of carbs seemed to keep me normal but steady and without drops during the day. Might have to stick with doing so!
I use the Freestyle Libre. It’s not as high end as a Dexcom but it has worked pretty well for me, the reader is about $89 and the sensors which last 10 days are $42 cash price. My CVS actually applies some sort of discount that brings the price down a bit more. I also get my pen needles from Amazon for about $14 which is way better than the $40+ at the pharmacy.
That sucks that your insurance doesn’t cover a CGM. I wish I could tell you to switch insurance providers, but we all know how difficult that can be.
I also get my pen needles from Amazon. I think the ones I use are like $13 per 100, which is pretty darn cheap. They aren’t the highest quality, but hey, they get the job done.
My insurance only covers One Touch strips, which I don’t like. So I started using a Dario meter and just pay cash. Their strips are about $80/300, which isn’t too bad. It works with my your smartphone, which is cool. I’d certainly recommend it over the One Touch.
Yeah I’ve looked into that one, but unfortunately can’t even afford that one at the moment. Maybe one day! I’m trying to make due with what I have though, and so far I’ve done pretty well. It’s annoying to test constantly but I’d much rather know what my levels are than to not test enough!
It does! And my husband actually just got a new job with better insurance than we had previously, which I’m thankful for since it covers my insulin. However, still doesn’t cover supplies. It’s sad that a lot don’t, but I’m trying to make due with the tools I have! So far I’ve done okay without, I’ll keep trucking along for now. And I get my pen needles from walmart, pretty affordable, and my test strips are $22 for 100 from Kroger so that’s good. I was looking into the relion brand from WM but the one near me doesn’t stock the strips enough and are the same price as Kroger, so I went with that one. I used to use the Freestyle lite meter on my old insurance, but the Kroger one seems to be pretty close from what I can tell.
Hi, just wanted to say thank you for this thread. I am having the same problems with tresiba. I used to take levemir. Severe nighttime lows. I have reduced my tresiba amount from my levemir amount from 25 to 15. For first time it seems to be working. But the swings are different from what I’m used to. 161 at 11:30, 186 at 1:30 and 128 at 4:00. I seem to be seeing this a lot. Sharp decreases that are not related to what I’m eating; meaning I’m feeling I need to eat and eat and eat just to cover this medicine tresiba, and I don’t like that. When it was 186 I ate two pieces of 90% dark chocolate (6g carbs 11 g fat). I normally never had to eat when my sugar was high, but with tresiba I feel that I should. Yeah it balances out, but it keeps going down, like all the time. I’m not used to that. There was one night when my sugar was 137 before bed when I was taking 25 u of tresiba, and I ate two full Twix bars. Woke up in morning and it was 83. I mean come on! I know exactly what you’re saying. It’s good that you are aware of certain situations of your own that do affect your blood sugar. I have been having trouble with that, like at times when I’m asleep which is making me more nervous with tresiba. Thanks, and I hope everything is going well.
What is the context for these numbers? Did you eat anything after dinner? Did your blood glucose return to normal range after your evening meal? Like < 144 (8)?
Did you look into basal testing? I’m here to tell you that basal testing works. It’s something we all need to learn how to do. Once you get your basal well calibrated to your body, it is possible to then make some changes without having to do the full basal tests again, especially if you use a continuous glucose monitor or CGM.
Tresiba does not have a bad reputation for causing lows. You may have read that somewhere on the internet but it’s just not true. You are a unique metabolism and you may not be able to tolerate it, but you can only discover that with personal testing.
I totally get that you’ve been frightened by recent hypos and are not sure what to do. When you get down to it, there are very good reasons for most hypos, we just need to be honest with ourselves and look at all the facts. Sometimes it’s complicated and we can’t discover all the facts. In that case it’s more important to just move on.
Have you considered setting an alarm for 3:00 a.m. for you to check your blood glucose and make any needed corrections? Maybe this would be a good practice until your overnight blood glucose settles down.
I wish you luck. I know it’s not easy and it’s hard to decide which advice you can trust. It looks like your doctor is making rational changes to your Tresiba dose based on your bad overnight hypos. You will feel much better once your basal doses produce good results and you can confidently sleep through the night.
Have you talked with your doctor about getting a CGM? A CGM alarm could have woken you up in time to treat those bad hypos before you seized. I hope you soon discover the solution to this frightening situation.
These were my numbers (the context) dinner time 250, after eating peanut butter crackers and a little juice for a snack because my sugar was 81. It went to 160, and then by dinner went to 250. Took 8 u of humalog as per my sliding scale chart. Ate full plate of tortellini with just plain 100% tomato sauce, little olive oil, some Parmesan cheese, some raw spinach, and some garlic bread a normal serving. Typically I would not think of eating dinner with a glucose of 250, but I did. Post eating, my sugar was 107. I said great, it all evens out. I even had another piece of garlic bread too. Around snack time a little before, my sugar was 72. These are the swings that I’m talking about. My sugar does not typically go to 72 after eating a big plate of pasta and garlic bread. So I had two slices of cheese with an apple and some unsalted pretzels. Serving sizes. Then I go to 161 before bed. I say ok. Take my 15 u of tresiba. Wake up a couple hours later, and first thing I think of is test yourself, because I am nervous. My sugar is 186. I say ok well that’s better than 60s or whatever. But I still think eat something. So I ate 2 pieces from a bar of 90% dark chocolate. Wake up again 3 hours later my sugar is 128. Well ok, I’m thinking at least things worked ok this night. Another hour later 123. Ate breakfast. What I’m saying is tresiba is making me think about eating in a way that is worrisome and I’m not sure it’s good. If my dose was not changed by my doctor imagine what would have happened again last night. I have never in my life had a hypoglycemic reaction where paramedics needed to be called and revive me when taking only 5 u of Bolus insulin for the whole day and eating 3 meals. Never. It’s unfathomable for that to happen, and a life jeopardizing risk.
Yes at the moment my benefits did not at first cover a CGM, but I’m talking or really waiting to hear back from a company to set me up with a dexcom meter. There are ways around getting one. I’m in the process of doing that.
Thank you Terry, an alarm is a good idea. I really like this website. Sometimes we don’t find the right conversations to have you know. It definitely helps to think about things and talk about things with people who do understand and are willing to talk.
Some people in your situation might consider eating fewer carbohydrates, at least until they can restore some semblance of control. High carbs mixed with high fat can further complicate the post-meal situation. Many of us use a reduced carbohydrate diet to help us control our blood glucose. It’s a very personal decision that’s entirely up to you.
A green salad with chicken, steak, or even hard boiled eggs added would likely produce much more moderate blood sugar swings. This is a controversial issue and people hold strong opinions on this topic. I just wanted you to be aware of it so you can make a deliberate choice for yourself.
Are you taking notes? Writing stuff down can be a great aid in troubleshooting.
I think the sliding scale dosing of your Humalog is the main culprit. I posted a lengthy response in another Tresiba thread you posted in about calculating your total daily insulin need, carb coverage ratio, and correction factor. Most people are more successful at taking bolus insulin prior to eating calculated to cover the carbohydrates than a pure correction dose after the fact.
