New to Tresiba, had major side effects

Treatment Insulin
1

I started on Tresiba this morning(10am) as I’m working on transitioning off my pump(been on one since 1980). Kept my pump on a lowest basal rate for today as I wanted to wait a day or two till the Tresiba built up as I heard it takes a few days to “overlap” and get the full effect. Within 2 hrs of my injection I was shaking, dizzy, weak, spacey and nauseated. I felt trembly and had to lay down off and on. No lows however, so it wasn’t low sugars. I had only 2 higher blood glucose readings and kept a close watch on my numbers and would take extra to keep it under 200. However, I’m very concerned about taking another dose tomorrow, unless this is something that will settle down with time.

Did anyone else have these symptoms?

2

I have never used a pump. I just switched from Lantus to Tresiba. I made no accommodations for the Tresiba to build up. I saw no difference in the transition between the two.

It sounds to me that you are essentially doubling up on your basal. I would try without the pump if it was me. I did find that I had to dialback my insulin to carb ratio just a bit after I started Tresiba. It was like I became more sensitive to my Humalog.

3

I neglected to write that I actually took my pump off when I began the Tresiba. I only put it back on later in the day when I had 2 200’s and when I did, I dropped my basal all the way down to the lowest amt and my sugars leveled out. These things happened within the first 2 hrs of taking it. I felt like I was going to pass out and could barely walk. My sugars were perfect during that time 89 and 122 and 124. Only later did they shoot up and stay up. I took it off when they came down.

4

That is very strange. If it only happened that one time I guess it really doesn’t matter, but things like that are unnerving.

I’ve seen quite a few people say that they have “ditched their pump” in favor of Tresiba and Afrezza. After using it for a little over a month, I can understand how that would be so appealing.

5

I have felt like this all day. It’s eased off now but it’s been over 12 hrs since my injection, so not sure what tomorrow morning will bring. Thanks for your reply.

6

I would go back and see the Dr @Susanelizabeth. I know of other people who have been alergic to insulins and although the insulin still worked like insulin the side effects were devastating. I personally think while it is still working perhaps go back to the Dr to at least talk to him/her about it? get a prescription for one of the other long acting insulins if the Dr is concerned also about the tresiba?

7

I’m not so convinced this is an allergic reaction. I suspect it is your transition. The onset of action of Tresiba is 30-90 minutes and it reaches a peak at about 2 hours. It may be that your pump basal was still acting when the Tresiba peaked, which induced a low. A better strategy might have been to stop your pump before your Tresiba injection (remember that a rapid insulin has a 3-5 hour duration of action). You could probably could have stopped you pump 2 hours before injection and avoided any stacking. This should have been something that your doctor reviewed with you. I’m sorry you had this experience.

And as you note, reach full cumulative effect takes 2-3 days, so at an ideal dose you may experience highs in the first 1-2 days which should be corrected. After say 3 days if your fasting blood sugars are high/low than you should adjust your basal up/down appropriately. As always do consult with your doctor on this.

ps. I’ve been on Tresiba for more about a year.

1 Like
8

Solid advice Brian_BSC. I mistakenly stacked when I changed from Lantus to Tresiba about a year ago and had hypo reactions too. Took an entire day off basals (yes it was tough) and restarted Tresiba - no reactions. I also dropped my daily basal dosage by 25% for first 3 days until I knew how it would react in my system, then went back to full dosage. I am currently on U-200 Tresiba at + 80 units daily

10

Thanks everyone! Today is MUCH better! Last night it hit me that at the same time I injected the Tresiba I had just returned from picking up another pair of eyeglasses(this was my third) and the trifocals were horribly off since they just popped them into new frames to see if I could wear them(long story). The two bottom lenses were off, but she wanted me to use them for the entire wkend to mk sure I could wear them. She said just wear for for distance, but I kept them on for 2 hrs and during that time is when I got more and more dizzy, which is why I think the other symptoms kicked in.So far today, there have been NONE of the problems I had yesterday! It might have been some overlap from basals, but again, I had no lows during the time I was feeling so punk, only normal ones, so who knows?

I had a wonderful 1st night! I kept the basal at 00.00, and only kept my pump in so I could bolus for extreme highs during the night as seeing those little lines are difficult for me even in the daytime LOL Ran a little over my normal target range all through the night(145, 165, etc) with only one more slightly elevated glucose of 173 at 4am which is the only time I took a very small bolus, much less than I normally would. Woke with a 132! I was thrilled and felt so hopeful. At 9:25am it went from 140 to 246 and 248(still fasting) so I took a small amt, dropped to 220 one and half hrs later, took a tiny amt again and it was back down to 154. Next was 111, Yeah! However, after lunch, I sat for 2.5 hrs watching a movie and it went to 199 on one meter and 201 on the other(doing ck on my meters since 2 are older). Took small amt and now I’m down to 146.

I’m feeling soooo hopeful about today and my numbers. Yesterday I took the Tresiba at 10am, today, 8am, same amt. Since I ran over my desired numbers I thot about upping 1 unit in the a.m. IF tonight’s are running a bit high again, but don’t want to react too quickly and cause lows since it takes several days to lap over with tresiba.

I have several friends who take 1-2 fast acting in the morning to counter DP so if my numbers stay consistently high in a few more days, I might do that if my numbers are normal in the nighttime(highest basals were at 9am and 8pm).

I want to be patient, ride it out, taking into account IOB, DM, stacking and etc. I so appreciate everyone’s feedback because after trying Lantus a yr ago, this first 24 hrs was a piece of cake! Reading the shares/topics about this really helped and I am determined to stay the course with this and get off the pump. My skin demands it LOL. Thank you!
Susanelizabeth

1 Like
11

Can I ask what dosage your doctor put you on in comparison to your basal amount on the pump? My daughter was started at 20% less then her pump basal amount (Novolog) so her pump is 15 units daily basal and we started with 12 units of Tresiba. Friday I gave 12 and you would think she wasnt on insulin-went back to pump and full settings through the night after all day of novolog correction injections for high 300s and low 400s. Then I found a post on decreasing pump as you go for first 3 days. So yesterday I went to 66% pump settings upped Tresiba to 13units-there was a slight movement in blood sugars and this morning went to 33% on pump and gave full basal amount of pump with 15 units of Tresiba. So she/we are on our 3rd day of Tresiba and today is much better but still have pump on at 33% running just under 250-180s). Thinking I am going to stick with 15 units Tresiba tomorrow and see about decreasing pump to .1 for day so she can just bolus through pump for corrections and meals since she goes back to school…I was SO hoping this transition would be a little smoother-Silly Me!!!

12

My dr is pretty clueless about pumping since I’m her only patient on a pump. She writes the RX for my supplies but I do the rest. She’s a family dr, not an endo, which I prefer. I researched as much as I could and found that some people reduced their pump basal 50% and keep it hooked up when they began their Tresiba. Many said they took about 50-85% percent of what their pump basal was.

The nurse called me to ask how much insulin I took and I explained my totals run from 27 total to 44 a day with about 17-25 total basal and yet, she had the nurse tell me the next day to start off with 30 units Tresiba. I didn’t as that would total more in basal than I tk in my total amt of insulin some days. I’ve had more highs today as I guess the left over basal is completely gone. I’m ckg almost hourly at times and just taking tiny amts as I know the T will continue to build. If my sugars are running elevated through the night tonight, I will definitely increase my T tomorrow morning from 17 to 18 or 19. ’

I’m just trying to ride it out and not overtreat at first, plus I’m watching my food intake very carefully. So far the highest I’ve had is a 246, several other 200’s and just running a bit high off and on with a few normals. But, it’s vastly better than Lantus where I raw in the 300’s and 400’s constantly. I’m praying I have a better day tomorrow as my levels build and also when I increase it. Sorry I couldn’t be more help. There are many on this site who could help as they’ve been doing this a long time. God bless!

1 Like
13

Sorry, but am I missing something, I didn’t see that if you guys are bolusing for your meals? I was on pump for more than 20 years and switched to Tresiba and Humalog. The first 2 days my highest was around 275. Took correction humalog and got monitored. Went very smoothly. I hope you figure it out, because the feeling of freedom without pump is fabulous. Oh, I do have a DexCom and this helps me a great deal with the control. Tresiba so far has worked good for me.

14

I don’t have a Dexcom, but ck my sugars up to 14xdaily. Been Type 1 since 1976, pumping since 1980(I’m also a nurse, tho not working now). So, yes, I’ve been taking Novolog for my meals and for corrections. With my pump I had 8 basal and always ran an A1C in the 5’s. Only reason trying MDI now is skin break down and thinking with being on Medicare as of the 10th of April it’ might be cheaper(possibly) and also allow my skin to heal to try MDI again.

However, the biggest issue I’ve had today(again) is I’m having side effects, from the Tresiba. First injection left me dizzy, weak, nauseated and headachy(even tho my numbers were great). It wore off later in the evening.I attributed it to other things, but it happened again today with a vengeance when I increased my dose 2 units. Today’s been much worse and I could barely lift my head without feeling like I was going to collapse, so spent most of it laying down. I’ve used other long acting insulins and fast acting but never had this response to an insulin so I’m not taking it tomorrow morning and will call dr about maybe trying Levemir next after my body recovers from this. I am used to mkg switches and dealing with covering myself with extra insulin, but never experienced any reactions like this and it’s happened both times now, first when I took my first dose then later when I upped it. I so wanted it to work but since it was so much worst today, I’m done.

Glad it’s working well for you JuneBugg as I know it does for many.

15

I’m so sorry to hear you are allergic. I understand that some people are sensitive to some insulins. You will find one that works for you. Until then take care.

16

We have been bolusing meals and corrections. The first day we took pump off and did corrections and meals via novolog pen-LOTS of corrections. That night I put pump back on her for meal and correction boluses. As of today we are running basal on pump at .100 and correcting/meal bolusing through pump. Had a decent night…went to bed 130 started dawn phen. around 1-2 again but stayed under 230. Back in 160s now…which is great for her! Her A1Cs are currently 7.5 pretty much her norm on pump so hoping to get them under 7 would be great! We do carb ratios of 1:5.5 all day dinner 1:6. Upped Tresiba to 19…had to do a lot of correction boluses yesterday too so we shall see how today ends up and anxious to see another night. Feeling positive…

17

@Susanelizabeth I’m so sorry you aren’t feeling well! My daughter has had some REALLY rough days and nights the past month too. It is so frustrating playing this guessing game… Hope it leaves your system soon and you start to feel better!!!