Question about Tresiba

During my last check up my doctor was concerned about my A1c being 4.8 because he thought I was having low blood sugars. Which I really have not had in any serious way, but I have gotten into the low 60s and high 50s on several occasions.

I have been using Lantus as my basal insulin for about six years. He switched me to Tresiba because it is less likely to cause lows.

I’ve been using Tresiba for about a week now and I absolutely love how it works. Even when I know I should have eaten and am probably low I find that my meter shows a much higher number than I anticipated.

I am finding that my FSB has been below 100 consistently. I’m also finding that when I bolus with my Humalog as I have been doing all along, it turns out to be a bit too much. I decided to reduce my Tresiba dosage by two units today. I will see if this makes any difference.

So here is my question. Has anyone else experienced increased insulin sensitivity when using Tresiba?

Last year, for four months, I went from a pump to MDI of Tresiba + Apidra. My Tresiba dose went up by 5 units/day versus the pump delivered 14 units. My I:C ratios did not change and my Apridra doses were about the same across the transition. One complicating factor with me, however, is that I also used Afrezza to whack-a-mole emerging highs. All in all my sense was that my meal and correction insulin dosing did not change much going from pump to MDI.

Are you satisfied that your Tresiba dose is not subsidizing the bolus doses?

I’m really not sure what exactly if anything is going on. The first two or three days nothing seemed really different. In fact, it seemed like my fasting numbers were a little higher. But I had been doing some food experimenting about that time.

I lowered my Tresiba dose today because of this; fasting blood sugar today was 74, yesterday 76 previous three days were under 90. It has not been uncommon for me to be in the 90s and maybe once in a while under 80. I have never had this many consecutive days with these results. And I have not changed anything about how or what I am eating. I actually figured I would have somewhat higher numbers today.

In the past I have found that I need to take at least one unit of Humalog in the morning with breakfast even if my fasting number is as I mentioned… When I have done my normal morning bolus since using Tresiba I end up testing and needing to eat at least an hour and a half earlier than I normally would have.

The only thing that I have really changed is going to Tresiba from Lantus.

I switched from Lantus basal to Tresiba in January. My experience has been positive. I:C ratio has not changed. I have noticed that correction bolus using Humalog is much more effective and predictable with this basal.

I also noticed that basal dosage for Tresiba has to be spot on. I am at 20 per day. At 21 I was fighting lows often, at 19 I was correcting highs. I tried each basal dose for 4 days before adjusting.

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For me on MDI before Tresiba I used Levemir 2x/day, which worked well. I use the same units w Tresiba 1x/day. As always, YDMV

I switched to Tresiba from Toujeo in February. To me, this sounds like the problem I was having in that my Tresiba dose was way too high. I had to cut my Novolog quite a bit while fine tuning the Tresiba dose. Now that I’m almost at the correct Tresiba dosage, my Novolog needs have returned to about what I was using before.

As @John58 mentioned below, I have also found that my dose needs to be spot on. 14 units was too much but 12 was resulting in too high numbers. Last night was my first dose of 13 units so I’m hoping that will work for me. Although many say that the switch between the two should be a 1:1 ratio, I was taking 25 units of Toujeo and am now taking 13 of Tresiba.

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So first of all, congratulations on such an amazing A1c! Most endos are obsessed with their phobia of lows, but that’s because they often don’t understand the benefits of minimizing variability through the right choice of foods and activities. It’s a conversation my local endo has given up having with me. He used to give me the stern fatherly talk about how risky this is, I’d then show him my Dexcom numbers with a standard deviation that rivals most non-diabetics.

Tresiba is an amazing insulin. From what I’ve read and experienced myself, it does take several days to dial in the right dose. It is remarkably consistent, and that was my problem with it, my body isn’t. I need more at night than during the day, so I had to switch back to the split Levemir dose.

What I also noticed that my TDD basal dose did go up with Tresiba, as did my weight. Just shows that we’re all different. However, if it works for you, run with it. Just give yourself a little more time to dial it in.

Hey everyone, thanks for the input it has been very helpful. Keep those cards and letters coming in!

I was on 28 units of Lantus and doing pretty well, but I often found myself sub 70 and dropping with any unusual or unexpected activity. Or if I forgot to eat on time (shrug and roll eyes here). I started out at the same dosage with Tresiba and had some, but far less, of the same issue. After five consecutive days with an FSB below 90 (two are in the mid-70s, one mid 60s) I lowered the dosage by two units. Have been doing that for only two days now. I am leaning towards dropping some more, but will give it a few more days before I change.

All in all I am very happy with the results I am getting. Even when I have dropped low it has been gradual and easy to correct. I’m hoping that I can find that sweet spot. I have noticed a definite change in my reaction to Humalog. I normally take anywhere from 2 to 4 units when I bolus. So far it seems that I am needing to short that by one unit to get the same results. Again, just starting this so we will see how it goes.