So I’ve only been on Tresiba for about 2 weeks now.
I’ve switched after about 15 years on a split dose of Lantus (1/3 in the morning, 2/3 at night) in which it worked okay but I’d experience some basal peaks throughout the day that forced me to eat at specific times of day even though my BG would otherwise be very stable.
I get fairly stable BG levels throughout with one dose of Tresiba (taken around 9-10 at night) but noticed a rise in early morning with it (DP) and then somewhat of a rise in the late afternoon, early evening before dinner.
I wonder if splitting my dose, similarly to the way I had it when taking Lantus could help prevent those “mild gaps”—for lack of better words, in coverage. Has anyone here tried that? What was your experience like?
A side note: I eat very low carb, and basically follow Dr. Bernstein’s 6-12-12 rule though due to DP tend to skip breakfast on most days.
I LOVED Tresiba, but during the afternoon hours I require more basal insulin for some unknown reason. I would always dose my Tresiba in the morning and never tinkered with a split dose. I think some have on here so I’m sure they will share.
Unfortunately, I went back on the pump because of the afternoon rise and the ability to have an adjusted basal rate during those hours to control it.
Keep us updated if you figure out something that controls that spike. I don’t mind the pump but like I said I loved the Tresiba (except for the noon to 4pm time frame).
I have been using levemir. Do you guys have any concerns with tresiba with any long term side effects. Due to it being relatively new. I just got a sample pen from my endo and we to try it.
I don’t see much potential benefit to splitting tresiba doses, but that’s just me… Trying to tweak something with something like a 24 hour half life in order to counteract trends that only last a couple hours seems like it might be a fool’s game. I’d be more inclined to try just raising the dose and snacking accordingly during times of greater sensitivity to prevent downward trends… Or otherwise trying to tweak other variables, eg when/ how I excercise etc. to try to level things out…
I don’t think “eating for insulin” is ever a good idea. Having to do that is an indication that the dose isn’t right. One of the reasons I switched from Lantus was having basal lows that forced me to eat/snack when I didn’t want to.
I believe I can make insulin work for me and my needs, not vise versa.
As for exercise, I already do an hour of light workout every night immediately after dinner (anything more strenuous spikes me) which used to work at curbing the effect of DP when on Lantus, but has no effect on nighttime/morning BG while on Tresiba.
I ended up taking more tresiba than lantus for quite a while… Like 6+ months? Or so… Then seem to be taking less more recently, not sure what to attribute that too…
Not saying you should have to eat for your insulin, but am saying I think that trying to level out hour-hour trends by splitting up a basal that lasts several days seems like a wild goose chase to me… I have found some success in altering what time of day I take long acting, and altering what time of day I exercise… And while eating for insulin isn’t optimal, it’s kind of one of the primary variables within ones control.
Hey Sam. Man I loved it too, except for between 12-4pm. I just ran high constantly and quite frankly it beat me down. The temp increase a pump allows just keeps things so much more in line. Trust me, I’d much rather stay on the Tresiba, but felt at the end of the day going back to the pump was the best for me.
A small adjustment to lunchtime bolus wouldn’t/didn’t fix the issue? That’s frustrating, indeed. I’m curious what bolus insulin (if any?) you were taking at the time you were off the pump? Or were you using the Afrezza?
Hey Beast - i tried small, incremental boluses and it just didn’t work. It was very frustrating.
I was using a combo of Afrezza and Novolog for my bolus. At first I thought maybe the short acting nature of the Afrezza was part of the problem when using for my lunch bolus, but I tested with Novolog as well and I just couldn’t control the prolonged spike in the afternoon. The only thing that would control it is an increase in basal for about 4 hours.
Mike, I had a similar Tresiba experience but with different results. My primary problem was with overnight highs. I also had a minor issue with late afternoon lows. I adjusted the Tresiba dose size and also the time of day I delivered it. I tried for a few months and could not find consistent success.
I did not try to add a second dose each day; perhaps that would have been the answer for me. My motivation to try Tresiba was to identify and have some experience with an MDI protocol that I could fall back on if my pump was not available. When faced with further experimenting with Tresiba or going back to my tried and tested pump, I chose the pump.
I really like the once per day rhythm of Tresiba and its strong flexibility with failing to dose at the exact time each day. If I’m ever forced off of the pump for any reason, Tresiba will be my first choice for a basal replacement.
I am interested in reading any comments about splitting Tresiba daily doses.
I’m wondering, honestly, if Tresiba isn’t just really, really geared towards T2 more than T1 though, thus resulting in some of the problems in this thread.
• Watching the few commercials I’ve seen, everyone in the commercials is overweight, which seems to imply T2.
• The front page of the Tresiba website mentions a study specifically geared towards T2.
• Further into the site, only 1 out of the 4 studies they list was done with T1 patients.
• The insulin comes in a U-200 form, which again would be mainly geared towards T2.
Hey Terry - no doubt that if I was forced off a pump I would 100% go with Tresiba. Also, if I ever wanted a pump vaca then I would feel comfortable using the Tresiba and would just do my best to control the high in the afternoon.
@Sam19 - yes, I had a couple interesting fasting tests that I did not share here. On 3 occasions I fasted from the night before until around 5pm (almost 24 hours). Each time my blood sugar increased and continued to climb upward during those afternoon hours, peaking around 4:30pm.
Not sure on this one. Maybe it is, but for my issue (spike in afternoon) this would happen I would think with any basal. I just need a little more insulin during those hours and right now (unless I’m missing something) the only way to combat the spike in a stress free way is to wear a pump which allows the multiple basal profiles.
It’s also available in u100 also. My doc initially started all type 1s on u100 and type 2s on u200 but now offers the u200 to everyone unless they need ultra small doses that can’t be rounded up or down to an even number… Eg 7 units isn’t an option with the u200 pen but 8 and 10 are… The u200 pen only has 2 unit dose increments.
Sam, my memory is that you are young enough and haven’t had diabetes long enough to have experienced the days of NPH and Regular insulin. Many of us spent a good chunk of our lives eating to insulin’s schedule and I hope never to have to go back to the days of scheduled snacks between meals!
I haven’t had the opportunity to try Tresiba. My insurance doesn’t cover it and I can’t think of any way I could justify my need for it. If I weren’t a pump user, that might be different. Although I use Lantus for part of my basal, I have never taken a pump vacation and have never wanted to.
But I am always interested in reading the posts of those who you who are trying some of the new insulins and therapies.
You’re right I missed out on that party. I do have a SHTF stockpile of R and NPH but I’ve never used it. It doesn’t sound like much fun… My sense is that the gentle downward trends that taking a little more tresiba might cause would be in no way comparable to the “eat now or die” sensation that I’ve heard NPH described as…
