I start on Medicare in April 2017, so about a year. I know some people who get Part B insulin with no problems. Others struggle. I do think that it is a money-losing proposition for the seller. I plan to pursue it as long as it is in the regulations, but we’ll see how successful I am…
I woke up at 5:45 this morning and checked my CGM – 189. Ugh! I’ve had some overnight rises with Tresiba, but not for a few days. Maybe I need to up my nightly dose again. But then I thought, " Did I take my evening dose of Tresiba?" I couldn’t remember it.
So I got up and uploaded my CGM to my computer; I log my dose on my Dexcom to keep a record. It wasn’t there. But sometimes I do take the dose and forget to log it. This is one of the arguments that I’ve held against MDI for me. Memory is not my strong suit. And when I take several doses every day, seven days a week, 52 weeks a year, it’s easy to see how they can start to blur together.
I had no positive memory and my blood sugar suggests a missed Tresiba shot so I took my Tresiba dose this morning. I don’t know what trouble, if any, that’ll cause. Not sure if I will take my dose tonight at the usual time.
What I need is a pen with a memory, I know. This kind of thing undermines my confidence in MDI. As I get older, I can see that memory failures will be a continuing challenge. Taking my pills at the correct time is also a challenge. When I used my pump, a memory failure could be quickly cured. If I forgot a dose, I could simply examine the pump memory and go from there.
Hi Terry4. Had you considered getting a Timesulin? https://timesulin.com/ I’ve been thinking of getting one for my Levemir pen.
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That would help me. I’ve decided to use an audible smart phone alarm that rings every day, automatically, at 9:00 p.m. My phone is always within earshot, so I’m hoping this will do the trick. But thinking about my meal doses makes me think I need a pen with a memory also. I take two doses for every meal, one 30-60 minutes before I eat and one at mealtime. I think there’s another pen product that competes with Timesulin. In fact I think it’s referenced upthread. I’ll check that out too. Timesulin just tracks one event, your last shot. I’m thinking tracking several events would even be better.
Thanks for the suggestion, @Trudy1!
I checked out that suggestion above by @swisschocolate for the NovoPen Echo. It also tracks the last event only. I think Timesulin or the Echo would help me.
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Do you know how many times i couldn’t remember whether i had taken my insulin or not? And i am only 20 years old, lol
I could always go back to my Pen and find out 
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Thanks, @swisschocolate. Maybe I’m not suffering the ill effects of aging prematurely!
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I called Novo Nordisk and found out that the Echo is only compatible with Novolog, not Tresiba. So, Timesulin is my only choice. I think I’ll depend on my smartphone alarm for awhile and see how that works out.
Kittens 2-year Planner (2016-2017) Amazon.com
Dixon Ticonderoga Wood-Cased Pencils, #2 HB, Yellow, Box of 12 (13882) Amazon.com
@Terry4 sometimes the best solution is the most simple one. The cute cat pocket calendar and a pencil are a pretty fool proof and timeless method. All it takes is marking an X each day when you take the basal…
For me remembering bolus is nowhere near as challenging as basal because you are reminded to take it naturally every time you’re getting ready to eat.
My advice for getting back on schedule would be to take your next dose about mid-day tomorrow, and then pm the next day, or drag it out over a couple more days to get back on schedule, but I would not take 2 full doses in the same day
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When I talked to the Novo rep, she said when you realize that you’ve missed a dose and at least 8 hours have elapsed since your missed dose time and it is during waking hours, then take the missed dose and resume normal dosing after that. It didn’t make sense to me that if you realized you missed your dose two hours later, that you wouldn’t just take it and move on. She put me on hold twice to double-check with someone when I challenged the protocol. She also made a big deal about me calling my doctor to get advice. I don’t have the same confidence in a doctor.
Maybe I’ll set my alarm for 3:00 a.m. tomorrow to take my next dose. That’ll be 21 hours after the last one. Then maybe 10:00 p.m. for the next and that will be 19 hours later and finally back to my usual 9:00 p.m. dose and 24-hour intervals.
It’s curious that the Novo rep said that Tresiba is designed to be taken at any time of day and I was led to believe that inconsistent timing would not be a problem.
Here’s the advice written on the Tresiba package insert:
Instruct patients who miss a dose of TRESIBA® to inject their daily dose during waking hours upon discovering the missed dose. Instruct patients to ensure that at least 8 hours have elapsed between consecutive TRESIBA® injections.
I think this is what the Novo customer rep was trying to say to me. The 8 hour between doses seems like an extremely flexible dosing schedule and infers an insulin that isn’t likely to cause problems with stacking. I might resume my usual dose tonight at 9:00 p.m. and test it out. I’ll have my CGM and an alarm set for mid-sleep to check my sugar.
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Another thing I used to do was have an alarm clock set in my kitchen to go off at 9:30 every day-- I’m always home by then so I always heard it and it prompted me to take my basal
Did the rep at NovoNordisk specify as to why the Echo is only compatible with NovoLog? I can use it with Tresiba and have no issues. Is it that in the U.S. there is no penfill version available of Tresiba? this is the only reason i could find, as my Tresiba vials are exactly the same as the NovoLog ones.
I didn’t question her with full knowledge of pens. I’m thinking because Tresiba only comes in pre-filled throw away pen. In other words I don’t think we can buy the 300 ml replaceable cartridges. I would prefer to use a system with less throw-away stuff. If I make a decision to convert to Tresiba for the long haul, I’ll have to ask Novo Nordisk USA about the replaceable cartridges.
Update: I called again and found out that Tresiba is only available in the USA in one form factor, the Flextouch 300 ml disposable pen.
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weird. if they produce them, why not sell them in the U.S. as well?
i think @meee has a way of taking flextouch pens apart so she can put the levemir cartridges into the junior pen for half units, not sure if she still does it and if you are willing to try that.
pharma concerns always make stuff so difficult. why would they keep something away from you guys if they produce it for other parts of the world?
I imagine it has to due with the burden of the lengthy and cost prohibitive FDA approval process that has to be gone through to even just package the same med differently— if the majority of their customers are content with pens, there’s really no incentive for them to jump through the long series of hoops to get a different packaging approved. Beauracracy at its finest.
@thas also has a technique for taking apart pens-- None of these elaborate practices are really in keeping with my own personal preferences for pursuing the ultimately simple protocols that are ideal to me though…
You can always set a recurring alarm on your smart phone to go off every day, or use a med reminder app that makes you acknowledge you’ve taken your med before it stops pestering you also— I believe such things exist?
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When I was using pens/mdi I had a lot of the plastic pens because my dose lowered and I would saw open the plastic around the cartridge with a kitchen knife and then put that one into my novopen echo. At some point I stopped that because it seemed like maybe the cartridge didn’t work as well or I just had used up all my plastic novolog pens and I used the prefilled cartridges. I still get them but I also use the vials now too since I’m on the pump.
All it takes is a flash clipper (or wire cutter or even a pocket knife) and a little patience… 
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I know this is probably a supremely dumb question BUT . . . where do I get the Novopen Echo? Do I need a script or do pharmacies have them? I’m searching and searching on where to buy and am getting nowhere.
For anyone in US using it - where did you buy it?
I bought one a couple years ago by prescription, so I got it at the pharmacy. I they may have had to order it after I gave them the prescription.
@mikep – I checked the Novo Nordisk USA website as well as the Novo Nordisk Global website. When I did a search on “echo” with both sites, I got hits with the global site and none with the USA site. I’m curious what you have in mind? If you can get the Echo, will you extract the 300 ml tube of Tresiba from the Flextouch pen and use with the echo? That seems doable from other comments here. Maybe you’ll need to enlist the help from an international member of the community?