Yes, inertia means resistance to change in state of motion (even if the state of motion is holding still). An important concept, but a difficult one to prove, in diabetes management as well
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Very interesting, cutting edge stuff. Still, remember these reports are anectdotal and subject to placebo effect and other influences. The official FDA product info for Tresiba and Lantus show very steady basal levels over 24 hours, probably similar to what a pump can do. but a pump has the advantage of being able to micro bolus with no additional needle stick and to lower the basal temporarily during lows. Does Tresiba have another stabilizing effect? Maybe, but we shouldn’t assume so. If it is this revolutionary, Novo should be happy to fund a study comparing Tresiba head-to-head with pumps, lantus and levemir. If they prove it is better in a controlled study, then they would be rich(er). I am interested to hear Dr Ponder’s comments from the diabetes conference if someone can report them here. Keep in mind, he is an AVID CGM using and says he glances at his readings about 40 times a day in order to microbolus or glucose nudge his sugar surfing AND he claims he can sense his glucose changes even without a CGM so he is not a typical diabetic. Also, I’m not sure how he would “engine brake” (what he refers to as a temporary basal decrease) with tresiba.
For those pumpers who switched and are using a CGM, how many additional injections are you doing daily?
Also, while I like Afrezza, I’m not sure I could “micro” bolus it and I do not want to lose lung function which was a documented side effect as noted in the FDA product insert. (“In clinical trials lasting up to 2 years, excluding patients with chronic lung disease, patients treated with AFREZZA had a 40 mL (95% CI: -80, -1) greater decline from baseline in forced expiratory volume in one second (FEV1 ) compared to patients treated with comparator anti-diabetes treatments.”)
I’m far more interested in real world users reports than I am in studies. Many things in this world can’t be proven by studies. Many studies prove things that aren’t correct or aren’t practical or even just don’t matter in the real world. The medical establishment is still clinging to studies that ‘prove’ we should be eating ridiculous amounts of carbohydrates that would make any semblance of control absolutely impossible. Some things will never be proven or understood by studying them. Try it, it works, that’s the proof that matters…
I used Lantus for 4 years. The first day I used Tresiba I ran 5 miles without jacking my blood sugar up first and it didn’t drop… that’s the kind of proof that matters in my life…
PS, Ponder ditched the pump for this too
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what’s up @Sam19 , I’m still going strong on Tresiba and have zero plans of going back to a pump. It remains to work extremely well for me. Keeps things very stable.
@Dr_T1 - I was a pumper (Omnipod) and use CGM. I inject on average (including morning Tresiba injection) of 5 times a day. With the pens and the micro size of the pen needles I honestly don’t find it bothersome at all. I glance at my CGM more than 40x per day and I thought Ponder dropped the pump for Tresiba???
You are now on Novolog? Any reason why the switch?
I understand that anecdotes cannot serve as evidence to create health policy for groups of people. Unfortunately things are often labeled as anecdotal when people wish to undermine demonstrated effects of one person’s experience. Not every good health idea attracts the money and resources to run a double blind randomly controlled trial.
My experience with limiting carbs comes quickly to mind. There was a rush of anecdotal evidence of people with diabetes reporting very good results with their blood glucose levels when they limited carbs in their diet. The medical and dietitian organizations argued that this was merely anecdotal and they would not support this method as a way to control blood sugar. Their active opposition to this way of eating continues in many ways to this day.
My personal N=1 experiment with carb limits was an epiphany. I was astounded at how much my life and health markers improved. And I was angry that the medical community stonewalled this idea and sought to undermine its legitimacy. There was no party that stood to make a lot of money to do the expensive study that could demonstrate that carb limiting in diabetes works.
Now, I realize that Novo has deep pockets and it could set out to prove through studies that Tresiba can effectively replace the complex basal profiles that many pumpers use. Novo has already received FDA approval for Tresiba. Maybe their thinking is that that is good enough for the time being.
In the meantime, I am a big fan of N=1 experimentation. I’ve discovered a ton this way. I do not see it as illegitimate for making personal decisions. I understand that if something works for me that it may not work for everybody. Even drugs that go through all the expensive studies have long lists of disclaimers in their patient communication.
Some of the biggest treatment breakthroughs I have made in my 32 years with diabetes have been made observing and reading about other’s anecdotes and then doing the experiment myself. I think N=1 testing should be the bedrock of personal diabetes decision making. We have been kept far too long viewing medicine through “the doctor is god” lens. Doctors are simply educated human beings with major limitations on their abilities. Patients can do more for themselves. And when we experiment and share on this site, that means others can do the experiment, too. We often like to say that “your diabetes may vary,” but that is not what makes me participate in this community. What keeps me coming back here day after day is sharing and learning about the what we have in common, especially the anecdotes.
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Yes, I’ve been using Novolog for bolus and corrections. Got constrictive cough with prolonged Afrezza use and have been taking a break from it. I sounded like a smoker and I’ve never smoked. Stopped the Afrezza and the cough went away. As much as I love it, not sure what I will do moving forward.
Still on it. Going ok, however, having about the same struggles as i used to with the pump, i guess my sugars are just not as stable as you guys’…
still happy on it though, remember, i ditched the pump bc of horrible alarms with the 640G, and am happier on tresiba than on levemir, so this is my way to go.
i did experience some quite annoying overnight highs, up to the 300s i creeped which annoyed me a lot, but i hope i got them under control now.
I know I’m not typical, either (especially with a T2D diagnosis – just ask Dr. Ponder’s co-author of Sugar Surfing!), but I can also detect changed in BG - to some degree more accurately than my CGM! Unfortunately, in my case, it’s not foolproof, and I miss change sometimes by a lot - especially on the low end - so the CGM earns its keep.
@Dr_T1. You’re right though we are certainly all subject to placebo effect. But if we’re all just viewing our results through a cloud of placebo that makes us all think it’s making our lives easier and our blood sugars better… That’d be ok with me;)
I hope you will try it yourself and let us know your thoughts…
Discoveries often come from those inventive and courageous enough to try something different and you may all be on to something here; that’s what I like about this site. This idea has captured by imagination and I will try and get Tresiba samples and try another N=1 study (perhaps if we have enough of us, we can do a meta-analysis). Still, I’ll have to carry my Tslim which displays my CGM data, carry an insulin pen and inject often but I won’t need the continuous insulin site. While Dr Ponder may have replaced his pump basal with Tresiba basal (and we are waiting for his opinion of his trial), I haven’t heard anyone say he gave up his CGM which provides the data trends he proactively acts upon. In his book, he attributes success to surfing, not basal. He carb nudges, he insulin stacks, he adjusts frequently – so it sounds too simplistic to think that Tresiba can provide this benefit with less work. (BTW: his coauthor has a daughter with T1 but the book does not say he has T2.) Perhaps there is something special about Tresiba - but if so, what? Is it just a bit longer acting basal insulin than Lantus that is more convenient but less flexible than a pump, or is there more to it? Perhaps it works nicely in highly-experienced, low carb’ers where not as much adjustment is necessary. There is a worry that some less experienced might think Tresiba it a panacea and not check their sugars as often. And I do agree with you that some of the medical establishment has not seen the benefit of low carbs often enough; however, not all patients are as motivated as those here. I appreciate your ideas.
I’m not sure why he would give up his CGM because he’s taking Tresiba?? I hear you on Placebo, but for me, placebo doesn’t really hold up because the numbers are what they are no matter how much I want to love an insulin like Tresiba. I wish I could “Placebo” my numbers into range - LOL. Maybe I am over simplifying but Tresiba has done these things for me -
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It’s given me a steady basal through the day and night via one injection in the morning with dosing flexibility.
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It has allowed me to free myself of an insulin pump.
Admittedly, I did not have any crazy basal profiles set up on my Omnipod, I was pretty steady/consistent throughout the day and night. However, I did have one increase in basal in the afternoon hours that I was concerned about when going on Tresiba but after two fasting tests I saw no spike in blood sugar during those afternoon hours. Not sure how to explain this. Maybe my carb counting at lunch wasn’t aggressive enough and I was covering my lunch with some increased basal? Not sure, but something I am actively working on to figure out.
Personally, I am not suggesting that Tresiba has made my diabetes treatment easier than a pump (just don’t have enough data to support that yet). However, I am confident that Tresiba has successfully replaced the need to wear a pump for a nice, stable, consistent basal with a once daily injection.
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I too have stopped using my pump and switched to Tresbia. My basal rates have been great! But I’m only on day 3. I started out at 16 units (first night of tresbia had stubborn highs all day), then bumped up to 20 and now 22. I think I’m going to stick with 20 units for at least a week and see how things go. I haven’t had any lows during the day which is great for me! I’ve been able to eat when I’m hungry vs. when I’m low. I’m excited for this!
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I’ve had similar experiences with the dosing, Terry 4. Over the last three nights I’ve had similar hypers and treat with humalog. However, I’m waking up low (48) and wondering if I shouldn’t back off the correction to see how things level out for themselves. Or if I should take my tresbia earlier than bedtime (9-10:00). Good luck. I’m excited to be off my pump and hope this works out as Levemir did nothing for me and I gained a bunch of weight on Lantus.
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i had the same problems.
i was on 14 units of tresiba, took it at bedtime.
always had to correct at 2-4am, which annoyed me quite a lot, and i woke up on the lower side as well. i went up with my basal to 16 units, since then i have a more or less flat line, dont need to correct anymore and it seems to work better.
only question is for how long this works until my body decides to react differently to the whole thing…
oh the joy of diabetes 
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So far I’ve increased my basal from 18 to 22 for the last two days and I keep spiking at 2:00 in the afternoon. I jump up to 250 and stay that way until bedtime; then I correct with Humalog and take tresbia. Does this mean I should increase the tresbia? I thought it was suppose to last 40 hours without a peak? I do take it every day.
When I wake up high in the night, it’s due to protein at supper that causes my blood sugar to spike 5-6 hours after I eat. My basal won’t address that. I’ve been trying to finish eating supper by 6 pm so that I can catch that spike and dose before I fall asleep and that has helped.
After using 3 pens of Tresiba, sadly I have stopped Tresiba for the next 3 months or so, until I use up my stocks of levemir (financially I could not afford to not use these up…).
I will be going back to Tresiba once I finish this stock. Tresiba gave me very stable worry free blood sugars… at a 20% lower dose than I was taking for levemir.
I feel the same many days @Sam19 Sam19! Both of these drugs have been a real game changer for me!! It has helped my emotional sanity so much!
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