Tresiba Basal Insulin

Ps Mike I’ll be starting my tresiba experiment either tomorrow or Tuesday night… Granted mine isn’t as far a departure from my norm as yours is because I’m just switching from lantus instead of pumping like you are. I’ll really be interested to compare notes with you though. I hope our outstanding results won’t prove to be inflammatory and controversial this time around, but instead helpful to people who are struggling to control their blood sugars as tightly as they’d like to.

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@Sam19 @mikep please keep me in the loop, i would like to learn from you guys also, as i switched to tresiba last thursday…
it’s been good so far, except for some weird sugars at night that i cant explain. as soon as i fall asleep, my BG raises about 5-8mmol/l, without having eaten anything. i know about DP, but this?


It’s gotten better last night, but i would still prefer a flatter line. during the day it’s awesome.

question to the dexcom people out there: as i am new to the dex as well, could this also simply be a dexcom error? you see i dont have full coverage of the sugars with pretty long “blackouts” which are unexplicable to me as well.

thanks mpg. I hope it works well!!! Would be a pretty cool combo!!!

amen to that, Sam.

Hey Swiss - that’s interesting. Will be sure to report back once I get rolling on it.

I don’t have a ton of breaks in my Dex (especially at night) so I’ll let someone else comment on that.

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@swisschocolate

I only used the Dexcom 7+ for a few months… One of the main complaints I had was that it often went all wonky when I laid down— it would frequently show skyrocketing highs or plummeting lows shortly I laid down that a meter confirmed every time weren’t actually happening— so the first thing I’d recommend is verify that this is actually happening instead of your cgm just getting thrown into a weird loop when you lay down… My doctors only theory on it related to how thin I was at the time…

@Sam19 was the problem lying onto the sensor or just your physical position of lying down?
might try another placement the second time around. yeah, i will double check with fingerstick, however once i did and it was true.
but my alarm clock will ring tonight at 1am or something :worried:

It wasn’t a matter of lying on the sensor, I think I just didn’t have enough of a fat layer to keep the sensor consistent between different body positions… That’s just my theory

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I can take some educated guesses but you’ll have to troubleshoot your high overnight lines. First of all, the initial 24 hours or so on a Dex can show erratic lines. Calibration is important and people have different systems to handle it. After the initial two calibration numbers I will let the line run falsely high or low but will calibrate when it finally reaches its high or low extreme and levels out. Then I give it a calibration. Make sure you wash your hands with soap and warm water and thoroughly dry them as well. When I do a calibration I usually do two fingersticks and take the average.

I never calibrate unless the arrow is sideways. I try not to over-calibrate and ideally only do it when the Dex requests it. If the Dex requests it and your BG is not a sideways arrow, wait until it is. The ??? reading is when the system can’t square the reading its getting from the sensor with its recent past. You just have to wait it out. Sometimes, near the end of the sensor life, I get more ??? readings. It’s an indication to me that the sensor will need to be changed soon.

The blackouts are times when the receiver is getting no signal from the transmitter. I’ve had that when I sleep on the transmitter and my body is blocking the radio frequency signal. You can also get “compression V’s” when you sleep on the sensor. It’s a false low signature.

If you think that your BGs may be high during the night, set an alarm and do a fingerstick. Good luck. I love my Dexcom CGM.

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I just switched insurance, so I too am trying to get on the Afrezza/Tresiba combo. Doctor recommended tresiba to me when I asked about Toujeo, and there happened to be a sales rep there who was doing “diabetes education” for tresiba.

Ill let everyone know how the combo is doing for me too! :slight_smile:

Good luck everyone and please keep the rest of us posted on your progress.

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Great, the more the merrier— sounds like there will be several of us trying triseba and tooting the whistle. Have you been using afrezza already? I hope so because to start two new insulins at he same time might be hard to know what to blame or what to applaud for what…

@Terry4 any interest in joining the party ?

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last night went wayy better! woke up 2 times to double check dex, and it was working perfectly. came in low-ish in the early morning (around 6am), but with that i can work! :slight_smile:

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I’ve been slowly reeling in my BGs since my travel in November followed by a cold. I’ve just returned to the good control I had in late October. I think I’ll let you and others discover how Tresiba and Afrezza work together.

At some point I do need to develop my MDI skills. I haven’t used MDI at all since 1987. It would be better to get the experience under good conditions than if I’m forced due to outside factors. I hope Tresiba performs well.

I’m happy to hear it’s going better. I’m often still surprised to see how darned accurate Dexcom is, and don’t know how I managed my daughter’s T1D before we had this amazing device.

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Congrats on the good work, and I’m happy that you’re feeling better, Terry!

Ok here goes. First PM dose— direct switch from 12u lantus in pm to 12u tresiba. First impressions of the pen-- not a huge fan of the new dial-a-dose mechanism which I believe is the same that others have mentioned on the newer levemir pens… Kinda wonky, not my favorite at first impression. Will take some getting used to. Blood sugars have been rock solid stable all day between 70-95 with breakfast and lunch bolused with afrezza, dinner with novolog (home-made bean soup, slow digesting carbs). Ran 5 miles before dinner. No reason to think based on past history with lantus that I might expect to wake up out of control tomorrow morning. Will update.

Noted in instructions that they say not to refrigerate for 56 days after starting to use a pen. I’ll use it much faster than that, so for now I’ll start the experiment by leaving the pen at room temperature as indicated in the instructions, although I kept my lantus pens refrigerated even after starting to use them (against the advice of the instructions). But i want to start off following directions precisely before I start experimenting.

Apologize in advance (and for past posts) for all the typos, don’t currently have a computer so typing with an iPhone.

@Sam19 be aware that the second dose will overlap the 1st dose (since it works 42 hrs) so you might be heading for some lows on your 2nd day. hopefully not though.
what pen do you use? i use the novo pen echo and have no wonkiness at all… is this different in the states?
good luck!

Mine is the disposable flextouch disposable pen… Use it til it’s empty then throw it away and get use new one type of pen— is the novopen echo refillable with vials?

I discussed the concern you mention of stacking with my doctor (mentioned above also). He didn’t think it would be an issue because it’s still the same dose of u100 insulin taken every day— so even though it lasts longer it wouldn’t really be stacking doses because you’d not effectively be taking any additional insulin over any given period of time even if it is lasting longer— this is on my radar screen though and I’ll be watching— he used a lot of big words and talked over my head somewhat when explaining it but that was the gist of it… I bought into his explanation as presented— we’ll see

— edit to add— extrapolating this logic out— it could be considered that throughout tomorrow I might be considered to only have taken 24/42nds or about 57% of my actual lantus-equivalent dose (assuming lantus lasts 24 hours and this lasts 42) until I take a second dose tomorrow— so I’m also going to have my eyes open for highs tomorrow— and as recommended by my doc, not make any adjustments at all until I’ve been taking it for at least 3-4 days and not adjust any more frequently than that.

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yeah, the novo pen echo is refillable with the penfill vials. i love that pen, it tells you the amount and time of your last injection, which has come in handy before :slightly_smiling:
here some advertisement:
http://www.novonordisk.com/content/dam/Denmark/HQ/patients-devices/images/novopen-echo-novo-nordisk2.jpg
my doctor did mention that tresiba is a bit more potent than levemir, no idea regarding lantus though. i cant imagine how one kind of insulin is more effective than the other if you inject the same amount, but well, my doc has quite some patients on tresiba and thats his experience…

EDIT:
i even found this:
Studies have shown that patients taking insulin degludec needed to take significantly smaller doses of basal insulin than those taking insulin glargine, while achieving similar blood glucose levels.
(i know Wikipedia isn’t the most reliable source, but i dont have time to research this in detail, maybe you can find more)

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Well, woke up at 94 and had a perfect tight control day with no hiccups or learning curve whatsoever.

Did do one experiment that I found interesting. At 4 pm (about 4 hours after eating lunch). My bg was 83. I normally would have eaten some sort of snack in this situation (an apple seems to be my go-to lately for this purpose) prior to working out. This time I wanted to test out the new basal, so I didn’t eat anything and went for a pretty grueling run on the treadmill… Running 5 miles at a faster pace that I’m used to— I am not a great runner and this is pretty heavy exertion for me. Afterwards I tested and was 68. That’s better than I would have expected to see with my past history with lantus (the only other basal I have used) which is why I’d have snacked first in the past.

Tooted afrezza for all 3 meals, bg never went above 120 after meals and it took a grueling 5 mile run to dip it below 80.

Day 1 – very pleased.

Edit to add— tonight used the novofine plus 4mm pen needle that came with the sample. Absolutely the nicest pen needle I’ve ever used. Bar none. I’ve been using the novofine 6mm for a long time and I always thought they were great, but they don’t even compare. (Have used quite a few other brands as well)

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