@Terry4 & @Sam19 how do you decide whether to use Afrezza or Novolog(or other short acting insulin) for meal time boluses?
Depends on both the type of food… High fat meals digest more slowly and are a better fit in some cases for injected bolus,
And even more importantly, to me, it depends on what I’m doing, if I’m on the go, if I want to just eat and then dose afterward and get on with my life instead of making a big headache about trying to count carbs, plan meals, prebolus, then monitor for several hours afterward… That’s the huge advantage of afrezza to me.
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I primarily use Apidra for all meal doses except when I get caught short and can’t prebolus as much time as I would like for the carb dose. Then I use Afrezza for my carb dose and Apidra for the protein/fat dose. I also use Afrezza for most corrections. In addition I’ll do an intra-muscular syringe correction in combination with Afrezza when I need to bring it down further than the Afrezza can do alone. I’ll use Afrezza when I want a decadent dessert on the spur of the moment and don’t have the luxury of planned pre-bolus time.
I am pump free for about two weeks. I’m still trying to figure out if I have the right dosage but I’m going to stick with 18 units at night for at least a month and see what happens.
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Hi @borijess!
Don’t want to destroy your hopes, but it’s defo possible to go low with this insulin. For me personally, it’s not a “miracle insulin”. It’s just the best option mdi wise for me. I still have highs and lows, crazy days, etc.
but i had those on my pump as well. That’s just life. But it does provide great stability and i still love it. Maybe you belong to the lucky club and have perfect results, or you are like me and have “normal” results.
Best thing would be if you could try out both options (pod and tresiba) and see what works best.
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Funny thing. Been using Tresiba and out of the blue tonight 2-3am I’m getting stubborn lows. No insulin on board except the Tresiba from the 9am shot.
Bg wants to hover at 55. Even after 10-15 carbs. Weird. Tresiba? Concerned about reducing Tresiba because daytime numbers might go higher. I don’t know. Frustrated.
B[quote=“Jacob2877, post:430, topic:50202”]
Funny thing. Been using Tresiba and out of the blue tonight 2-3am I’m getting stubborn lows. No insulin on board except the Tresiba from the 9am shot.
Bg wants to hover at 55.
[/quote]
Do you feel that this situation is dangerous? If not-- there’s an easy solution, take off the cgm and actually get a good night sleep. That’s my MO.
Not sure I understand. I’m saying the low is stubborn and will not come up after carb correction. Taking off the cgm will just cause me to not detect the low or not correct. I wouldn’t do that. Could not wake up!! Lol. strong text
That’s why I asked if you felt the situation was dangerous… Only you have the experience with your own condition to answer that… By all means if you feel it’s a dangerous situation, stay up al night glued to the device…
I know with my own situation that a cgm would just cause nothing but totally avoidable anxiety in this situation, wheras a couple pieces of candy and long nights sleep would solve all my problems
I don’t think I would feel safe with an overnight low of 55 mg/dl unless I had treated it and felt comfortable it wasn’t just going to come back.
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I call those basal lows. Basal lows don’t respond quickly to carb treatment and are tenacious about staying low. I had those sometimes on the pump and I found them difficult to deal with. I would try to treat them but not over-treat. That leads to the low going on for an hour or more. When the low finally responds to repeated carbs, my BG would go high due the combination of the carbs and the counter-regulatory hormones brought on by the sustained low.
Did this just happen once or is it part of a repeated pattern? If it’s a pattern then you could do a couple of things. One option is to back off on your Tresiba dose. Or you could feed the overnight basal with something like a tablespoon of peanut butter at bedtime We live in a dynamic metabolic environment. Plus you may have been more active the last few days. With the time change, people often find themselves more active after dinner. Things change, that’s normal. Your body is giving you an important cue, respond to it.
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Terry
You are 100% correct. In fact, that was a wonderful response and I thank you very much for that. Yes I do believe it could be the basal or related to 1 million other variables that type one diabetes brings. I will continue to monitor and keep you all posted thank you I will say for 90% of my day tresiba works wonderfully.
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I started on Tresiba almost two months ago and have met with overall favorable results. I have had challenges to both overnight lows and more recently highs. I tried doses from 14-22 units per day and have settled in with 19 currently.
I’ve varied my dosing time from 9 a.m to 9 p.m. I started with 9 p.m., tried noon and 9 a.m. and have recently moved back to 9 p.m. I know that the package insert says that Tresiba is not sensitive to time of day dosing or consistency of time of day dosing. I’ve found that 9 p.m. dosing has eliminated the tendency of my BG to go high during the 3 a.m. to 9 a.m. window, the time for classic dawn phenomena.
Now I know that there could be other explanations for this effect, such as the cumulative effect of stabilizing my dosing level at 19 units for a few weeks. I’ve also tried to minimize evening snacking on nuts, so that may explain the elimination of highs 3-9 a.m.
I know that Tresiba is billed as flat basal that lasts at least 24 hours and can go to 42 hours. I also realize that the variations in human physiology can impact this “flat” characteristic. Based on my experience, I think that Tresiba may be slightly more active during its first 12 hours after dosing than it is in the second 12 hours post-dose. I know this is merely anecdotal but I’m thinking this is the most likely explanation for me.
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I was in the habit of snacking on nuts every evening with lantus… I mentioned this above… I at first found it irritating that with tresiba I’d wake up higher if was grazing in the evening than I would with lantus… But I came to view it in a light of being even more predictable than lantus was… As if the basal was ONLY keeping my fasting blood sugars flat with tresiba wheras with lantus there was some slop to pick up for a few carbs here and there… I’m still quite happy with it, and with my erratic schedule and weird hours I really do find the long acting aspect of it to be quite beneficial.
I have been using Tresiba for about a month now. Switched from Levemir. So far, Tresiba has been excellent for keeping early morning blood sugars where I want them. Now I just have to convince my insurance company to cover it. It’s way too expensive to pay out of pocket for. Anybody have insurance that covers it?
Yes my prescription coverage covers it with similar copay to any other insulin pens
Hi Sam. What company do you have?
Cvs Caremark is the prescription benefits manager for my Union health trust…
Just joined the forum and would like to post my experience with Tresiba. I am 59 years old and have had T1D for 56 years. I used a pump for the last 20 or so, first a minimed, followed by an omnipod. I am extremely brittle and have never had a good A1C (usually low 8’s). Due to frustrations with pump sites becoming clogged or other problems, resulting in high sugars, I decided to try Humulin N and MDIs for boluses. It was ok, but I had to take two shots of the N daily and struggled with its peaks and drops. Tried Afreeza for the boluses briefly, but had dramatic inconsistencies on absorbtion, so went back to Novalog. Last December, my endo suggested trying Tresiba in place of the Humulin N. I have been delighted at the consistent levels it has brought me. No nighttime lows, the only highs are from eating too late or too much. I can skip a meal during the day with no change in blood sugar. I take my Tresiba shot at night (20 units right now - used a 0.8 units/hr basal on the pump) and just love the consistent sugar levels. Best I’ve felt in about 56 years. Nothing I’ve used before has been as good for me. I enjoyed reading about others who have tried Tresiba. Thanks to all of you for a great forum!
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Good to read about your improved results with Tresiba. I’ve been on it for two months after a long time on a pump. So you switched from N to Tresiba? That’s a big jump in terms of performance. I really like it and I’m using a daily dose similar to yours, 19 units. I’ll be curious to see if you get an A 1c drop. What really matters is if you enjoy a better quality of life.