We should make a “ditching the pump and needles” calendar. You can be Mr. February.
3 Likes
I dropped my initial dose by 3 units (from 25 to 22) - still observing - but i think i have a uti - which is mucking up my numbers just now, so they’ve gone up, plus 2 nights of eating out doesn’t help either. I am only 1 week into this, so early days so far.
i went down from initially 22U to 13U. i might raise it to 14 when i am done with finals, but for right now i am happier at 160 than at 60 
i was on a pump until december where my basal rate was around 23U/day
in post no 39 i believe (scroll this discussion up to answer no 39) i talk about the pen i use. i can use 1/2 units. even other pens should at least be able to digit one unit separately. is there no line in between 2 and 4?
It looks like the Novopen Echo uses replaceable 300unit vials and has half-unit increments. The Lilly Luxura pen works the same way (but without the fancy digital readout). Under my plan here in the US, only Humalog is available in the replaceable vials.
I have seen Tresiba disposable pens (no replacement cartridge, just a use-it-up and toss pen) in both U100 and U200 formulations. The mechanical workings of these disposable pens appears to be the same, so for U100 you get single unit increments, but the “double strength” U200 pen can’t deliver a smaller volume of insulin, so it delivers in 2-unit increments.
1 Like
This Tresiba thread intrigues me. The idea of a one or two-shot daily basal and more importantly its reputed flat BG response really appeals to me. I’s love to see someone up for a challenge and a personal experiment with Tresiba. Someone who uses a CGM and thinks that they’ve got the Tresiba dose pretty well dialed-in, should try a 24-hour fast and post their 24-hour line here. I’m very interested in what range the BG varies and how wide that range is.
One of the biggest attractions to me of my insulin pump is its ability to match my varying profile of basal needs over a 24-hour period. I think I need that variation in basal insulin but I am puzzled how people like Dr. Ponder who simply deliver a flat pump basal rate and do well with their control. It seems Tresiba simulates this basal profile and reports I read here is that it is flat.
Anyone interested in this challenge?
I nominate you, @Terry4!
You’re the perfect person to answer this question yourself by trying your own experiment, for the following reasons
-
you’re an highly skilled pumper who takes advantage of many advanced techniques
-
with a pump you use complex basal profiles
-
you have a cgm
-
you are skeptical it will work well
I’d do a 24 hour fast, and post my results if you were interested— but people seem to get a lot more impressed by seeing it on a cgm screen— to me this just begs the question, if you have flat and stable blood sugar, why have a cgm?
2 Likes
You’re right, of course. Unfortunately, other demands in my life pre-empt me from doing this right now. I’m also in a bit of a skirmish with a new mail-order insulin supplier over their preferred formulary choice of Novolog, an insulin that I’m allergic to. I’m thinking letting the dust settle on this and at my endo appointment in March I can raise the Tresiba issue and get a script to try it.
My former mail-oreder firm never put 2 and 2 together and questioned the combined quantity of my Apidra and Afrezza. That worked to my benefit. This new firm is looking at things more skeptically, as a new set of eyes can. If I wait till March, I can sell this change as one that my doctor has ordered and hopefully they will not request a cut-back on my short acting insulin.
I want to try Tresiba since I realize I am vulnerable to any pump interruption, whatever the trigger. Having a proven plan B makes sense to me. Who knows? It may even become my plan A! I’ve been tethered to a pump for 29 years; I may enjoy losing this tech-tail.
I definitely understand your reluctance to upset he prescription apple cart. I’d definitely recommend you get a free sample (I’d ask for two pens free sample from your doc) before getting anywhere near the prescription plan with it…
@Sam19 – After I posted my last comment I thought about the doctor office sample possibility. Good suggestion. Do I need to get a pen plus a cartridge or is the pen part of a throw-away assembly? I could do this trial sooner if the doctor’s office could set me up. I’ll check.
I’m still interested to see if a CGM-Tresiba user could post a 24-hour fast-day line.
The pens are throw aways, the sample I got came with about 8(?) pen tip needles. You’ll need more than that. I buy them on Amazon too for like $13 a box for cheapos— but with pen tip needles you do get what you pay for in terms of quality, so I’d recommend you spring for a box of nicer ones like novofine or BD if you’re trying to do an experiment to see if it’s a pleasant alternative.
If we’ve learned anything over the last couple years it’s that insulin doesn’t really work exactly like the linear A+b=c model that we use to manage it. If that were the case, any reasonably intelligent person could maintain perfectly flat blood sugar 100% of the time— but clearly there’s more to it than that… So in my estimation, because one type of therapy requires complex and varied basal rates to achieve good results, doesn’t necessarily mean that this will be the requirement for every other type of therapy…
In europe i get the penfill cartridges for my echo which makes it a comfortable experience. I think with tresiba i could do without the half unit increments, but its just nice to know when you injected last. With novolog i’d defo have a problem without the half units.
I was on a really diverse basal until i switched doctors a year ago (still on pump).
The first thing he did (with my permission of course) was switching to a flat basal. It worked amazingly and i had no issues with it. It made things a lot easier, as changing basals wasnt such a hassle as it had been before. If you are up to the callenge definitely try.
2 Likes
gonna up my dose as I’ve been running a bit higher. We shall see. It is so nice to not have a pump attached.
1 Like
I’m not on cgm, but i will be prepared to rest tresiba for 24 hours measuring every couple of hours… once i set the fuse up right. May need to lower still. Didnt eat out last night (ie. Very moderate dinner), at 92 took 1 unit of fast acting (target 80ish) since 22 units tresiba. Woke at 68.
1 Like
Just remember it’s going to take a few days of any dose, whether it’s too little, too much, or just right, to reach a state of equilibrium and show its true colors
But on a negative note, I currently have hemorrhagic cystitis (first time ever). Symptoms started 2 days after starting Tresiba. Currently 5 days later. Already talked with my Dr and he’s not prepared to rule out Tresiba as being contributor - his words “We have to consider that as a possibility”. However, he is super cautious about everything (I guess that is good trait in one’s Dr). Starting antibiotics today, and we will observe. I sure hope not.
Hard to know if that’s attributable to basal… Because you introduced another variable with the rapid acting…
Sam. yes, you’re right. My experience so far is that wherever I am when I go to bed, is close to where I’ll land when I wake up. So I’ll try again tonight with same dose and no fast acting.
thrilled with overnight results. Woke up 105 with pretty much straight line all night.
4 Likes