How will the costs compare to pumping over time?
Sam, it has to be cheaper than pumping without pump purchase, infusion sets and cartridges costs. It would be interesting to see the numbers based on actual cost, not just out of pocket costs.
I do like the pump’s ability to remember whether I took my dose or not. Perhaps a pen with an electronic memory would work. When I was on MDI many years ago I do remember that I struggled with trying to remember if I took my dose or not. And I was a lot younger back then. I guess I’d just need a good system. But even the best systems can fail when there’s some kind of excitement or distraction competing for your attention.
Interesting question, @Sam19.
This is how I estimate for me, were I to try it: When I switched last year from MDI to the Asante Snap pump, my cost, other than the upfront cost of the pump (which, for Asante, was minimal to me) was less than MDI, as the pump supplies prescription cost me the same as the Levemir it was replacing. Since then, I had to switch to another pump. Omnipod would cost me the same as the Snap did; however, since I’m on the Vibe and have to buy both cartridges and infusion sets (and miscellaneous batteries), the cost of pump supplies is the same so it would cost me the same as MDI did then. Meanwhile, Levemir has moved to Tier 1, so the cost would be $50 less. Tresiba and Afrezza are not on my insurance formulary, so if approved, they would be no better than Tier 3. If I still carried a rapid script in addition, I would have three Tier 3 copays, so there would be a $25 upcharge for Tresiba/Afrezza/Apidra over pumping for me; however, it could be higher, if they make my pay “speciality” pricing.
A good system doesn’t have to be complicated gadgetry… A calendar and a marker is a pretty good system… It’s just once a day…
Once per day for the Tresiba plus all the meal boluses and corrections, unless I switch over 100% to Afrezza.
I don’t know if this is available in the US, but there is such a pen. See Tresiba Basal Insulin - #39 by Sam19
Thanks, @truenorth. That looks like a winner! According to Wil Dubois’ March 2014 review, it’s available in the US and he gives it an excellent marks.
1 Like
it is! i even use it to calculate IOB over the thumb. plus, i think it looks really elegant and nobody thinks that it is a medical device which is another cool advantage.
1 Like
Thanks for the first-hand advice. What do you mean by “over the thumb?”
hihi over the thumb is a german expression, meaning you calculate roughly. the translation i found online is “rule of thumb estimate”. so what i mean i know that my insulin works around 3-3.5 hrs in my body, and when i see i last injected 2 hrs ago i know i still have some IOB. not as exact as the pump algorithm but it works for me.
2 Likes
helping out fellow diabetics and learning some German expressions . . . win win for everyone!!!
1 Like
Cost here in philippines (no insurers) is php1300 / pen. This about usd35. Levemir costs equivalent of about usd20/pen.
Went to bed 80 with no iob and woke at 69. Will reduce to 20u tonight (that is a 20% reduction compared to levemir dose). The cost difference Will be partly offset if i end up on a much lower dose.
My dr said peak action is after 5 shots.
Tresiba safer than insulin glargine, says Novo Nordisk
I can avoid hypoglycemia with lantus too but I have to be a little more cautious, elevate my blood sugar before exercising etc etc wheras the tresiba seems to require a little less babysitting, which is nice
What’s bizarre and I really don’t understand is I’d tend to have mild lows only when the lantus should be wearing off, contrary to logic… With this stuff that shouldn’t ever be wearing off between doses, it doesn’t happen
I seem to have trouble covering big (even if very low carb dinners). I can eat and 3 - 4 hrs later even with no fast acting insulin ill be in the 80s at bedtime (and don’t want to take fast acting). So take ‘normal’ amount of basal that usually works at bedtime and I’ll be 30 - 40 points higher than usual when i wake in the morning. With levemir i would just take 5 or 6 units extra levemir and wake up more or less on target.
Haven’t worked out if i can do that for tresiba. An obvious solution is not to eat dinner but that isn’t always convenient or socially acceptable.
Going well. Last night took 21u tresiba. Went to bed at 10pm (after a very light dinner) at 87. Woke at 85. Took 2 u of fast acting to cover coffee and walking the dogs ). 2 and 6 hours later at 84. 8 hrs later, ready to have a late lunch and bs was 71.
I read the tresiba info sheet carefully. Interestingly all their study patients had hba1cs in the 7s. Regarding coversion from orher insulins, it said it is typically 1:1 from other long acting insulins, except in patients using 2 daily doses of long acting (ie levemir) who have hba1c of < 8, who may require lower doses. This would seem to indicate that this insulin becomes relatively more effective at lower overall hba1c. The info sheet study data showed lower risk of lows compared to other insulins.
It sounds to me like your numbers are so tightly controlled that whatever you’re doing is working 100% perfectly. I personally am not big believer in adjusting basal frequently… But hey if it works for you then that’s a good plan… I ended up with a 1:1 transition from 1x daily lantus… A lot of times I thought i was going to need more, or less, and I still evaluate it daily…
Ultimately I think you probably have tighter blood sugar control than the vast majority of non-diabetics-- so I wouldn’t lose too much sleep over the fine print:)
1 Like
I am super pleased with how this is working. May well get my second ever under 5. 0 hba1c next time (first was durig my pregnancy nearly 8 years ago), and this takes relatively far less effort than i have previously experienced. Doing the happy dance here.
1 Like
I have to say that after being on Tresiba for the past week I am absolutely thrilled. So much so, that the pump is likely a thing of the past for me. I’m not being critical of the pump, but not having anything connected and beeping at me is so very nice.
2 Likes
^^^remember, I predicted this a year ago, when you first started afrezza. Before you know it you’ll be ditching the cgm as well I bet.
3 Likes
^^ second that
first stages on Afrezza - Is this for real? too careful in calculating, over compensating
second stage : dialing it in and slowly stop carb counting and adventuring with stacking
third stage : ditching pump
fourth stage : Freedom and now diabetes is an after thought
1 Like