Tresiba Dosage

My Diagnosis was 3 months ago and I’m only on Tresiba once a day.
The Doc started me on 20 units and had me increase by 2 units every three days until I got my BG below 120 in the mornings.
I’m currently at 38 units of Tresiba and generally below 120 (usually 92 - 118 with occasional morning highs of 130 or higher and occasional low in the 80s).
I also eat a low carb diet.
Is my dose of Tresiba considered abnormally high?

I don’t know if you are taking a high dose of Tresiba or not. I take 11-12 units but I only weigh 105. I have a friend who weighs about the same as I do and she takes 8 units. I do know that Tresiba is better than any basal insulin I have taken.

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Thanks for that info. I’m a big guy (300lbs+) so I guess it makes sense that I’d take a higher dose. I was just starting to get worried that most of what I was seeing in the forum involved much smaller doses.

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A VERY, and I must emphasize the very, crude way to calculate basal is as follows.

First we must find you Total Daily Dose (TDD) which is in the range of your weight in kg divided by 2 to your weight in kg. We’ll say you’re 140kg so your total dose would be 70-140 units.

Basal insulin, once again in a crude sense, is about half of that. So we would expect you to take ~35-70 units of Tresiba.

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The most frequent posters in these forums, tend towards those who are very tightly controlled and highly insulin sensitive (thus much lower doses than average diabetic).

If 38 units per day is your total daily dose, you are actually at the low end of insulin usage yourself.

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Thanks for that! I’m much less concerned, now.

You have not mentioned which type diabetes you have. Type 1 or Type 2. There can be a huge difference in require basal amounts especially among T2s.

38 units basal can be just a drop in the bucket for some insulin resistant T2s. While insulin resistance is more of a problem for T2s it sometimes also happens in T1 and you can see higher basals in them also.

I was diagnosed as LADA (so type 1) 3 months ago and have Hashimotos as well. So there is probably some insulin resistance in the mix as well.

Is this the only insulin you take or do you also bolus with a fast acting insulin to cover your blood glucose (BG) increase after meals. This approach, MDI or Multiple Daily Injections, is used to try to increase the amount of time your body’s BG is “in range”.

How much information do you have on how much your BG varies throughout a 24 hour day?

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That’s a very “normal” dose if there is such a thing

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Yes, it’s the only insulin I take so far. As for BG throughout the day, so far my test strip prescription only covers enough strips for testing twice a day. I’ve been testing first thing in the morning then before and after dinner, so my results are less than comprehensive, and I’ll have to get my strips filled early if possible.
I may pay another Glucose tester that takes cheaper strips so I’m able to get a more complete read on glucose throughout the day.

That is great strategy, 2nd to having cgms. Do a fasting bg, and pairs of before/after meals is helpful.

Did you have C-peptide or fasting insulin tests? These can help show how much insulin your pancreas is still making, and how fast it may be declining with repeated tests.

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No C-peptide but insulin came in just inside the low end.
I already have antibodies affecting my thyroid.
Those things, plus blood glucose at 430, incontinence issues, and 50lb weight loss over a three month period, convinced my doctor that I had LADA rather than type two.

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I am Type 2, weigh 156 pounds, and currently am on 30 units once per day. I assume everyone’s milage varies.

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I am type 1, I am on a pump. I’m 6’3 I weigh 190 lbs, my basal insulin is 26 units, and my bolus is about the same. My average total is 50-55 units most days.
Roughly your basal should be equal to your bolus. That’s a type1 thing. Not sure about a type 2 rule of thumb