Tresiba is legit! Read if you have the dawn phenomenon

Tresiba + a partially working pancreas is a dream combination. Good luck to you!

Josh are you making dosage changes after 2-3 days of similar results? I’ve found one can “chase their tail” doing dosing changes of insulin (any type) too frequently. Long acting insulin dosages especially, need to have time to “settle in” over some period of days.

I decided to give Tresiba another try and had the opposite experience of you - the worst dawn phenomenon I’ve ever had. I think the problem is it worked exactly as advertised almost right away - completely flat for ~24 hours. For some this is a blessing because it means less basal-induced hypos, but unfortunately I don’t think Tresiba is a good fit or pump substitute for everyone.

I think this is the key - those with sufficient insulin production can compensate for when Tresiba’s flat profile isn’t enough basal on its own. Again, 1 shot of 10 units of Levemir each night worked great for me when I was first diagnosed - I actually thought that was how Levemir was supposed to work at the time, and only went on the pump because I’m a gadget geek and figured it would make bolusing easier. 11 years later I need almost double my initial Levemir dose, split into 2 shots just to make it last and it still isn’t perfect.

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When I was prescribed Lantus about 15 years ago the doctor claimed it would keep my BG’s stable for 24 hours and just take Humalog for meals. WELL it kinda did but it didn’t quite live up to that standard. One day I found an article that said Lantus can cause unexplained highs and lows and the light bulb turned on for me. I’d been beating myself up over my wacky BG’s for years and thought this might be the reason. Went to my Dr. got the prescription for Tresiba and quickly noticed the difference. Now when I’m high I always know why when before I could hardly ever figure it out. The first few weeks though the Tresiba didn’t last 24 hours and I’d get some BG’s in the 200’s in the afternoons, after increasing my dose by a couple of units and being a bit patient that problem was resolved.

I just read through most of this discussion. Huge differences of opinion in this group. Thanks for sharing your experience.

My son was diagnosed a year ago. He was immediately started on Lantus and Humalog. He would run higher through the day and low at night. We tried morning and night Lantus dosing. We also tried dividing but it developed into a routine of treating night lows and activity lows.

His A1C was 5.7 in the summer and I had developed into a hyperaware treating routine. I just thought…this is how it has to be and was okay with the way things were going.

At diagnosis, he didn’t want the pump. He didn’t want something attached to him. Dosing for meals was a problem MDI as well. It wasn’t precise enough. Rounding up or down made a huge difference for him.

He decided he wanted to try the pump over the summer. It has been the best thing to happen to the entire family. He doesn’t even notice he is carrying it. It frees up time for him to be a kid without bottoming out and keeps him out of the nurses office and in class learning with the other kids. It frees me up to give more attention to the entire family.

He detaches for wrestling, swimming, trampoline and any strenuous activity. Don’t get me wrong, he still goes low…but it is not a constant fight anymore. I sleep more knowing that his basal is set to a level to give him a safe BG through the night.

On wrestling meet days…he needs to be completely insulin free. He eats all day at meets without ever needing to dose.

On a normal day his biggest daily insulin dose is for breakfast in the morning but then we have to completely suspend basal until lunch to avoid lows. His basal goes high after lunch, higher after dinner, drops at bedtime, drops to the lowest setting at midnight and cranks up at 6am. It is by no means easy. We adjust a lot but the precision is amazing with a lot less effort.

That being said, I would much sooner give up the pump than Dexcom. It is a life saver. I think I aged 10 years in a couple months before Dexcom came along.

That is what works for us (for now) but I am not hard headed enough to think it is right for everyone. In this short year, my opinion and our norm has changed countless times. All of us are different.

At some point, pumping might not work for my son anymore and it is nice to read posts about other people’s experience with treatment options. Low carb, high carb, moderate carb, pumping, MDI, Dexcom, Libre. Lots of options and management techniques.

Without hearing the opinions of others with an open mind…we could never expand. I am happy Tresiba is working for you. It is an amazing feeling when you find something that works and makes life easier.

(Sorry for the poor format and lengthy posts. I am a terrible writer and tend to just throw down what is jumbled in my mind. I haven’t paid any attention to how it can be bothersome.)

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Thanks Josh, definitely agree on keeping BG level as being very important. I have an HbA1c of 6.5% but I had massive variability in my levels. I find Tresiba fantastic now. I also use Afrezza for my mealtime insuin and I have non diabetic numbers so I expect to have a much better HbA1c next time!

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This thread is very interesting and reinforces my interest in Tresiba. I’ve been using insulin for over 50 years and am doing well. Over-all I’m very pleased with Levemir but its profile is significantly less predictable than Tresiba,and I’m interested in a flat basal. Understand those who like to adjust split-dosages w/other basals for variables, but I would love a flat profile.

I couldn’t try Tresiba sooner only because an employer United Healthcare plan didn’t cover it – at all. Employer switched to Anthem Blue Cross effective 1 Jan. Their website isn’t working (yeah, right but that’s another thread) so I’m on the phone now to see if Tresiba is covered.

Improved results in T1 mgt are always a cause for celebration. Happy for you Josh, and thanks for sharing the details!

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Just thought I’d update this thread. Like I said I would. As insulin effects and dosing can change for a person over time.

So far Tresiba is still keeping me fairly steady overnight and reducing my dawn phenomenon still. I have no spikes. Just early morning rises. Around 5am I can start rising when I get up. And be around 120-140ish by breakfast if I am below 100. Not a big deal for me. Some days this doesn’t happen. But my opinion of Tresiba hasn’t changed. It seriously is the best basal insulin I have ever tried and glad it is still working for me :slight_smile:

The graph below was last night-this morning:

I have a dumb question here. I’m TypeII and fasting glucose is in the 140-160 range. I definitely have DP because I’ll test at night and be lower. So I was thinking, why don’t I just fast for 8 hours sometime during the day and see how it goes?