Well last night, I purposely made my sugars high before going to bed. After the 85 reading, I ate half of a Hershey’s King size chocolate bar with almonds, one of those Kind bars, and drank one of those Starbuck’s cold coffees. A total of 67 g of carbs, which I would never do unless having a very low blood sugar reaction, especially not before bed. I’m eating like I’m smoking ganja tbh and I’m not. And that’s on top of the cheesecake as well. Well I woke up with a sugar of 276. It’s not egregiously high, but I felt that was the only way I could sleep peacefully. Given the fact that I have reduced all my insulin by half, I’m not sure what to think about this. Considering the fat content in all of this food as well, (way over a normal daily recommended value) I just think that there’s something I personally shouldn’t trust about what’s going on. My back hurts a little, I have gotten slight headaches repeatedly, and my legs have itched as well since starting tresiba.
I take Tresiba daily as my long-acting insulin.
If you’re concerned about running low at night because you’ve had to severely reduce your daily humalog doses, then your dose of Tresiba is too high.
Tresiba is wonderful, but it does take a few days to truly dial in the dose. That can be a bit frustrating until you’re able to find the right basal rate.
You can’t expect to really see the full results of increasing or decreasing your dose until 3 days after you changed it. This is because you’re essentially layering several day’s doses. The benefit to this is that you can create a flatter profile, there’s more flexibility in dose timing, and you’re less at risk of DKA because of a missed dose. The drawback is that you have to wait three days before you can really tell how a current dose is working.
If you’re concerned about lows, then I would reduce your dose further. It’s better to start out with a dose that is too low (subsidize with Humalog as needed) and then work your way up to the correct dose, but with Tresiba you have to keep in mind that you can’t see the full effects of a dose change until 3 days after you changed it.
A basal rate set way too high makes me feel jittery all the time, and I have to constantly eat to avoid lows. I’m not at all surprised that you feel crappy and that you have headaches. You’ve had a lot of severe lows!!! The whole thing sounds like a stressful experience.
It’s very strange that you’ve had to lower your dose so substantially, and I’m wondering if your body may be more sensitive to the U200 concentration. I wonder if your body was not fully absorbing the Levemir at the U100 concentration.
Well I saw my doctor today. She told me I should be taking 73 u of total insulin every day based on my weight; I weight about 160 lbs. I’m not sure I’ve ever taken that much on a daily basis. I used to take between 50 and 60. She said that 1 u of insulin would cover 13 to 15 carbs. And that 1 u of insulin would lower my sugar 46 points.
After she saw my readings, all she had to say was that it was nonsensical. Her exact words. She didn’t have anything else to say. And I asked her specifically for the prior information I just mentioned above. After she said nonsensical about three times, she said that there’s something else going on here that I’m not telling her. Well after that I realized I was not talking to someone that could help me or have anything to say. I asked her what does she mean. She said this looks like I am taking a lot of humalog. I am not taking a lot of humalog. I am taking 10 u some says , 5 units other days, 18 was the most I took one day. All day. I basically walked out of the office telling her she’s calling me a liar. I said I came here for help in understanding what’s happening, and instead of helping me or understanding anything about what’s going on or why, you merely call me a liar and dismiss everything I said. I stormed out of there. That’s never happened to me ever. I am honestly in shock. I can’t believe first off, and second off I tried to listen to her follow what she said, and it’s my fault that it didn’t work out the way she expected it to? She told me in the beginning to take 25 u tresiba, and then in 3 days to up it to 30 u. Then she tells me to lower it to 15, and this is my fault???!!! I’m honestly hurt, insulted, and feel unappreciated and disrespected as a patient.
I pretty much decided to go back to levemir yesterday. I can’t be forcing myself to overeat or not understanding why my sugars are reacting the way they are. I guess we’re all different and different medicines work differently for different people. I am so very confused by this doctor, and now need to find another doctor. Great.
Levemir is great. Your doctor doesnt understand diabetes. You will learn more on this forum or through experimenting.
Do not take this literally. That’s probably some average amount based on thousands of patients, none of whom are you. People’s individual daily doses of insulin vary tremendously.
Thanks Scott_Eric and everyone else. I appreciate the time you all took to hear me and tell me your thoughts.
You need to find a new doctor. As is frequently said on these forums Your Diabetes May Vary and it’s a highly individual disease. Like my primary doc tells me, “We learn this in school, but technology advances and drugs are constantly improved so what I’ve learned is only a starting point. YOU are the expert about your diabetes because you live with it 24/7. MY job is to help you stay well and WE have to work together to make sure you do.” (I’m never leaving her practice)
If you are comfortable with the Levemir and it was working well for you in controlling highs and avoiding lows that might be the approach to take. I do encourage you to run through the formulas to calculate your total daily insulin requirement, carb coverage ratio, and correction factor as it will help you better understand and manage your diabetes.
Hi J1112,
This is sad to hear that you were treated in this manner. I am so sorry for you.
It appears doctors have become conditioned to thinking their patients are never completely honest with them. For instance, if a patient states they consume NO alcohol at all, they think that translates into a glass or two of wine per day. If someone says they have one beer per day, this translates to a six pack in the docs mind.
I use alcohol just as an example but it applies to all facets of a patient’s comments to a doc. They do not believe the amount of carbs the patient states they consume.
Since being diagnosed with diabetes, the ONLY beverages I have consumed for well over a decade are water, coffee, and a limited amount of 2% milk. (I had eliminated milk but re-introduced it into my life several years ago.) I have not allowed any other beverage to cross my lips except the occasional Glucerna shake as recommended by my doc. I doubt any of my docs believe this but I know for a fact it is totally honest. I have written down everything that I eat or drink for over a decade. The ONLY thing I do not record is water. Every cup of coffee, every sip of milk.
I can relate to your not understanding why your blood sugars act as they do and have done much experimenting to understand my own.
I kept telling my doctor that after my fasting blood sugar in the morning when I first get up, I would have one cup of unsweetened coffee and spike to nearly 220. The response was studies show coffee will increase blood sugar 15 points regardless of what is used in it.
When I started using the Libre Flash system, I discovered that one cup of coffee does indeed spike me about 100 points within 45 minutes to an hour and then come back down about 75 points over the following hour, not back to the original starting point.
And if I do not wait a FULL two hours before I have a second cup, the spike begins high and goes up another 90 points. With just 2 cups of coffee on board since a fasting level, and a wait of 2 hours, I stay up around 40 points until I use mealtime insulin and eat.
I took the graph from Libre with me on my last visit.
It might be a taste thing for you or even a health reason, other than diabetes, but did you know that 2% milk has more carbs than whole milk? Heavy cream is even lower than whole milk. So, if you’re using it to flavor your coffee, you might be better off with heavy cream.
I’ve heard where people (myself included) have an increase in blood sugar with coffee. Recently my husband and I were shopping and taste-tested a coffee. We liked it a lot and decided we’d get a box. The box was large - Cosco size, lol. As we were strolling to the checkout I decided to read the ingredients - it was that good! Yep, there was more than coffee bean listed, and that list included sugar! I now check all coffees before I make a purchase. These days I’m only consuming a cup or two of decalf coffee anyway, so I no longer see a spike in numbers. I don’t flavor it with creams or sugars, it’s straight up. If I have a cup of regular caffeinated coffee, I don’t notice any difference there any more either.
You’re not alone with this; a lot of people go high. Up 100 is an awful lot though. I don’t think I ever did go that high, but I’ve read where others have.
A doctor has told me about coffee causing blood sugars to rise. I didn’t really believe her, but after hearing about your stories I’m thinking she was right.
Thanks for the info. I bought some half and half and will experiment to see if that has any effect on the amount of rise. I am also going to try some decaf coffee and experiment with it.
The 2% milk is for a swallow or two following a meal on occasion. I like milk. Went to 2% years ago when trying to lower my cholesterol. I don’t use it in my coffee. I use a powdered creamer most of the time because I don’t go to the grocery on a regular basis. I am also disabled and semi home bound. Perishables are purchased about once a month. I tried freezing milk but find it watery when thawed.
Well it’s been 5 days since switching back to levemir, and as I expected I have not had any severe low blood sugars. I had one that was 49, but very manageable. Yesterday I only tested myself twice, as opposed to 15 times when I was on the Tresiba. 104 when I woke up, and 147 before dinner. My sugars are pretty normal, 88, 131,141,161,175. And one high of 209. But I feel pretty good and a lot less worried. I’m really unsure of where this doctor was coming from, and dissatisfied with her lack of understanding lack of disclosure, and lack of empathy. Unusual in my opinion for a diabetes educator. Anyways, I feel better and all the best!
I agree Sam19. I have been on regular insulin for almost 30 years, type 1, and this is a major improvement. I have more energy and feel better. Much less insulin needed too for me. My doctor just put me on this a few weeks ago and now wish he would have told me sooner.
thanks,
Godzzla