What a basal difference! An experiment and share your knowing please

So I was fighting with my Dawn Phenomenon…the fight was about me and turning off the alarm and going back to sleep…no amount of chastising seemed to change my rolling over.
I noticed with my Tresiba as my basal that mid day 8 hours after my shot my numbers would dip…hmmm. This happened daily like clockwork.
So I thought why not go for that drop at Dawn Time ( so to speak). So I changed my basal administeration time to coincide with my rise in the morning.
Whoa! Was getting readings of 50! What a difference!
And way to low I feel.
Why so low?
Why such a difference?
And I did adjust my basal to be less so I won’t go so low.
Thanks!

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Did you notice any change on the time you changed from? Are you going high then, or staying level?

If a lower basal works, great. Otherwise, just tweak the timing agin.

Smart thinking! Even a relatively flat basal insulin like Tresiba still has a peak. This is taken from the prescribing information published by Novo-Nordisk.

49%20AM

The mean maximum glucose lowering effect (GIRmax) of a 0.4 units/kg dose of TRESIBA® was 2.0 mg/kg/min, which was observed at a median of 12 hours post-dose.

Since our individual experience can vary some, I’m not surprised that you observe the increased glucose lowering effect as early as 8 hours.

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Tapestry…
Well this am I woke to 107 … as I tweaked the basal down a bit via MDI which is not easy to do…just a little bit.
So it made a difference.
I then took my usual unit for feet on the floor and tanked to 56.
Grr.
Tells me my body was already primed with feet on the floor but only by waking up early and going back to sleep?
It didn’t occur to me to shift the basal time again.
I consider myself a slow learner with this insulin stuff…coming up on my two year diabetes birthday. Much improvement and more to go.

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Thanks much…had no clue.
I find learning about my diabetes a wonderment!
My endo seems to me unattached to teaching and learning about my diabetes.
It’s frustrating to have to explore, research and learn online.
Thanks to this site for the many times I have had an “aha “ moment.

YES!!! I switched from Lantus (2x a day never really happy with its lack of flatness) to Tresiba a little over a year ago.

I take it in the evening around 10PM, and it has a real broad peak next morning at 6AM. Whoomph, like that, my trouble with high morning numbers and dawn phenomenon is gone.

Tim.

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I still learn a great deal even at 35 years of living with diabetes. I used to think that the doctors were the diabetes experts and I held onto that idea for far too long.

I think curiosity and persistence, in addition to skin-in-the-game motivation, enables the cumulative knowledge of a diabetes patient to easily surpass the clinician’s about insulin dosing and other treatment tactics.

Other members here have taught me many valuable lessons about treating diabetes. Keep up with your good common sense!

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Tim12

    June 14

YES!!! I switched from Lantus (2x a day never really happy with its lack of flatness) to Tresiba a little over a year ago.

I take it in the evening around 10PM, and it has a real broad peak next morning at 6AM. Whoomph, like that, my trouble with high morning numbers and dawn phenomenon is gone.

Tim.


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Yea Tim!
Question:
Did you figure it yourself?
Still in amazement my endo just nodded when I told her about The Dawn Phenomena and feet on the floor rises in my blood sugar numbers.
No offer of information or ways to work with those two events.

Thanks!
I often think what it must of been like years ago with no internet to connect with other people with diabetes. I would be so so lost !

@NatureOrbs Learning is a constant with diabetes. No sooner do we think we’ve figured it out, something comes along to change it, again!

How are your BGs the rest of the day/afternoon/night?

Have you noticed any appreciable highs or lows?

I’m wondering mostly about highs since you changed the time to help with the morning highs, what, if anything, happened when you changed the peak time to cover dawn phenomenon/feet on the floor, from the time of day it used to help?

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My numbers are fairly good. I am happy with them…and I made another change a couple of days before changing my basal.
I now eat two meals a day instead of three. I did this for two reasons. Giving my digestive system a rest ( I have issues with digestion) and my after dinner time numbers required monitoring after I went to sleep. Waking to check my numbers was aggravating, so I eat earlier now.
I am an avid monitor of my blood sugar numbers.
BIG difference for me less stress and nosleep disturbance now and between the two changes, basal timing and food my body feels pretty darn good.
Overall I feel more stable…staying in range and yep tweaking seems the nature of diabetes.

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Same with me. I get up very early, between 4 and 5am, have a cup of coffee and do indoor chores. By the time I get back into the house from feeding the critters outside, it’s about 9:30 or 10am, and that’s when I eat my first meal of the day. My next meal is sometime around 3pm. I go to bed between 8 and 9pm. And I, too, feel much better and don’t have to worry about highs through the night. Works for me.

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None of my endos believed me when I told them Lantus then Tresiba wasn’t perfectly flat. They were willing to let me try either 2x a day.

The thing is, you and I figured out how to use Tresiba’s non-flatness to our advantage.

It actually took me a while (taking Tresiba in the morning and not having it match my needs well) to figure out that if I shifted to taking it in evening that it’s lack of perfect flatness would help with dawn phenomenon.

IMHO, Tresiba is clearly superior. Lantus once a day never ever worked for me at all. In a lot of ways Lantus 2x a day for basal felt inferior to NPH 4x a day for basal.

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I’ve had diabetes for almost 43 years and you will learn that there is no end to the ways to mess up trying to manage it!

IMO those of us who self-manage and keep learning new things do the best to handle this PITA condition. I like and respect my endo and she is fabulous at seeing patterns in my CGM tracings. But most things I know about diabetes I learned online.

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