Change of basal insulin

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Pat91

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Hi all how do I go about changing my basal insulin ? I'm currently on tresiba but I'm finding I need less insulin at night and more in the day. Is it just a case of asking my Dr to switch me to levemir ? Thank you.
 
Usually a prescription change for a Type 1 would need to be sanctioned by your consultant, so the way you would go about it would be to discuss the problems you are having with your current basal insulin, with your DSN or consultant. That would involve explaining why you think a change to Levemir would be helpful. It is a good idea to document specific instances so they can see evidence of the problems.
I love Levemir and don't understand why they prescribe Tresiba to so many people because human bodies are not uniform, they vary day and night and often hour by hour. Trying to get a very long acting insulin to cover that is a bit like saying an XXXXXXL t-shirt will fit everyone! Yes everyone could fit into it, but it will fit a lot of people very badly.
I do think that clinicians assume that one less injection a day is a good thing or significant to us, when in reality the frustration of levels not being stable is a much bigger issue. Getting your basal insulin as good a fit as possible in terms of type of insulin, time of injection and dose(s) makes an enormous difference to diabetes management. It is the foundation that the rest sits on. If it is uneven, the rest all just becomes unstable.
 
rebrascora said:
Usually a prescription change for a Type 1 would need to be sanctioned by your consultant, so the way you would go about it would be to discuss the problems you are having with your current basal insulin, with your DSN or consultant. That would involve explaining why you think a change to Levemir would be helpful. It is a good idea to document specific instances so they can see evidence of the problems.
I love Levemir and don't understand why they prescribe Tresiba to so many people because human bodies are not uniform, they vary day and night and often hour by hour. Trying to get a very long acting insulin to cover that is a bit like saying an XXXXXXL t-shirt will fit everyone! Yes everyone could fit into it, but it will fit a lot of people very badly.
I do think that clinicians assume that one less injection a day is a good thing or significant to us, when in reality the frustration of levels not being stable is a much bigger issue. Getting your basal insulin as good a fit as possible in terms of type of insulin, time of injection and dose(s) makes an enormous difference to diabetes management. It is the foundation that the rest sits on. If it is uneven, the rest all just becomes unstable.
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Ok thank you, I shall give them a ring tomorrow. Tresiba is definitely not for me as around 4am every morning I'm dropping around 2.5 -3 mmol into a hypo. This makes it difficult as.im up for work at 6pm.
 
Good luck. Do be firm in your request because they may suggest you bump your bedtime levels with some digestives or toast and peanut butter or cheese and biscuits as a first alternative, so maybe try that tonight if you don't already do that. They usually suggest going to bed with your BG around 8 to prevent a night time drop but you shouldn't have to eat to your insulin and you do have a right to an insulin of your choice if you have a good reason for requesting it, I believe.
Do let us know how you get on.
Unfortunately it will likely take several weeks for the change of prescription to come through to your GP so you are unlikely to get Levemir before the New Year even if they do agree. Sorry if that sounds a bit negative, but forewarned is forearmed as they say!
 
rebrascora said:
Good luck. Do be firm in your request because they may suggest you bump your bedtime levels with some digestives or toast and peanut butter or cheese and biscuits as a first alternative, so maybe try that tonight if you don't already do that. They usually suggest going to bed with your BG around 8 to prevent a night time drop but you shouldn't have to eat to your insulin and you do have a right to an insulin of your choice if you have a good reason for requesting it, I believe.
Do let us know how you get on.
Unfortunately it will likely take several weeks for the change of prescription to come through to your GP so you are unlikely to get Levemir before the New Year even if they do agree. Sorry if that sounds a bit negative, but forewarned is forearmed as they say!
Click to expand...
Will keep you informed thanks again
 
Hear hear to that - my GP queried my desire to have 'another injection every day'. I replied that he wouldn't appreciate that when you're already having 4 jabs a day (1 of basal and 3 of bolus) what the hell inconvenience would having 5 cause, when it could probably give me better control of BG long term and though I was middle aged by now, I had no plans to pop my clogs anytime soon, thanks - so I'd very much like to be given the opportunity to try it on myself please!

I'm still here, and he's retired ......
 
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