Constant high glucose - fiasp/tresiba

[Kirsssty]

Hi guys, I'll try to keep it simple and descriptive as poss. Really need some advice or some tips if anyone has any please!

I'm currently on fiasp for my bolus, ratio 1:1 all day and I'm on 27 units of Tresiba for my basal which I take at 7am.

I find when I take fiasp if my levels are above 11 they do not want to come down. Sometimes I'm having to take triple the amount of insulin hours after for it to try and work. (A little walk can help it come down but surely I shouldn't have to keep doing this)...

Also I have my dinner at about 7pm and every night without fail between 10pm - 12am I am trying to go to sleep and my levels go between 12 and 15 and they don't want to come down. (I don't really want to have to go for a walk before bed every night lol).

I know Tresiba is active for 24 hours - so I'm guessing changjng this to evening won't matter?
I also take Tresiba in my thighs. Usually take Fiasp in my arms and stomach. Could taking tresiba in my thighs be an issue too?

Losing the will with all this

 

[Inka]

I’d try a different insulin to the Fiasp @Kirsssty Have you used other bolus insulins? Fiasp doesn’t work for everybody.

 

[Kirsssty]

I was on novorapid for years but changed as it wasn't fast enough for me, most of the time I'm not sure what I'm going to eat/how much so Fiasp is great for this when my levels are in range - I've recently heard of Lyumjev not sure if this will be any good

 

[Lucyr]

I use apidra and I like that, never desired to change to the newer ones like fiasp as they sound difficult to get along with. Hated tresiba too, was glad to get off that as I didn’t need a basal that’s flat all day long I needed one that tailed off towards the time you take it.

 

[Inka]

I was on novorapid for years but changed as it wasn't fast enough for me, most of the time I'm not sure what I'm going to eat/how much so Fiasp is great for this when my levels are in range - I've recently heard of Lyumjev not sure if this will be any good

You could try Apidra like @Lucyr suggests. Humalog is generally faster than Novorapid too.

 

[PhoebeC]

I found Tresiba the best background I have been on, but not prefect at all and ran out at the end of the day. I split it, not supposed to but that worked better but when my nurse found out she didn’t like it and we attempted to go back to one dose.
I also moved from Novorapid to Fiasp which I do prefer, it is much quicker for me personally and if I am in range it works so quickly, I never wait about for it to kick in only take it making my breakfast and lunch and by the time I’m ready to eat it’s effective.

Never fixed my background on Tresiba via MDI completely, my menstrual cycle impacted my background requirements every 2 weeks and it took to long to adjust it.

Pump and the Fiasp is the best control I have ever had. Sorry that’s not helpful.

Sounds like you need to increase one of them but without your patterns and data it’s hard to say which.
I think I would try increasing the Tresiba slowly, I think I was told do it for 3 days and then increase a little again.

Good luck and keep your chin up.

 

[PhoebeC]

I’d try a different insulin to the Fiasp @Kirsssty Have you used other bolus insulins? Fiasp doesn’t work for everybody.

Yes this seems to be the case for sure.
It’s been great for me and I know that’s not always the situation. On the pump it’s the best background set up I have ever had.

 

[Bloden]

You could try Apidra like @Lucyr suggests. Humalog is generally faster than Novorapid too.

I was on Apidra for about 15 years and I really liked it - very predictable and reliable, it always had the same profile and suited me really well. I switched to Novorapid when I switched to a pump, but don’t think it’s as good as Apidra (for me, we’re all different ). I’d like to switch back to it tbh.

 

[helli]

Humalog is generally faster than Novorapid too

I was told that some people find it faster but not all
I found it much slower than NovoRapid for me.

I find when I take fiasp if my levels are above 11 they do not want to come down.

Yes, I find this too but am able to avoid double digits most of the time.
I have read of some people who have another fast acting insulin for when they get to double digits.

Have you done a basal test?
I am not a doctor but considering your insulin to carb ratio, your basal dose seems low.
Getting basal right is important otherwise your bolus is built on a flimsy foundation.

 

[Inka]

I remembered you’d said that @helli so put “generally” 🙂 We’re all individuals and different things suit different people, which is why it’s important to have a range of insulins available, including the original human and animal ones not just the analogues. With a big range, hopefully we can all find the best for us.

 

[nonethewiser]

Was a long time user of Novorapid & have used fiasp in pump for last 5 years, maybe more.

Can honestly say that both are slow at bringing down bg levels when in double figures, doubt there's any bolus insulin around that works fast but might be mistaken, but do find fiasp to be that little bit faster in normal range so needs slightly less prebolus time.

Still no harm in experimenting with alternative insulins @Kirsssty see if they make a difference.