Insulins

[John coomer]

I used to take novorid bolus and levermir basal insulin but my consultant changed it to novorapid and dedludec bolus insulin.do anyone have a reason why. Thank-you

 

[Robin]

I used to take novorid bolus and levermir basal insulin but my consultant changed it to novorapid and dedludec bolus insulin.do anyone have a reason why. Thank-you

Insulin Degludec (brand name Tresiba) is a very long lasting basal insulin which is designed to give you a flatter basal profile. It is taken daily, but it’s effects can last three days, so you don’t get any 'gaps' when it is running down. Levemir often needs to be injected twice a day to cover the whole 24 hour period, but because it lasts less than 24 hours, if you have a varied lifestyle and need to keep changing your basal doses to fit in with periods of extra exercise, for example, it can be a more flexible choice.
There are advantages and disadvantages of both, and your consultant should have discussed them with you before switching you.

 

[Bruce Stephens]

Otherwise known as Tresiba. And no, we're not quite sure why that's happening: NICE seems to recommend Levemir (twice daily) as the basal of choice (while allowing that others might be better for some people). Tresiba presumably has a nice flat profile over a longer period, so I can imagine if that suits someone then it would work better. (Might work for me, for example, because at the moment I'm taking the same dose of Levemir morning and evening.)

It's disappointing (and wrong, and rather strange) for changes to be inflicted without a bit of discussion. I've always discussed treatment options with my GP (or DSN), or rather they've always discussed them with me (I don't remember ever having to start such a discussion). It seems odd to me that some patients here report a different experience; I'm sure that's not how diabetes care is supposed to happen (given that it's obviously something that we're responsible for almost all of the time).

 

[LucyDUK]

Hi John,

Had you noticed any changes in your bgl readings that might have prompted the Dr to want to make a change?
More hypos or the basal dose not quite lasting until the next one?
As others have said Tresiba lasts longer in the system but also has a more levelled profile so less of a peak after injecting. One of those things is likely to be something your Dr feels you would benefit from, but it would be better for your Dr to involve you in that decision and explain what benefits they hope to see by making the change.
Are you able to speak with your DSN over the phone pretty easily? It would definitely be worth making a call to ask some questions, it can be hard to really get on board with any changes to your treatment without knowing why the changes have been made.

 

[LucyDUK]

It's disappointing (and wrong, and rather strange) for changes to be inflicted without a bit of discussion. I've always discussed treatment options with my GP (or DSN), or rather they've always discussed them with me (I don't remember ever having to start such a discussion). It seems odd to me that some patients here report a different experience; I'm sure that's not how diabetes care is supposed to happen (given that it's obviously something that we're responsible for almost all of the time).

Absolutely!

 

[trophywench]

I can't imagine 'being told' by a doc (any doc however high falluting) they were changing one of my drugs without explaining exactly they believed X would be better than Y cos I've absolutely never had that happen since I was old enough to remember going to see a doctor - so say aged 6-ish when me & big sis had the 3 consecutive first polio jabs - followed by the necessary 4th booster a bit later.

I also don't understand why some patients don't immediately ask WHY? when no believable/easily understandable full explanation isn't forthcoming.

I'm perfectly happy to try it if I 'get' why it might help. but not if I can't.

 

[stephknits]

My daughter was put on tresiba because it can be nice and forgiving if you don't always take it at the same time / forget for a bit etc. She is a teenager so that is why they gave it to her!

 

[rebrascora]

It is surprising that they have changed your basal insulin away from Levemir when they are supposed to be starting you on a pump in October..... which I read fro your other thread is on the cards. It was my understanding that they preferred people to be on twice daily Levemir before starting on a pump to help figure out their basal needs.... I might have picked that up wrong though.
For me a very long acting insulin like Tresiba would not be suitable because I need much less basal insulin overnight than I do during the day... I only take 4 or 5 units at night and still drop towards morning but 15 units when I get up, so I would likely hypo every night on Tresiba/Degludec or be massively high during the day.
How much basal insulin were you using with Levemir and when did you take it and what, if any, problems were you having with it for them to make the change?

 

[everydayupsanddowns]

Sometimes I think some Drs suggest a switch of insulin because it *might* help (or perhaps because it has already helped others in clinic), and is a simpler and more straightforward switch than trying to unpick the complex interactions between carb counts / carb varieties / basal dose / bolus ratio(s) / correction factor(s) and insulin dose timings.