Levemir to Tresiba?

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Lizzy78

Lizzy78

Well-Known Member
Relationship to Diabetes
Type 1
Hi all. Hope you are well.

I saw my consultant last week, who has now said he wants to switch me from levemir insulin to tresiba. I have only been diagnosed a year so this is my first big change in my diabetes management. Does anyone have any experience of this switch? Has it been positive/negative? Any advice would be appreciated?

Cheers.
 
Lizzy78 said:
Hi all. Hope you are well.

I saw my consultant last week, who has now said he wants to switch me from levemir insulin to tresiba. I have only been diagnosed a year so this is my first big change in my diabetes management. Does anyone have any experience of this switch? Has it been positive/negative? Any advice would be appreciated?

Cheers.
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Hi Lizzy, I know there are people on here who have switched to Tresiba, but I can’t think of anyone specifically who went from Levemir. I think @Kaylz swapped to Tresiba from Lantus.
I went the other way, and switched to Levemir because I thought it would help with my nighttime dip. I'm not sure it has solved the problem completely, but it has helped to be able to adjust the two doses up and down independently of each other.
Tresiba is supposed to have the advantage of giving a very flat profile (I say 'supposed to' because I don’t think any insulin actually does everything it says on the tin) but the disadvantage is that it takes three days for any adjustments to take effect. Presumably your team think it would help your particular blood glucose pattern to have a smoother basal? All I can say is, try it and if it doesn’t suit you, or you think your basal control has got worse on it, you can always ask to swap back to levemir.
 
Sorry @Robin I have no experience with a switch in basal as I was lucky enough (if you can say that) to be diagnosed not long after it was approved for use in Scotland so as it was the Professor dealing with my case he put me on it straight away even though the DSN's had basically no knowledge of it at the time 😳 I know @Bloden is also on Tresiba but not sure what she used before, @TheClockworkDodo also uses Tresiba but again not sure what she switched from either, there are quite a few of us on it and I am probably biased as its all I've used and have experience with but I like it, if you enter Tresiba in the search bar and have a look through you might find a thread about switches, sorry I couldn't be of more help :( xx
 
Kaylz said:
Sorry @Robin I have no experience with a switch in basal as I was lucky enough (if you can say that) to be diagnosed not long after it was approved for use in Scotland so as it was the Professor dealing with my case he put me on it straight away even though the DSN's had basically no knowledge of it at the time 😳 I know @Bloden is also on Tresiba but not sure what she used before, @TheClockworkDodo also uses Tresiba but again not sure what she switched from either, there are quite a few of us on it and I am probably biased as its all I've used and have experience with but I like it, if you enter Tresiba in the search bar and have a look through you might find a thread about switches, sorry I couldn't be of more help :( xx
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Thanks, Kaylz, I'd forgotten you started out on it.
 
Lizzy78 said:
Hi all. Hope you are well.

I saw my consultant last week, who has now said he wants to switch me from levemir insulin to tresiba. I have only been diagnosed a year so this is my first big change in my diabetes management. Does anyone have any experience of this switch? Has it been positive/negative? Any advice would be appreciated?

Cheers.
Click to expand...
Hi Lizzy 78,

I switched from 20units Lantus to 20units Tresiba (taken each morning) a couple of years ago. It has given me a really good steady basal over 24hrs, unlike the Lantus which dropped off towards 24hrs. Adjustments in Tresiba take 48hrs to take effect, for example, if it was Tuesday morning and I decided to change (not that I ever do btw now i'm settled) my Tresiba dose that morning, this wouldn't have any effect to basal until same time Thursday morning onwards. Also, it took me a good while because of this to get my basal steady, which in hindsight, I should of just switched to exact same dose (someone at hospital said Tresiba requires a smaller dose than other insulins so I initially started on a much lower dose) so in the interim I had to take lots of extra (Humalog) with each meal to keep blood sugars in range.

The good thing about Tresiba beside giving a good steady basal is you don't have to worry about taking it at precisely the same time each day, you have hours of leeway on taking your next dose. Very clever!

Downside is, as I found out this year when I climbed Mount Snowden, you can't adjust it from one day to the next. So I ended up eating (extra carbs) my way up and down the mountain. For the next 48 hours, I was on 50% of usual Humalog due to increased sensitivity from the vigorous exercise. Same goes for illness, cant up the Tresiba dose if your blood sugars are running high, you need to do this with extra bolus at meal times to keep in range.

Any other questions just ask.
 
If you can't adjust it and your BG goes up or down at that time of the month and many ladies BG does - isn't that a drag having only bolus insulin to adjust with? What about extra hot (or indeed cold, I've never needed that one) holidays?
 
I changed to Tresiba from Lantus rather than Levemir, I'm afraid, so I don't really have anything to add which hasn't been said already. I certainly like it better than Lantus, but I'm actually thinking about asking to switch to Levemir, because I'm still spiking and plummeting a lot, and I think my basal needs are too complicated for the flat profile of Tresiba. As people have said, with Tresiba (and indeed Lantus) it takes three or four days for adjustments to take effect, so I often spend three or four days fending off hypos or hypers.
 
Btw, I was quite nervous about switching, especially as I was moving between two basals which are quite long lasting, but I actually found the switch from one to the other very easy.
 
Nicely summed up @Amity Island. 😛

Hi @Lizzy78. 🙂 I changed from Lantus to Tresiba because Lantus was causing lotsa probs. Everything amity island said rings true for me too, except I lowered my basal when I first started on Tresiba (I looked online for advice, not sure where, it was a while ago now) which was the right thing for me. I think I was on about 16 units of Lantus. I take 11-12 of Tresiba.

Have a look on this forum for @KookyCat’s posts on Tresiba. Her posts were very useful, I seem to remember.🙂

Tresiba suits me much better. The only thing that could be a problem is the slow reaction to a dose change. It isn’t a problem for me cos I know it’s going to take 48 hours for the dose change to kick in, so I’m ready for it. 🙂

Good luck!🙂
 
My daughter went from Lantus to Tresiba and likes it better but it does have that big lag when you increase or decrease dose and it can be less responsive if you do exercise only on some days but as the results are pretty predictable as long as you allow for that with more carbs or less bolus at the appropriate times then it’s manageable.
 
Thanks all for your replies. I'm making the change tomorrow so a bit nervous. I think my DN wants me to have a flatter line overall. In terms of exercise I try to walk for an hour each day and do a little swimming at the weekends. I'm a bit concerned about losing the flexibility of the dose change that levemir gives, but I can only give Tresiba a go and see how I get on.
 
Lizzy78 said:
Thanks all for your replies. I'm making the change tomorrow so a bit nervous. I think my DN wants me to have a flatter line overall. In terms of exercise I try to walk for an hour each day and do a little swimming at the weekends. I'm a bit concerned about losing the flexibility of the dose change that levemir gives, but I can only give Tresiba a go and see how I get on.
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its easy enough after you know how you react to counteract any more vigorous activity with a reduction in bolus insulin, it is a good basal and doesn't have to be taken bang on the same time everyday, good luck 🙂 xx
 
Cheers Kaylz. I'm hoping it gives me a bit more stability. Will be good to cut out my nightime injection, as I plan to take in the mornings when I get up.
 
Lizzy78 said:
Thanks all for your replies. I'm making the change tomorrow so a bit nervous. I think my DN wants me to have a flatter line overall. In terms of exercise I try to walk for an hour each day and do a little swimming at the weekends. I'm a bit concerned about losing the flexibility of the dose change that levemir gives, but I can only give Tresiba a go and see how I get on.
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Hi,
Please let us know how it all goes over the coming weeks and how you manage your bolus adjustments with your swimming. Also, if you are using a Libre? once your Tresiba dose is established, can you let us know if strenuous exercise which lowers your bolus doses effects the background blood sugar also?

I avoided any exercise whilst I was establishing the initial Tresiba dose.

Good Luck
 
Lizzy78 said:
Thanks all for your replies. I'm making the change tomorrow so a bit nervous. I think my DN wants me to have a flatter line overall. In terms of exercise I try to walk for an hour each day and do a little swimming at the weekends. I'm a bit concerned about losing the flexibility of the dose change that levemir gives, but I can only give Tresiba a go and see how I get on.
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It would be interesting to know exactly what your consultant/DSN was trying to ‘fix’ with this change. Otherwise I think it’s quite hard to know if it’s working as expected and/or how to make the insulin(s) work best for you.

Were you having any particular basal-related challenges Lizzy? Or did you get the impression they just wanted a general improvement and thought they would try this as it had worked for others in clinic?

Good luck with the changeover and keep us posted!
 
I agree with Mike above. Seems an odd change to make. I switched from Lantus to Levemir just to get that flexibility in dosage adjustments. Tresiba just has the same profile as Lantus, so i can't see the benefit. Still, no great harm in trying it out I suppose. Best of luck, and let us know how things go.
 
He said they wanted me to have a flatter line overall in my basal and that my pattern was showing on my libre of peaks and troughs. He said the degludec would give me more stability with my basal. He said it would be reviewed at my next appt in 6 months.
 
Hmm, I'm afraid the pattern on my Libre is one of peaks and troughs even though I'm on Tresiba, or perhaps because I'm on Tresiba. If I drop it half a unit I still have peaks and troughs, just higher peaks - and if I put it up half a unit I still have peaks and troughs, just lower troughs.

I hope the change works for you - but if it doesn't don't hesitate to ask them to switch you back!
 
Lizzy78 said:
He said they wanted me to have a flatter line overall in my basal and that my pattern was showing on my libre of peaks and troughs. He said the degludec would give me more stability with my basal. He said it would be reviewed at my next appt in 6 months.
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Hi, Just wondered how you were getting on with tresiba?, I may be going on it next week from Levemir but am a bit anxious about it.
 
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