Three evenings now; my nurse felt Tresiba was a more steady insulin. She reduced the dose because it can be more sensitive apparently- perhaps it’ll sort itself out. But it’s frustrating to have high readings after a few weeks of pretty good levels
Hello
@butterfly_rainbow23,
I've been on Tresiba for about 2 years. It suits me very well. I find it very steady and because it is long acting, c.40 hrs, today's dose is topping up yesterday's dose. I asked to move to a basal that only needed 1 dose daily, which turned out to be Tresiba.
As
@helli says I need a minimum of 3 days for any Tresiba change to take effect. I'm not sure what is meant by "the dose being the same as with Lantus". I was on c. 28 units of Levermir, split 2x daily; my DSN started me on 16 units of Tresiba, which was progressively reduced to 14, 12, 11, 10 and I'm now on 9 units in winter and was last summer on 8 units. However one does the maths, my Tresiba usage is not the same as my former Levermir usage.
I consider that Tresiba needs an entirely different mindset from the "quicker" basals. I have optimised my Tresiba to keep me steady through the nights. I know that my daytime basal needs are unlikely to be the same as my nighttime needs (and I suspect this is true for most people) so my daytime insulin needs are managed ENTIRELY by my NovoRapid bolus. I do NOT attempt to adjust or correct daily BG movements with my Tresiba. I only alter my Tresiba when it is clear to me that for several nights my BG is drifting up or down. I have the NovoEcho 1/2 unit pens and usually now only make necessary Tresiba changes in 1/2 units.
Since you are new to diabetes and have such a steep learning curve in front of you I think Tresiba could be great for you, with the caveat that not every brand of insulin suits every individual. If your DSN helps you get stable nights from your Tresiba, then you will only be juggling your bolus to keep you in range during the day - this includes bolus for meals, correcting highs and adjusting bolus down when different exercise or activity is occurring. Personally I think that is a bit easier, rather than juggling both basal and bolus and trying to sort out in your mind what is achieving what and when! But others do seem to take that double juggling in their stride.
You might find it helpful to know that any insulin is ... well ... just insulin. Your body doesn't know that your natural insulin is very speedy, that bolus is relatively quick(ish) and that basal has been chemically created to give a slow steady release over a longer period. If insulin is present, your body will use it - either to facilitate glucose transfer from your blood into your cells, or to cause your BG to lower to the point that makes you hypo! So while we try to think in terms of what either insulin is for and dose accordingly, your body doesn't think that way.
For your reference, comparison or just interest (and what I need will not necessarily be the same as anyone else) I have averaged 30 units of NovoRapid bolus daily over the last 10 days, for all meals and corrections, across a full 24 hours. So for a typical 24 hours I need about 39 units. Before I started Tresiba my total daily insulin used was greater - but my control and management was far worse, with more highs and lows. No doubt caused by having too much insulin inside me, all from my injections and nothing from my non-existent pancreas.
I came to Diabetes abruptly after my pancreas was removed, so my start experience was very different to yours as a T1, with a steadily declining insulin production. How did you become diagnosed? Are you using a CGM such as Libre 2 to monitor your BG? Has anyone suggested a useful book to get a better feel for what this is all about?
Do keep asking questions, no question is considered foolish. We were all new to diabetes once and we came to D at different ages; I was 70 when I joined this club! Good luck.
