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Sarahmort

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Type 1
Hi im a newbie to the site ive been diabetic 21 years I take levimre and noverapid 6 weeks ago my nurse changed my bedtime insulin from levimere to tresiba i feel terrible on it my bloods can be in range average 6 before i go to bed then at 3 in the morning i wake up randomly drinking loads and a blood sugar of 25 happened everynight since ive been on it through the day bloods are great its an hour after my tresiba im currently on 52 units at bedtime im tired had ketones amd my nurse wont change me back because she says she cant has anyone ever changed back to there old insulin

Thanks in advance

Sarah
 
I don’t see why you can’t change back or onto a different basal. It may be worth moving your tresiba back so that it’s in the morning rather than the evening (slowly over a week or so) to see if that helps. Usually tresiba takes a few days (2-3) to fully get into the system as each dose lasts longer than 24 hours.

Other things to check. Have you tried a different vial/batch? Are you using an old injection site and it’s not absorbing properly.

Can you speak to your consultant?
 
Thebearcametoo said:
I don’t see why you can’t change back or onto a different basal. It may be worth moving your tresiba back so that it’s in the morning rather than the evening (slowly over a week or so) to see if that helps. Usually tresiba takes a few days (2-3) to fully get into the system as each dose lasts longer than 24 hours.

Other things to check. Have you tried a different vial/batch? Are you using an old injection site and it’s not absorbing properly.

Can you speak to your consultant?
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Thankyou for the reply. I have never taken any bedtime insulin in the morning so would be curious of that. Ive been on it 6 weeks now never injected in the same time always move. Im on my 4th batch i have spoken to my nurse she just keeps saying i need to put up with this and shes put the tresiba up from 52 to 54 but still happening i really dont want to inject it anymoreive told her but she hadnt got back to me yet
 
6 weeks is long enough to know it’s not working for you. Is this a nurse at your GP practice? It makes no sense to keep you on an insulin that isn’t working.
 
h
Sarahmort said:
Hi im a newbie to the site ive been diabetic 21 years I take levimre and noverapid 6 weeks ago my nurse changed my bedtime insulin from levimere to tresiba i feel terrible on it my bloods can be in range average 6 before i go to bed then at 3 in the morning i wake up randomly drinking loads and a blood sugar of 25 happened everynight since ive been on it through the day bloods are great its an hour after my tresiba im currently on 52 units at bedtime im tired had ketones amd my nurse wont change me back because she says she cant has anyone ever changed back to there old insulin

Thanks in advance

Sarah
Click to expand...
Hi @Sarahmort
I changed from Levemir to tresiba few months back and my Dr. advised me to take a lower dose at the beginning till i get used to it, and back to my old dosage after almost a month.
I know few people hated tresiba as it didn't work well with them and switched back to levemir, and lots of people they split the bedtime dose into 2, first one at bedtime (half dose) and the second between 3 to 4 am, didn't try it to be honest.
but I am not sure why you can't switch back the levemir, I guess you need to insist or at least your Dr. should give you an explanation
 
@Sarahmort Your nurse won’t change you back to your old insulin? I felt angry on your behalf reading that. There’s no reason why you can’t change back - and I’m pretty sure there’s guidance somewhere that says we’re entitled to have the insulin that suits us best.

You’ve given the Tresiba a good long go. I’d insist on changing back if that’s what was working best for you. Different insulins suit different people. Nobody has to use an insulin that doesn’t work for them.
 
Sarahmort said:
im tired had ketones amd my nurse wont change me back because she says she cant has anyone ever changed back to there old insulin
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If your DSN (dumb silly nurse) can't/wont change you back then contact your GP as a matter of urgency. Explain about the ketones and ask to have your Levemir back as you wont be taking the the new insulin any more.

You are entitled to use the insulin of your choice (NICE guidelines) Personally I would change clinics as well.
 
Pumper_Sue said:
You are entitled to use the insulin of your choice (NICE guidelines) Personally I would change clinics as well.
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It's 1.7.3 in https://www.nice.org.uk/guidance/ng17/chapter/1-Recommendations#insulin-therapy-2

That is, twice-daily detemir is recommended, with alternatives (such as Tresiba) to be offered if twice-daily detemir (popular brand name Levemir) doesn't work. (Though there are general recommendations to work with individual patients to find things that work for them, so if a patient wanted a long acting basal like Tresiba that ought to be fine.)

I wonder if there's some newer evidence in favour of Tresiba over detemir?
 
Why did the nurse change you from Levemir to Tresiba? Levemir is a very popular and reliable insulin although not the best for everyone. Many users split their Levemir as it doesn't last 24 hours. Do you carb-count your NovoRapid and are you having a lowish carb diet?
 
Probably not the best advice but i would tell your doctor you are just going to refuse to use your tresiba and you want the levi back.
 
Thebearcametoo said:
6 weeks is long enough to know it’s not working for you. Is this a nurse at your GP practice? It makes no sense to keep you on an insulin that isn’t working.
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I
DaveB said:
Why did the nurse change you from Levemir to Tresiba? Levemir is a very popular and reliable insulin although not the best for everyone. Many users split their Levemir as it doesn't last 24 hours. Do you carb-count your NovoRapid and are you having a lowish carb diet?
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I do carb count its because I was on levimere i was injecting 60 units so she thought she would try another one to see if i needed that much insulin as I've been on levimere 21 years switched to tresiba 6 weeks ago because she said i could need a change i do have a low carb diet not everyday but most day's
 
I have left a message this morning telling her that i cant do it anymore getting up 2 to 3 times a night im mentally exhausted drinkin loads ketones ++2 i have begged her to put me back on it hopefully tomorrow i get a reply or i will just take matters into my own hands
 
Sarahmort said:
I have left a message this morning telling her that i cant do it anymore getting up 2 to 3 times a night im mentally exhausted drinkin loads ketones ++2 i have begged her to put me back on it hopefully tomorrow i get a reply or i will just take matters into my own hands
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Sarahmort said:
Hi im a newbie to the site ive been diabetic 21 years I take levimre and noverapid 6 weeks ago my nurse changed my bedtime insulin from levimere to tresiba i feel terrible on it my bloods can be in range average 6 before i go to bed then at 3 in the morning i wake up randomly drinking loads and a blood sugar of 25 happened everynight since ive been on it through the day bloods are great its an hour after my tresiba im currently on 52 units at bedtime im tired had ketones amd my nurse wont change me back because she says she cant has anyone ever changed back to there old insulin

Thanks in advance

Sarah
Click to expand...
Hi Sarah,
This sounds like you are better on a split dose basal (or a pump). I can't see tresiba giving the variation in basal variation needs.
Stronger insulins are available, could you require a stronger insulin?
Or is it insulin resistance?
I use tresiba, took ages to get dose right, no thanks to NHS diabetes nurses, I had to go private to get sorted. My basal needs seem constant, so tresiba works really well. NHS diabetes nurses said same thing about not changing back, they were horrendous to speak too, attitude was absolutely appalling and they were all the same. I got transferred to different nhs trust.
You need to see/speak to a consultant about your difficulties with basal.
 
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Sarahmort said:
I do carb count its because I was on levimere i was injecting 60 units so she thought she would try another one to see if i needed that much insulin
Click to expand...

Ah, OK. That makes some sense: she thought you might do better on Tresiba (or maybe another basal insulin).

But it seems like that's working much less well than Levemir, so the experiment has failed and I'd have thought the easy solution would be to change you back to Levemir. (Levemir twice-daily, that is: one dose in the morning and one in the evening, roughly 12 hours apart.)
 
Sarahmort said:
Thankyou for the reply. I have never taken any bedtime insulin in the morning so would be curious of that. Ive been on it 6 weeks now never injected in the same time always move. Im on my 4th batch i have spoken to my nurse she just keeps saying i need to put up with this and shes put the tresiba up from 52 to 54 but still happening i really dont want to inject it anymoreive told her but she hadnt got back to me yet
Click to expand...
Hi,
The other thing I found with tresiba was it felt like it wasn't working, until I got the exact dose. It was literally only when I increased it by the extra unit that my basal readings kept steady. Made more difficult cos it takes 3 days to see any effect to any changes in doses. They started me on a much lower dose, turned out I needed exactly the same dose as previous insulin (lantus).
 
Sarahmort said:
have left a message this morning telling her that i cant do it anymore getting up 2 to 3 times a night im mentally exhausted drinkin loads ketones ++2 i have begged her to put me back on it hopefully tomorrow i get a reply or i will just take matters into my own hands
Click to expand...
Hello Sarah,
I hope that things are a bit better for you this morning, and that you get a helpful reply to your message.
 
No insulin is ever actually 'bedtime insulin', even if you take it at night before bed! I took Levemir twice a day, as most of us need to in order to gain best control, once when I got up, so normally between 7 and 8am - ish, 14u then another 4u at around 9.30pm. Hence, not equal doses and not 12hrs apart either.
 
trophywench said:
No insulin is ever actually 'bedtime insulin', even if you take it at night before bed! I took Levemir twice a day, as most of us need to in order to gain best control, once when I got up, so normally between 7 and 8am - ish, 14u then another 4u at around 9.30pm. Hence, not equal doses and not 12hrs apart either.
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I no that i have just always known it and nurses and doctors around me have always called it bedtime insulin ever since i was 3 my nan has hers in the morning its never worked for me doing it in the morning obviously shows everyones different
 
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