Preferred basal insulin for twice daily injections advice pls

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One thing...i have been on g6 a year now, and twice within that time there have been delays with my 3 month shipment as the hospital team have not done what they need to do to authorise continuation. This should just be once a year on your dexcom 'birthday" but in my case it seems the hospital failed to do something that effected all dexcom orders before i had used up the year.
I now keep any eye on my orders website when the next 3 month is due, as dexcom puts a note on to say they are awaiting info, and a stock of libres in as a fall back. luckily my gps have left them on my px list.
First time it happened i was rather panicing.
I didn't think this is a general problem but worth keeping an eye on the dexcom orders website when a order is due.
The delivery firm dexcom use sent emails when order due and you have the option of chosing a collection point...can't fault dexcom, actually.
Also, if your phone is not compatible you can use the 'build your own dexcom app' available via reddit...i've been using it for a year with no issue but get a back up reciever to be on the safe side
 
mitchsi said:
Oh that’s an interesting take on it.
The lost signal is a concern, was it at times of fast transitions eg high carb or exercise? How long ago did that happen in case since then they’ve worked through the bugs?
On the dexcom compatibility page iwatch series 9 is not mentioned but at least iwatch is there unlike Libre, I’ve had to use two apps to get the Libre on my iwatch.
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It was 6 months ago. Signal loss just happened randomly, and frequently, throughout the day and night. Possibly it was a faulty sensor, but as it was a free trial there wasn’t a lot to be done. Dexcom never asked for any feedback, which I thought was odd.

Anyway I didn’t want to risk pursuing G7 as I would have been self-funding it, but I would certainly suggest getting a trial if you can, as what suits one doesn’t necessarily suit another.

The same goes for readers/receivers: some swear by them, but I found the Libre one a complete pain - clunky and non-intuitive - as well as being one more thing to carry around/lose at the bottom of the handbag.
Maybe I was lucky, but I had no issues with the Libre CGM upgrade other than deleting and reinstalling the app once.
 
JJay said:
Maybe I was lucky, but I had no issues with the Libre CGM upgrade other than deleting and reinstalling the app once.
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As a matter of interest, how does your 'Logbook' behave? Slow? A minute to load, and a minute when changing from one entry to another?
 
barrym said:
As a matter of interest, how does your 'Logbook' behave? Slow? A minute to load, and a minute when changing from one entry to another?
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No, nothing like that at all - appears instantaneously. It’s an iPhone 12 if that helps?
 
JJay said:
No, nothing like that at all - appears instantaneously. It’s an iPhone 12 if that helps?
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Ah, that's good to know. In another thread (here or .co.uk) on the logbook, I asked if anyone with iOS had this problem, as I suspected the 'default' database on both platforms may differ. The plot thickens!
 
I’ll dig into the dexcom discussions later but wanted to update that since yesterday I’m now on Levemir, alarms set to take them at the same time each day!! I’m not always the best at routines
 
I don't set an alarm. It's before I get out of bed on a morning and when I climb into bed at night or sometimes earlier if my levels are going through a spell of rising on an evening. They probably told you it needs to be 12 hours apart but most of the time when I wake and when I go to bed works well for me.... but then I have a much bigger dose in the morning which lasts longer and a very small dose at night. One of the great things about Levemir is that you can not only change the individual doses, but change when you take them to get the cover you want when you need it.
 
rebrascora said:
One of the great things about Levemir is that you can not only change the individual doses
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Yeah, I need to experiment a bit what works but if stick to the same times and same dose then it should be clear how I need to adjust it time & dose wise. More experimenting 🙂
 
Interesting how advice has gone full circle. When I was on the D.A.F.N.E course a good few years ago, the whole course was based around a twice daily basal. They mentioned to me about switching from my once a day basal. Now trusts are saying that tresiba works well for many and no need to change.

Tresiba is no good for those who want to do sport /running in unplanned and irregular patterns, it's kind of a all or nothing basal. Fine if you hardly exercise or exercise everyday.
 
My daphne, nov 23, was based around levemir.

I'd like to go onto levemir but as only on 3 units/24 hrs at the moment it can't really be split
 
Tdm said:
My daphne, nov 23, was based around levemir.
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Hi,

Is the twice a day basal still being pushed by the DAFNE course? It was when I attended about 10 years ago. However, the diabetes consultants are not pushing this anymore.
 
Amity Island said:
Tresiba is no good for those who want to do sport /running in unplanned and irregular patterns,
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Exactly, I like to do spur of the moment things so it didn’t really suit me but I had a different issue to crack but should have gone straight to Levemir in hind sight.
 
Amity Island said:
Hi,

Is the twice a day basal still being pushed by the DAFNE course? It was when I attended about 10 years ago. However, the diabetes consultants are not pushing this anymore.
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It was on mine. I was skipped as i only took 2 units abasaglar (24 hr) at the time and they won't give me a half unit pen.
Instead they persuaded me to stop my basal. It didn't work!
 
JJay said:
I wangled a free trial of both G6 and G7 as I had concerns over the waywardness of my Libre 2, and was frustrated by the lack of an app connection to Apple Watch.

I thought the G6 was a bit of a monster compared to Libre, and rather a faff with its 2 parts. It was hardly more accurate either. The G7 was indeed very small and neat, and very accurate, but constantly lost signal even with the phone right next to me. This was a real concern at night.

So I’m still with Libre plus a 3rd party app (xDrip4IOS), and have to say things are improving accuracy-wise. I just cannot understand why, with the explosion in smart watch usage, Abbott have not developed an app that can be used with them.
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Interesting what you've said there, don't think they'll ever be one device that suits all & that's a fact, pleased libre 3 is working out well for you.
 
Amity Island said:
Tresiba is no good for those who want to do sport /running in unplanned and irregular patterns, it's kind of a all or nothing basal. Fine if you hardly exercise or exercise everyday.
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Without wishing to be confrontational, but @Amity Island do you have personal experience of this?

Admittedly I no longer sprint for a bus nor run half-marathons, but I live a pretty full and irregularly active life and find Tresiba to be excellent.

I don't think it's fair to outrightly condemn Tresiba. It needs a unique management technique and once that is understood it can be truly beneficial. If it were not, then surely it wouldn't be as successful as it apparently is world-wide. I agree that Tresiba, like any other D medication, might not be perfect for everyone. If I can find a moment I'll start a new thread in defence of Tresiba and stop highjacking this post which was asking about twice daily basal injections.
 
Proud to be erratic said:
Without wishing to be confrontational, but @Amity Island do you have personal experience of this?
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The statement made that it’s no good might be harse but I do think it depends on intensity of training, 30mins+ of running even if I ate before with no bolus I would be crashing and would need to keep consuming dextrose. I didn’t find it ideal - I think that’s the jist of what is meant. This was why I asking about twice daily basal.
It is manageable though with tresiba but perhaps not the optimal solution if there is reasonable or high intensity of exercise. If it wasn’t for the crashing during exercise I found Tresiba very convenient!
 
I understand both @mitchsi and @helli's rationales (up to a point) and I've always said Tresiba won't be ideal for everyone.

@mitchsi, probably nearly 3 years ago, we had an older male training for an Olympic sport (I suspect it might have been for para- olympics, but I may have got that wrong) and that person seemed to be managing well with Tresiba - having understood that there was a need to use Tresiba in a different way to a more conventional basal twice daily basal. I don't remember who it was, nor can I find their original post. But from the couple of exchanges that were posted I also suspect their training was not only intense but also pretty regular and that regularity might be the winning point.

@helli, we've been here before exchanging views about Tresiba. I was informed by my Consultant a year+ ago that Tresiba can be workable with hormonal changes. I simply did not go further into the "whats and hows". I do feel that if a Tresiba user wants to adapt their thinking and usage of Tresiba to recognise its strengths and predictability thus adjusting their mindset into how to get the benefits of those characteristics, it could be sensible. That Consultant also pointed out that we regularly hear from those who don't succeed with any one medication, but less so from the many who are doing OK.

I certainly know when I've been excessively active that I need to compensate with either more carbs or less bolus or maybe both. Nowadays I just take that in my day's plan and get on with it. Yes, there is some guesswork; but my CGM mostly neutralises that risk from guestimates. But equally I'm not having to guess whether my bolus or basal needs changing. My Tresiba is moderately fixed and that gives me steady nights while I'm fasting and relatively inactive; whatever my Tresiba brings to my daytime party is what it is - I just use only my bolus or food, however it is needed.

My main concern was with @Amity Island's generalisation potentially perpetuating the idea that Tresiba is no good. I consider myself to be irregularly active and I am happy to work with Tresiba's strengths and limitations.
 
Proud to be erratic said:
probably nearly 3 years ago, we had an older male training for an Olympic sport
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That’s impressive possibly it’s also down to his dosage, like I said I’m sure it’s manageable but I see benefits of twice daily even if not as convenient.
 
mitchsi said:
That’s impressive possibly it’s also down to his dosage, like I said I’m sure it’s manageable but I see benefits of twice daily even if not as convenient.
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Or down to being regularly and predictably active?
Just like being able to use Tresiba with hormonal variations… if they are predictable.
I understand Tresiba suits many people and does not prohibit exercise. But there is a reason why insulin pumps exist to allow variations to basal every 30 minutes and allow the user to program 4 different basal profiles. I have profiles for “normal”, climbing, exercise and sickness as well as temporary basal (increasing or decreasing my basal by a percentage) and basal suspend.

The recently trialled weekly insulin has been proposed for people with type 2 who have their own insulin to assist with variations.
 
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