Tresiba Degludec - Review

[Amity Island]

Hi Everyone,
Thought I'd do a quick update (mainly because there's not a lot of information "out there" for Degludec) for anyone using or thinking of going onto Tresiba Degludec.
I've now been on Tresiba for over 6 months, I was previously using Lantus which I came off as a result of it being very unreliable and unpredictable. I'd been prescribed Lantus many years ago as it was new at the time, but always found it would swing quite a bit, with it running out sooner than 24hrs.
The switch onto Tresiba for me wasn't straight forward, when I first started taking the Tresiba it had no effect on my blood glucose control ( I was solely relying on my Humalog to control my blood sugars, which was really exhausting) until a couple of weeks passed and I finally decided something wasn't right and I swapped the prefilled Tresiba pen for a new one, 2 days later, everything was great. Whether it was a bad pen/compromised, I guess I'll never know.
Six months on, using Tresiba every morning -- 22units -- (which was exactly the same dose as the lantus I was previously using -- not less as some people have found) and things couldn't be better. I've never known such good results, typically between 4 and 8, with a few more lower readings below 4 due to tighter control. The good thing I've found is that my back ground readings (without food/bolus) are very constant, never varying any time during the day or night. The Tresiba gives me a very reliable datum to work from, making the boluses easier to work out and control. I couldn't be happier with the insulin. The Humalog is also working well with the Tresiba, although the Humlaog does tend to last for 6 hours not the 4hr test times which dafne design all their guidance on.
The negatives for the Tresiba are partly due to the very reason it works so well, that is, it is a 48hr insulin, which means, it cannot be adjusted on a daily basis. If say you had the flu, if you were taking a twice a day insulin, you could just increase the dose to give you a level basal during your flu and leave your food/bolus insulin ratios the same. However with Tresiba, you can only rely on increasing the food/bolus insulin to counteract any rising blood sugars caused by illness. You could possibly increase the Tresiba if you "knew" you were going to be ill for a week or more but this runs the risk of over doing the basal insulin if your illness lifts suddenly. Same for exercise, you can't adjust the basal on a day you wanted to do exercise, so you would either have to take less bolus or eat more food, but I haven't tried this as I don't think it is workable as exercise greatly affects sensitivity to all insulins you are taking (typically by reducing the doses by as much as 50%), which would mean dropping background blood sugars on the days following any vigorous exercise.

Tresiba works really well for me and I shall be sticking to this at least until an intelligent insulin is readily available -- one that you could take once a day and releases as it is reacts to the levels of glucose in your blood stream -- good times!

Any questions feel free to ask

 

[TheClockworkDodo]

I have found Tresiba a big improvement on Lantus too - I've been on it just over a year. I still hypo a lot, far more than I should, but the hypos seem to be more predictable so it's easier to reduce them by adjusting bolus doses - I could never do that with Lantus.
I don't often test in the night but when I do the result is almost invariably much the same as both my bedtime result and my result first thing in the morning, which suggests a flat profile overnight.
The 48 hour thing doesn't bother me - if I'm going to do something more than usually energetic I just eat a biscuit first 🙂

 

[Amity Island]

I have found Tresiba a big improvement on Lantus too - I've been on it just over a year. I still hypo a lot, far more than I should, but the hypos seem to be more predictable so it's easier to reduce them by adjusting bolus doses - I could never do that with Lantus.
I don't often test in the night but when I do the result is almost invariably much the same as both my bedtime result and my result first thing in the morning, which suggests a flat profile overnight.
The 48 hour thing doesn't bother me - if I'm going to do something more than usually energetic I just eat a biscuit first 🙂

Hi Juliet, the consultant I saw last week, said if I wanted to do some proper exercise, running for example, he suggested eating a biscuit or two before the run. But I am concerned that from my previous basal experience on Lantus, that my sensitivity to both my basal and bolus will be so great afterwards, I 'll be going hypo for days, and end up being up all night eating. I'd love to do some exercise and the consultant said the only way id find out is to try.

 

[TheClockworkDodo]

I think your consultant is right, tbh - the only way you can find out what works for you is by trying it. I'd start with a short run, taking plenty of glucose and biscuits with you, and testing part-way to see how it's effecting you, as well as before and after - then if you get on OK you can build up gradually.

I don't do anything like running, I'm afraid, because I have an illness which is made worse by exercise and which also means that exercise can have a very delayed adverse effect on me, so I am always careful not to do too much. Gentle gardening and short walks are about my limit.

I am extremely sensitive to insulin though (I'm on 4 units of Tresiba) and I've not noticed any difference in the way Tresiba effects me on the days I'm more than usually energetic - no staying up all night eating. I've had a few prolonged hypos (but not that prolonged!), but I think that's because I have very little hypo awareness, so I'd probably been hypo for some time before I noticed and treated it, and I don't think they were on days I'd done more exercise than usual - I think I'd have noticed if they were.

 

[Amity Island]

I think your consultant is right, tbh - the only way you can find out what works for you is by trying it. I'd start with a short run, taking plenty of glucose and biscuits with you, and testing part-way to see how it's effecting you, as well as before and after - then if you get on OK you can build up gradually.

I don't do anything like running, I'm afraid, because I have an illness which is made worse by exercise and which also means that exercise can have a very delayed adverse effect on me, so I am always careful not to do too much. Gentle gardening and short walks are about my limit.

I am extremely sensitive to insulin though (I'm on 4 units of Tresiba) and I've not noticed any difference in the way Tresiba effects me on the days I'm more than usually energetic - no staying up all night eating. I've had a few prolonged hypos (but not that prolonged!), but I think that's because I have very little hypo awareness, so I'd probably been hypo for some time before I noticed and treated it, and I don't think they were on days I'd done more exercise than usual - I think I'd have noticed if they were.

Hi Juliet, thanks very much for your thoughts, they are really appreciated.
Wow just 4 units, that is a small dose.....and you still have hypos! With the tresiba I always get a pre-hypo awareness (a weird subtle vision in eyes) this gives me chance to act before I officially go hypo (below 4). I don't know if this is just how it affects me or how it works for everyone. I will give exercise a go in a few months once I prepare myself for it. One small step at a time...only then will I will only know for sure.

 

[Rene Droomer]

Hi Everyone,
Thought I'd do a quick update (mainly because there's not a lot of information "out there" for Deguldec) for anyone using or thinking of going onto Tresiba Deguldec.
I've now been on Tresiba for over 6 months, I was previously using Lantus which I came off as a result of it being very unreliable and unpredictable. I'd been prescribed Lantus many years ago as it was new at the time, but always found it would swing quite a bit, with it running out sooner than 24hrs.
The switch onto Tresiba for me wasn't straight forward, when I first started taking the Tresiba it had no effect on my blood glucose control ( I was solely relying on my Humalog to control my blood sugars, which was really exhausting) until a couple of weeks passed and I finally decided something wasn't right and I swapped the prefilled Tresiba pen for a new one, 2 days later, everything was great. Whether it was a bad pen/compromised, I guess I'll never know.
Six months on, using Tresiba every morning -- 22units -- (which was exactly the same dose as the lantus I was previously using -- not less as some people have found) and things couldn't be better. I've never known such good results, typically between 4 and 8, with a few more lower readings below 4 due to tighter control. The good thing I've found is that my back ground readings (without food/bolus) are very constant, never varying any time during the day or night. The Tresiba gives me a very reliable datum to work from, making the boluses easier to work out and control. I couldn't be happier with the insulin. The Humalog is also working well with the Tresiba, although the Humlaog does tend to last for 6 hours not the 4hr test times which dafne design all their guidance on.
The negatives for the Tresiba are partly due to the very reason it works so well, that is, it is a 48hr insulin, which means, it cannot be adjusted on a daily basis. If say you had the flu, if you were taking a twice a day insulin, you could just increase the dose to give you a level basal during your flu and leave your food/bolus insulin ratios the same. However with Tresiba, you can only rely on increasing the food/bolus insulin to counteract any rising blood sugars caused by illness. You could possibly increase the Tresiba if you "knew" you were going to be ill for a week or more but this runs the risk of over doing the basal insulin if your illness lifts suddenly. Same for exercise, you can't adjust the basal on a day you wanted to do exercise, so you would either have to take less bolus or eat more food, but I haven't tried this as I don't think it is workable as exercise greatly affects sensitivity to all insulins you are taking (typically by reducing the doses by as much as 50%), which would mean dropping background blood sugars on the days following any vigorous exercise.

Tresiba works really well for me and I shall be sticking to this at least until an intelligent insulin is readily available -- one that you could take once a day and releases as it is reacts to the levels of glucose in your blood stream -- good times!

Any questions feel free to ask

I can confirm that theTresiba Deguldec has been a big improvement on the stability of my background insulin, like yourself I was also on Lantus and I found that I was getting early hours of the morning hypos, the Tresiba sorted it all out and I am now up and running ok, took about 2-3 days to settle after the switch. I researched different insulins after I started getting the night time hypos and came across the Tresiba study results and emailed my consultant and asked him to switch me, so glad I did.

 

[TheClockworkDodo]

I had to ask for it too, Rene - after years during which consultants knew I had problems with Lantus, and not one of them mentioned to me that there were alternatives. I only heard about Tresiba, Levemir, and other basal insulins on this forum.