Hi everyone!! I'm new to this forum and was wondering if anyone can help me? Late lastnight my Medtronic pump broke. I was on the phone to the company for over two hours but cutting a long story short it has ceased to function. There are no professionals around today to talk about my problem hence my request here. I am using my pens but I'm not sure how much Tresiba insulin to inject. I'm sorted with the Humalog. However, I was taken off Levemir and put on Tresiba and can't remember what I was told. All very frustrating! Can anyone help?
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Tresiba dosage query
- Thread starter Linda F
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Thank you for your welcome! I appreciate you getting back to me, thank you.
My Medtronic Minimed 780 pump does not use basal insulin, only Humalog, which is fast acting. It steadily drips in all day and extra is added for meals. Previous to my using a pump which was around 10 years ago, my long acting insulin was Levemir and I vaguely remember injecting 24 units. However, im unsure if Tresiba works in the same way. My new pump will not arrive until Wednesday or Thursday.
My Medtronic Minimed 780 pump does not use basal insulin, only Humalog, which is fast acting. It steadily drips in all day and extra is added for meals. Previous to my using a pump which was around 10 years ago, my long acting insulin was Levemir and I vaguely remember injecting 24 units. However, im unsure if Tresiba works in the same way. My new pump will not arrive until Wednesday or Thursday.
Our pumps use the dripping fast acting insulin as basal. Most pumps will have a display showing the total amount of basal and bolus it gives per day.
If your pump is not working, is there a webpage that shows the settings, etc. I am not familiar with the Medtronic but all pumps I have used have this
Or, if you know the basal pattern/profile on your pump, you can calculate the daily basal
If all fails and you are reasonably sure, you could use 24 units as you did with Levemir. The number of units of insulin are the same - it is just the action profile that will differ.
Keep a closer eye on your BG than normal and be ready to correct (hypo treatment on hand 9f your BG goes low and extra bolus if it goes too high).
If your pump is not working, is there a webpage that shows the settings, etc. I am not familiar with the Medtronic but all pumps I have used have this
Or, if you know the basal pattern/profile on your pump, you can calculate the daily basal
If all fails and you are reasonably sure, you could use 24 units as you did with Levemir. The number of units of insulin are the same - it is just the action profile that will differ.
Keep a closer eye on your BG than normal and be ready to correct (hypo treatment on hand 9f your BG goes low and extra bolus if it goes too high).
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
I’d start with the same amount of basal (Tresiba) that you take on your pump (look at your basal rate per day). That’s what I was told to do. This could well be too little, but you then gradually increase it so that you avoid the risk of hypos.
Thebearcametoo
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In your pump settings there will be the basal set up. If you scroll through that it will show your daily basal total. You often have less basal from a pump than from injections but it’s a good starting point. Pump basal is usually about 20% less than injected basal so you can factor that into your tresiba. Whatever you inject keep a close eye on your BG as everything will be out of whack.
Many, many thanks for your advice. Unfortunately as my
I really appreciate your advice regarding my pump. Unfortunately as my pump is not working I was advised to take it off lastnight and resort to pens. An added complication is I also use the Guardian 4 (CGM) which 'talks' to my pump and it delivers insulin as to requirements so essentially each day is different!
Inka
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As an aside, I’d also ask for the Levemir back. If you inject your Tresiba today, and your new pump arrives tomorrow, the Tresiba will still be active (it’s a very long-acting insulin that can last up to 3 days). You’ll therefore might have to reduce your basal rate in order to avoid hypos whereas the Levemir lasts a shorter time so you wouldn’t need to do this. More than that, if you want a brief pump break eg you’re spending the day at a water park or beach or whatever, Levemir is much easier to work with in removing and re-attaching the pump.
Inka
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Does it not come on at all to allow you to check the settings? Have you always used it in looping mode? (With the Guardian) If not, go by the basal rate you had on manual.
If you can’t find the basal rate (you’d take the average) then I’d start with a conservative dose of the Tresiba. You can always correct with your fast-actinginsulin if needed.
Even if it works in closed loop mode, it will be possible to find the total basal dose given.
And you should still be able to query the pump when it is disconnected from your body as long as it has power.
Once you get things up and running again, I recommend finding your total basal dose and making a note to keep with your insulin pens. This shouldn't happen but pumps do fail and you need to be able to revert back to pens quick and easily. It surprises me that DSNs do not encourage us to make these records when we transition from pens to pumps.
I agree with @Inka that Tresiba is an odd long acting insulin to prescribe as a backup to your pump when it lasts so long. Levemir makes more sense to my (non medical) mind.
Amity Island
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- Type 1
Hi,
Tricky.
I use tresiba as my daily basal. My dose was the same as previous basal (19u of lantus) when I switched.
If it's just to carry you over till your new pump arrives, tresiba isn't the most effective for this purpose. I'd say a standard 24hr basal (like Levimer or lantus for example) will be a better solution for you, if you can get it prescribed.
Typical advice from trusts if pump stops is to switch to 3 hourly short acting insulin via pen. Although when I was having issues switching basals I found taking my fast acting insulin every 6 hours worked well. You would need to take enough for you meals/carbs plus a quarter of your basal. Which for you would be 24/4 =6units. So 6 units plus whatever you are eating.
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
I was told to note down my hourly basal rates in case of a pump issue and just to make it easier when swapping to a new pump. I’ve used that list a number of times in my long pump career. At pump training, I’ve seen others refer to similar notes too, so I’d guess my clinic tells people to do it.
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
I’d be very wary using a fast-acting insulin like that @Amity Island I was told to do small corrections every couple of hours as needed, not to divide my basal like that. I think in the OP’s case, I’d want to verify her basal amount first. Pumps usually improve insulin sensitivity and often lead to a little weight loss. When I took my first pump break, my injected basal was lower than it had been pre-pump - hence the advice to start on the same amount of basal as your pump then titrate up if needed.
@Linda F I’d also see if you can speak to your pump nurse or DSN and get a little extra pump training, as well as possibly swapping back to the Levemir rather than the Tresiba as a back up basal.
@Linda F I’d also see if you can speak to your pump nurse or DSN and get a little extra pump training, as well as possibly swapping back to the Levemir rather than the Tresiba as a back up basal.
This is definitely not the advice I was given as backed up my the continuation of Lantus on my prescription as a pump back up.
Do you really expect someone to wake up every 3 hours to give themselves a basal top up? So much for not letting diabetes take over your life. Let alone the risks @Inka highlighted.
This sounds like a terrible idea.
trophywench
Well-Known Member
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- Type 1
Amity's trying to be helpful but you've utterly forgotten the fact that he's never experienced pumping, so us experienced pumpers automatically know stuff eg generally needing less insulin overall than on MDI.
However - the 'test every 6 hours' is more like it, I'd say - though I'd say every 4-ish hours, and adjust with fast acting, in the interim until new kit arrives. Doubtful any of us could get a prescription for summat we don't have already over a weekend, in a hurry - so that's a conversation for next week now anyway! IF the OP knows her 'correction' ratio - easier except she might not have a half-unit pen so will have to round the calculation, so I'd be inclined to round it down rather than up in this case - but anyway, usually to get rid of every 2.5 to 3.0 on a BG meter reading, shedloads of Type 1s need 1u of Humalog/Novorapid. So decide firstly the lower BG you'd like to get down to and OK we know we'd like to be no more than 5.5 constantly but aim a bit higher, don't try to be aggressive - I'd suggest 6.5 for this purpose so how much insulin you need for that, then add whatever you need for what you're going to eat right now, and inject that total - each time you actually test your BG whilst waiting. 36-48hrs running a bit higher than normal won't kill any of us suddenly!
However - the 'test every 6 hours' is more like it, I'd say - though I'd say every 4-ish hours, and adjust with fast acting, in the interim until new kit arrives. Doubtful any of us could get a prescription for summat we don't have already over a weekend, in a hurry - so that's a conversation for next week now anyway! IF the OP knows her 'correction' ratio - easier except she might not have a half-unit pen so will have to round the calculation, so I'd be inclined to round it down rather than up in this case - but anyway, usually to get rid of every 2.5 to 3.0 on a BG meter reading, shedloads of Type 1s need 1u of Humalog/Novorapid. So decide firstly the lower BG you'd like to get down to and OK we know we'd like to be no more than 5.5 constantly but aim a bit higher, don't try to be aggressive - I'd suggest 6.5 for this purpose so how much insulin you need for that, then add whatever you need for what you're going to eat right now, and inject that total - each time you actually test your BG whilst waiting. 36-48hrs running a bit higher than normal won't kill any of us suddenly!
Many thanks! I will certainly raise the Levemir/Tresiba issue with the hospital when I ring in the morning.
I've found my basal daily dosage - 15.7 - and injected 15 units of Tresiba this morning. It's taken a while for sugars to come down but then it did a little too far. What has astonished and scared me that there has been no health care professional to help me today. I've rung my surgery where I was directed to ring111 which directed me to the community team but there was litte knowledge of diabetes there. I rang Bradford Royal and although the lady was very pleasant suggested I come to A+E but the ikelihood was I would be admitted! Anyway with your help I've sorted it - many thanks! I had one Libre 2 in my stock so am utilising that and taken both my pump cannula out nd my CGM. I feel liberated!! Perhaps I'll see how it goes and have a break!!
Inka
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- Type 1
I’m glad you’ve got it sorted @Linda F Yes, those early times when something goes wrong and you need someone (and it’s always the weekend 🙄 ) is scary. However, it sounds like you’ve got to grips with things really well.
As you’ve gone a bit low with the Tresiba, I’d set the Libre Low alarm at 5.6 to give you a buffer. If it goes off, fingerprick to check and treat any lows. I’d take up a few extra nibbles for tonight for peace of mind as much as anything. You’ll then know they’re close at hand if you need them.
As you’ve gone a bit low with the Tresiba, I’d set the Libre Low alarm at 5.6 to give you a buffer. If it goes off, fingerprick to check and treat any lows. I’d take up a few extra nibbles for tonight for peace of mind as much as anything. You’ll then know they’re close at hand if you need them.
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