Tresiba Review

[mikeyB]

This is all interesting. I made the switch from Lantus to Levemir on the advice of the consultant to whom I was referred for a pump, the main problem being pesky nighttime hypos which I couldn't stop no matter what I did with bloody Lantus. These have virtually disappeared on split dose Levemir, but all this has shown is that I need wildly different basal levels through the day. The end result of this is that I will be getting a pump come April.

If this sounds similar to Kooky's story, it is, almost identical. When the consultant saw my Libre record, he said there and then I scored all the points needed for a pump. So I'm getting one. And so should Kooky.

 

[KookyCat]

I'm glad you've decided to go for the pump, I read your post about it earlier in the week and keep trying to respond in a way that makes sense but it's hard to articulate a response. I think you're doing the right thing btw. The consultant patently didn't believe me until the three CGM results came through, then he had to admit I might be right, only might you understand 🙄. He was still muttering about trying other basal options at that point but he seems to have given in now. I realise it must be tricky for them, I really do, I mean I don't understand my weird reaction to insulin either, but I know it's not my bolusing skills, or my basal dose because I test everything to death. Yesterday I managed to go hypo from a substantial mince pie despite under bolusing, I know it's because it was cold and I was running around trying to exchange a faulty gift I bought and because i'm currently doing 7 units of basal so I can keep the 11:30am to 3:30pm slot under the wire (6 wouldn't quite cut it, 6.5 is perfect but I'm trying to use up a stock of disposable pens they kept prescribing instead of cartridges) and I bolused at 11:20 just the exact wrong time. Seriously though who wouldn't think I was box of frogs when I wheel that explanation out 😱

I've been told now I qualify for the pump but there's no funding in my area. That said they got in bother from the CQC for failing to meet the target level of pump users so that seems to be changing slowly. They didn't have a single adult pump user (not one) and no pump specialist at all in adult services. I met one lady who had one as a kid and then they took it off her when she transitioned to adult services, I couldn't believe it but I ive heard since it might be a common tactic.

Rambling aside best of luck with the pump, it makes sense it will help with that weird profile but let me know how it goes, I'll be watching with interest 🙂.

Juliet, I'm glad you're finding the Tresiba useful, let's hope we all have more luck with the insulin in 2017 🙂 Ooh and MERRY CHRISTMAS

 

[TheClockworkDodo]

Good luck with the pump, Mike, and I hope you manage to get one too in the end, Kooky - it helps that you are a fighter. I am wondering about one too, now that Steph has told me that you can get one which sticks the cannula in itself, so I wouldn't have to see it.

Yesterday I managed to go hypo from a substantial mince pie despite under bolusing ...

That sounds familiar - I had an extra half unit today for the large slice of chocolate brownie I had with my lunch and I still managed to hypo. I couldn't exactly have bolused any less, could I?! 🙄

Juliet, I'm glad you're finding the Tresiba useful, let's hope we all have more luck with the insulin in 2017 🙂 Ooh and MERRY CHRISTMAS

Merry Christmas to you too!

 

[mikeyB]

Thanks girls. It bugs me no end that getting a pump when your basal needs go up and down like a whores drawers, and you are crying out for a pump to cover that, it's a bloody postcode lottery whether you get one, not a medical imperative. Why should I get one and not Kooky? It is so unfair.

Which underfunded area of Lancashire is refusing your pump, Kooky?

 

[trophywench]

What scares you about approx. 8mm of Teflon tubing Dodo?

Or - is it the introducer needle that put the wind up you? LOL - I fully expect it's the latter.

The cannula inserter for the Insight pump doesn't show you the needle either. You insert the hard plastic cover of the new cannula into the 'bonker' (it makes a 'bonk' noise when you 'fire' it LOL) and remove the waxed paper protective layer from the stick pad of the cannula. Still no needle in sight. Then holding the inserter away from you, you load the latter by sort of pulling the middle towards your body, which pulls a spring back. This actually does now expose the needle but you have absolutely no need to look, in fact mustn't since if you haven't pulled the spring back quite enough, it can go off accidentally and shoot the cannula and thus that needle wherever you happened to be pointing it, and when this happens (I've done it twice in 18 months, luckily no-one was in the way) it travels surprisingly quick!

So you then place the business end of the inserter firmly against wherever you've chosen as a site. and press the trigger button. This shoots the cannula needle into you. Lift the inserter off your skin and there's the cannula covered by a plastic cover except the edges all round the oval sticky pad. Hold the sticky down (smooth it onto the skin) then lift the plastic cover vertically upward off you.

The needle comes out of the tubing as you do this and folds back into the cover as you lift. If you look at the bottom of the cover now you can see the needle folded horizontally within the cover. But - you don't actually have to look - so don't! - just chuck the cover straight in the sharps bin!

The tubing to the pump attaches to the cannula with a plastic fitting.

Like the needle cover gadget you use with pens - you still HAVE to have a needle with any pump - but as far as I know only the Omnipod and the Insight make it so you don't HAVE to see it if you don't want to.

For all I know there may be others too - but I also know very well that some don't. Even for the Insight - if you need angled cannulas - you can't use the inserter. Only right angled ones fit them.

 

[TheClockworkDodo]

Thanks for all the info., Jenny 🙂 It's not fear so much as the knowledge that if I see a needle going in I'm probably going to pass out and possibly to vomit so it's just not something I can do. A few times diabetes nurses have looked at my bgl results and said to me "have you thought about going on a pump?" and I've said "well, I'd like to, but I wouldn't be able to insert the cannula because of my needle phobia", and not once has any of them ever said "oh, that's alright, you can get one which inserts itself, you just press a button" 🙄

But I had this exact conversation with Steph on this thread a couple of months ago and I'm planning to discuss it with my DSN next time I see her!

There is of course also the issue of whether or not I will be allergic to teflon (quite possible) or indeed to the sticky pad (highly likely), but I'll cross those bridges when I come to them ...

 

[mikeyB]

Juliet, have you investigated the Clickfine Autoprotect pen needles I suggested? They fit nearly every pen, and you never see the needle before, during, or after the injection. They are prescribable in Scotland, so should be in England. Discuss those with your DSN, because they could solve your problems at a stroke, without the need to find out if you're allergic to pump kit.

 

[TheClockworkDodo]

Mike, I've had covered needles from diagnosis, I would never have been able to cope otherwise. The ones I have are Novofine autocover - I'm really sorry, but (probably because of my cognitive dysfunction) I don't remember you suggesting different ones, or why they might be better? Are they shorter? The only issue with the Novofine ones is that they are 8mm, but I can live with that.

Because of having the Novofine covered needles, I've never actually had any problems injecting myself - all my problems with my diabetes have been to do with my level of insulin sensitivity, huge numbers of hypos, and the way (because of my ME) that things like temperature have a much bigger effect on my bgl than the things I eat - none of these at all helped by my adverse reaction to Lantus! - pretty much identical to Kooky's problems, in fact. So really the only things which would solve these are being able to change my doses by much tinier amounts of insulin at a time - tenth units rather than half units. But unlike Kooky I've been asked if I wanted a pump, it's just that I said it wouldn't be suitable for me because I thought I'd have to be able to insert the cannula manually.

 

[mikeyB]

Ah, I see Juliet. I was preaching to the converted! But now TW has explained how you can insert the cannula using an inserted without seeing a needle, you can perhaps give a pump a try. There is, of course, the possibility that you may react to the sticky, but you won't know till you try a sample before committing. I shouldn't worry about teflon, it's completely inert.

 

[TheClockworkDodo]

Thanks, Mike - I'm planning to talk to my diabetes nurse about it when I see her in April, though I might email her before that. I'm still adjusting to the Tresiba though and also planning to get a Libre in the new year, so I'm trying to do one thing at a time! Useful to know that about Teflon - I react to a lot of plastics, but I suspect it's likely to be the petrochemical-based ones which are the problem.