Tresiba

[Lucyr]

I currently use a twice daily isophane insulin, but my split is very unequal with much more basal a.m. than p.m. For this reason, I wonder how Tresiba would work in that situation as it has a pretty flat profile. I think this has also concerned @rebrascora and others too. It’s the logic of it - I can’t envisage how it would work.

I absolutely hated tresiba, worst basal ever. I don’t really need any basal at 5-7pm ish, so tresiba going full pelt then meant I would plummet to hypos just as I was leaving work because it was too flat. Hated the stuff and took me ages to convince the hospital to get me off it. Ever since I take my lantus at 6pm so I have hardly anything left 5-7pm which works fine

 

[Lisa65]

I suspect it might be worth waiting until you can get the Trurapi, to have both meal/correction and background/basal needs covered. It would also mean that any tweaks you make are in the context of your system going forwards, rather than making it work basal-only, and then having to start again when you have the rapid insulin to add in?

Yeah I'm going to leave it as it is for now, then when I get the trurapi I'll see how it goes using both. I'm sure they will let me have abasaglar again if I decide I don't like tresiba, I'll just have to promise not to split the dose 😉

 

[rebrascora]

I'll just have to promise not to split the dose

Or just not mention that you intend to and hope no one asks. It really is shocking that some DSNs and consultants have to be so domineering. I am so lucky with my new consultant.

 

[Lisa65]

Or just not mention that you intend to and hope no one asks. It really is shocking that some DSNs and consultants have to be so domineering. I am so lucky with my new consultant.

The nurse at my surgery is lovely, it's just that she asks the hospital team before making any changes to my insulin rather than letting me guide my own treatment because I know what works for me!

 

[rebrascora]

My nurse at the surgery was also like that. Absolutely lovely but really anxious about me doing non standard practices. I am sure some of the things I have done (like stopping my basal and just using bolus for a couple of weeks) have given her nightmares and she is always encouraging me to contact the clinic, but I have never really had much useful practical advice from the clinic helpline. My consultant appointments are generally more or less annual and it is just a "check in" rather than him suggesting different doses or whatever and to be honest my consultant knows that I know what I am doing. I don't have a DSN at the clinic, but I am happy being left to my own devices to carefully experiment and figure out what works for me. It sounds like you are doing the same thing and I personally think that more people should be encouraged to do so, because the only person who lives with our diabetes is us, so we need to become the expert.

 

[Lisa65]

I dug my heels in over the Tresiba and said I want to go back on Abasaglar, surgery nurse said I can, but I must only use it once a day so I said of course 😉
Review on 17th June when the DSN is next on site. No trurapi until then ffs 🙄 I wish they would just leave me alone to get on with it but I guess I have to play ball for now

 

[Leadinglights]

I dug my heels in over the Tresiba and said I want to go back on Abasaglar, surgery nurse said I can, but I must only use it once a day so I said of course 😉
Review on 17th June when the DSN is next on site. No trurapi until then ffs 🙄 I wish they would just leave me alone to get on with it but I guess I have to play ball for now

You may find that once you get the truapi then once a day may be OK.

 

[helli]

You may find that once you get the truapi then once a day may be OK.

That is an interesting thought.
Do you have experience or reference from others to suggest that a glargine insulin lasts longer when taken with a fast acting insulin?

As someone with Type 1, I have some (dated) experience but no medical training.
Before I started using a pump, I used Lantus (another glargine like Abasaglur) and NovoRapid (Trurapi is a biosimilar).
At the time, I would only use Basal (Lantus/glargine) once a day.
BUT
- I needed more NovoRapid/Bolus to cover the time when the Lantus ran out. I would do a "correction bolus" every afternoon.
- I did not have a CGM so I could not see the full extent of the gap

Using the tools and the knowledge I have now, if I had to revert to MDI with the insulins I have as a back up to my pump (Lantus and NovoRapid), I would definitely inject my basal twice a day.


But my experience is dated (and we are all different) so it is now theoretical. Maybe you know something I missed?

 

[Lisa65]

That is an interesting thought.
Do you have experience or reference from others to suggest that a glargine insulin lasts longer when taken with a fast acting insulin?

As someone with Type 1, I have some (dated) experience but no medical training.
Before I started using a pump, I used Lantus (another glargine like Abasaglur) and NovoRapid (Trurapi is a biosimilar).
At the time, I would only use Basal (Lantus/glargine) once a day.
BUT
- I needed more NovoRapid/Bolus to cover the time when the Lantus ran out. I would do a "correction bolus" every afternoon.
- I did not have a CGM so I could not see the full extent of the gap

Using the tools and the knowledge I have now, if I had to revert to MDI with the insulins I have as a back up to my pump (Lantus and NovoRapid), I would definitely inject my basal twice a day.


But my experience is dated (and we are all different) so it is now theoretical. Maybe you know something I missed?

I fully intend to carry on using it twice a day, BUT I have found my BG tends to dip by a few points throughout the afternoon irrespective of insulin intake. So if I were only to use it once a day along with trurapi, I would inject it around tea time as it would have started to tail off during the afternoon.

 

[everydayupsanddowns]

I dug my heels in over the Tresiba and said I want to go back on Abasaglar, surgery nurse said I can, but I must only use it once a day so I said of course 😉
Review on 17th June when the DSN is next on site. No trurapi until then ffs 🙄 I wish they would just leave me alone to get on with it but I guess I have to play ball for now

Sorry to hear you are having to wait for the appointment to get started on rapid. Must be really frustrating for you.

I can understand it from their perspective. But it must be a bit annoying with the number of forum peeps who arrive having been given insulin and little if any instruction. And here you are, well equipped and ready to get going (carefully) but you have to wait a month for an appointment!

 

[Lisa65]

Sorry to hear you are having to wait for the appointment to get started on rapid. Must be really frustrating for you.

I can understand it from their perspective. But it must be a bit annoying with the number of forum peeps who arrive having been given insulin and little if any instruction. And here you are, well equipped and ready to get going (carefully) but you have to wait a month for an appointment!

It is a bit frustrating, but this nurse has been so lovely and helpful that I don't want to make too many waves by trying to force the issue. The last practice nurse was a complete dragon and I was terrified of seeing her! it's only another few weeks to wait.