Day3. I took 22 units today. I woke at 137, after taking a small humalog correction overnight at 4 am (I woke up to pee which happens if my BG is at all high). But that could be either insufficient overnight basal or incorrect food/bolus the night before so not a bad start. I took what would have been a normal humalog correction amount on waking, but went a little low (54) in the late morning, so it looks like I need to lower my waking correction amount when using Tresiba (I saw the same thing the day before so this seems a solid conclusion). I eat a single egg for breakfast every morning and don’t need to bolus when using either Levemir or Tresiba, so this seems consistent.
At lunch started at 70 so took a slightly smaller bolus with lunch; that worked pretty well but 2-1/2 post lunch my BG went down to 63 so I corrected with 14g carb that bumped me up to 130, which then settled down over the next couple hours until I was at 90 at 6 hours post lunch bolus. So BG was trending down in the afternoon, but not dramatically.
Now to throw something new in the Tresiba mix, it was time to exercise, so did my 20min 5K rowing routine 9 hours after tresiba, 6 hours after lunch bolus (no bolus active during exercise). Started at BG 90, then BG immediately after rowing was 70, but then 20 min later by the time I got back to my desk it was 48 so I took another carb correction 21g since I wasn’t going to be able to eat dinner as I normally do immediately after exercise. Later needed another 12g carb correction about 11 hours after tresiba until finally able to eat dinner, by which time my BG was 88.
Using a basal insulin with longstanding T1 diabetes is always a matter of adjustment and compromise unlike using a pump which is infinitely adjustable. So I’ll settle on 22units tresiba for at least a few days as Katers suggested.
So with 22units tresiba in the morning, the day time was pretty manageable. I need to lessen my daytime boluses (for food and correction) somewhat, and it still looks like I have an insulin peak at 9-10 hours after injection. I could adjust to eating an unbolused pre-dinner dessert of a piece of fruit or cookie to meet that peak. More data needed on how exercise will affect this but no major issues there. But so far those adjustments seem manageable.
On the other hand, I had another overnight with a wake up high BG needing correction, more dramatic when taking 22units than it was when taking 25units. So far it looks similar to Scotteric, where dialing down on tresiba amount in order to get a workable daytime basal, leads to insufficient basal overnight. But I don’t have enough data yet to be sure, so will continue to check on that.
Sam, what time do you take your tresiba at night? A large part of the reason that I want to make tresiba work is that I occasionally forget to take my evening Levemir, even though I have a cellphone alarm set for it. It doesn’t happen often, but enough to be annoying. I almost never forget to take a morning basal injection. I think I could get used to taking my tresiba with dinner every night, though I would prefer morning. If I can’t make morning injection work, I will try taking it at night, though. More testing needed.