Sure, and for me, it’s still a good enough option that I’m reasonably happy with, moreso than anything else I’ve tried to date. But I think the way you talk about it sometimes makes a lot of assumptions that your experience is a general truth about Tresiba, versus framing it as your own personal experience.
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Yes you are right I can only speak as to my own experience. The reason I’m so enthusiastic about it is how I stumbled into it myself because I was certain it wouldn’t work for me… I didn’t even want to try it. I was mad that my doc insisted I try it first before I moved on to what I actually wanted to do (which was a more complex basal regimen). I knew it wasn’t going to work. It was just a hoop I had to jump through to get what I actually needed. So when it turned out to work phenomenally well it was actually a big eye opener for me… that was my reality too! That I had variable basal needs! I was so frustrated that my doc was screwing around making me try a “flat basal” when I was sitting there explaining that I had varying needs throughout the day and night and for exercise
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Ok, but then maybe it would be more accurate to talk about it from your experience, like you just did, rather than saying things like “Tresiba does [what it does for you]” as a general statement? It may seem like a small difference in phrasing, but it’s a fairly meaningful one.
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Is it possible you still have residual insulin production that makes it work better for you than for some? I think I honeymooned for over 3 years and when I was first put on Levemir it worked perfectly as a 24-hour flat once-a-day basal when I still had insulin production backing it up. I could be way off the mark here, just wondering since your Tresiba experience seems light years ahead of my experience with it or other comments I’ve read.
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Well I may have some residual insulin activity, but I don’t think that fully explains why with other basals I had so many more ups and downs than I do with This. I used Lantus for about 5 years before switching
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Well Lantus apparently has pretty extreme between-person variability in how well its slow-release crystallization method works. For the people for whom it does not work well, its absorption can be erratic and variable, I believe both across the 20ish hour period it works and as well as differ day-to-day. I’m not sure a small amount of endogenous insulin production could counteract that, if you were someone whose physiology it really does not work well for. The real test would be to compare it to Levemir—who knows, Tresiba works really well for you, but it could be that it’s just that Lantus didn’t, and Levemir would work just fine as well. So it may be less about Tresiba and more about the Lantus, which is a common enough phenomenon. You could certainly test that if you were curious enough, although obviously there’s no gain for you individually.
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I definitely believe it’s flatter and more stable than the other basals. My issue with it was it didn’t come close to meeting my basal needs from the late afternoon on, but was very strong overnight. I’ve read other people say they have had this problem too. I’m wondering if you have insulin production that fills in the gaps during times when the Tresiba does isn’t enough.
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Trying stuff out is really the best way to determine if something works or does not.
Funny to hear from all the endos who recommend insulins or pumps or CGM’s they have never used, but they’ve “read all about them”. 
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I think almost everyone has some tiny amount of residual insulin production… nowhere near enough, but some tiny amount… how this interacts with some exogenous insulins vs others I have no way of specifically knowing
@cardamom levemir split 2x daily into different amounts is actually what I was campaigning for when they insisted I try the tresiba first…
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Well endos also manage the results of many many patients so they do also have a pretty good perspective to see these things too. We each have then 100% perspective of one person. They have maybe the 1% perspective of several thousand
Right, and it’s impossible to say whether that would have also worked for you. Maybe. Maybe not! Certainly your results with Tresiba are ideal, so no need for you to experiment further and if you can get ideal results with a simpler and more flexible regimen, why not? But it makes it harder to draw firm conclusions about to what extent the shift is due to the magic of Tresiba or the badness of Lantus. (My guess would be both, but that not being on Lantus is a major component.)
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Perhaps, but I’m far far from the only person who has realized these great results with tresiba… I’ve seen many many people transition from pumps to tresiba and never look back, so in my estimation there is something about it that works really well for a lot of people… the main point I’m trying to make is that it’s not possible to know if any individual might be one of them unless they actually try it… your needs with one formulation do not necessarily indicate that those patterns are relevant with a completely different formulation
I went low every afternoon with Lantus, does that mean I needed less insulin in the afternoon? Or did that mean Lantus wasn’t working well for me? Initially I thought the first one… I’ve come to realize it was actually the second though
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I would think you’d have a pretty good idea within a week or so if it’s going to work out… and probably have had time to pretty much dial in your dose by 2 weeks or so