I have been on a pump break for 3 months and my BGs have been fantastic - I’ve been taking Lantus via pen, 8u at night and 6u in the morning; using a vial/syringes for my Novolog.
I feel free not having my pump on me - not worrying about tubing, alarms, charging, filling cartridges, time disconnected, etc.
Being able to move my injection sites around has really helped with absorption - my highs come down more quickly and I have fewer post-meal spikes.
Not having any short-acting insulin on board has allowed me to have longer workouts, without the need to prepare as much ahead of time (suspending my pump, eating snacks, etc).
Not needing to deal with my DME company as much.
So, I’m planning to continue my pump-free life for the foreseeable future. Lantus seems to be working well, but people say Tresiba is superior. My doctor gave me a sample pen to try out. To switch, should I just take a full dose at night instead of my Lantus? I know it takes a couple of days to fully ramp up. If so, should I start with the full 14u or go lower to start?
Thanks for any suggestions. Everyone on this forum is just wonderful!!
Because if you are, Tresiba would make it tougher.
With Lantus, you can adjust things much easier. For example, for morning runs you can reduce your evening Lantus and delay your morning Lantus until after your run.
With Tresiba, you’d be feeding your basal a lot during runs.
I’m done with half marathons (one was enough!), so just shorter workouts, 60-75 minutes usually. I haven’t had to adjust my Lantus at all for workouts as it is, so maybe that would be ok with Tresiba?
If you are splitting Lantus into 2x daily, there is a little bit of an increased basal time (when the 2 doses overlap) and a little bit of a lower basal time (when there is no overlap.)
The “no overlap” time might be coinciding with your workouts. Or maybe not.
With Tresiba, theoretically it’s going to be much flatter throughout the day.
So how it plays out for exercise is just something you will have to test out.
I almost always turn off basal. Even for the shortest stuff!
I think not having any short acting from my pump is the game-changer. Since long-acting just works differently, I think I’m personally not as affected when I work out. It’s nice to find that this works but I haven’t tried running more than 3-4 miles since my race in August
Indeed it’s very true! Basal insulin’s like Lantus are not affected by exercise as much as the little trickles of rapid insulin’s that pumps use for basal.
I think Levemir is affected by exercise the least.
The absorption of Lantus is affected slightly by exercise, but less than Humalog or NovoLog.
I have no experience with Tresiba. But I think it’s similar in design to the way Lantus works. It slowly breaks off little pieces from the end of its chain. So exercise won’t affect it too much.
@Allison – I’m on Tresiba! I switched over from Lantus about a year ago (maybe two?) and I really like it. Lantus was definitely not a 24 hour insulin for me and once I realized that, the tail-off at around 20 or 22 hrs made me nuts. I would definitely recommend trying Tresiba. Your blood sugars are incredible and the consistency of this probably can’t hurt. I also work out a ton and I’m able to do what I need to do on Tresiba (and was able to on Lantus as well) (but I’m not a super jock or anything).
I would note that Tresiba is more “efficient” for me, so I started at a lower dose than my total daily dose of Lantus (which was the same as yours - 14u total). The crazy thing is that I’m at 8u total for Tresiba now, but I also now take metformin, which has changed my insulin sensitivity, and I think allowed me to decrease my weight by a few pounds. My Tresiba dose did decrease over time. So maybe start at 10, 11, or 12u of Tresiba and go from there? Let us know how it goes!
I’ve had good results with both Lantus and tresiba. I found tresiba to be more stable overall for me, even when exercising a lot. Lantus had its advantages too I’d say… I think I probably had more predictable fasting levels with Lantus at night…. But more tendency to crash with exercise
I was certainly able to maintain tighter overall control with either than with the omnipod 5… but at the expense of significantly more work— and lately I’ve just had too many other things to juggle in addition to diabetes, so the pump has been nice in that scenario…
I’d hope if life ever settles down again I might switch back to mdi during the school year and just use the pods during cruise ship season
Thanks! I really appreciate you sharing your experience. I tried Tresiba once several years ago and I don’t think I gave it good enough of a chance. Whatever my dose was, one unit made a big difference in if I ran high or low for the day, which was very frustrating. I’m not on Metformin but do take Ozempic so I wonder if that might have any effect either (although I’ve been on similar meds for 11 years). I will try to post back after I give it a go
Thank you for sharing. I am surprised at how flat my numbers stay overnight using Lantus (unless I eat too much right before bed)! I’m almost afraid to rock the boat with Tresiba but hope it is a little more forgiving with dosing, since I’m now taking 2 doses, 12 hours apart.
I hope you can figure out what works best for you in this season of life!
I’d tend to agree I’d give Lantus a slight edge in overnight stability, although I only ever took it once a day… (and I had the best overnight numbers when I took it in the pm…. And I don’t do myself any favors because I’m a big time pm snacker
The nice thing about tresiba is it’s extremely forgiving in dose timing, I just took it generally the same time of day… like within maybe 4 hours, and it worked fine
thanks for this. My numbers are the same as yours and I am on a Humalog pen for bolus and a Glargine pen for basal. Pretty much 20/20. Folks have been trying to persuade me to try a pump but I have a bit of an aversion to the idea. Reading your comments, I will just stick with what is working for now. Thanks again
Glad to hear your success, @allison ! This thread has helped remind me of the benefits of MDI.
I’m reading with interest the part about transitioning to Tresiba, since I’m on Levemir until I can’t get it anymore. My initial run with Tresiba wasn’t good: constant lows when I had a physically active day (compared to normal desk work) causing me to switch back to Levemir
I’ve only ever been on Tresiba for my basal. I’ve had generally good results with it. The only caveat is that it’s hard to dial it down for just one day. The active life of Tresiba can be around 36 hours, so if I have a heavy exercise day ahead (long hike or other physical activity) that I know about, I would have to start dialing back my basal 2-3 days in advance in prep for it. Lantus being a shorter duration basal means these changes are easier to manage. Not as easy as a pump, but I’m not doing that yet.
Thank you for sharing your experience! It sounds like it may be worth trying the pen I have to see how it goes. Unfortunately the amount of activity in my days really varies.
If you are doing well without a pump, I don’t think you necessarily NEED to try it. But, for what it’s worth, pumps have 30-60 day return periods if you decide it isn’t for you.
wonderful!!