I wish I had waited 4 days before I made any adjustments. After upping my dose by 1 to 24, my flat morning line disappeared and was replaced with a slight downward slant. Nothing too alarming…
However despite not taking any fast acting since 12:30 pm, my blood sugar plummeted on my walk home (1.5 miles) from work around 5 pm. I had a really hard time raising my sugar level too. I didn’t have too much trouble with lows during the night because I think I was still digesting everything I had to bring my sugar levels up… the patterns are messy all night long before finally ending with a downward slant.
I’m lowering my basal back to 23 units today. I don’t know why there was such a dramatic change with one unit, but I am a little concerned that light/moderate exercise might have a big impact on how my body handles Tresiba. Not jumping to that conclusion yet though. Hopefully I just shouldn’t have bumped up my dose.
Goodbye beautiful morning flat lines. I have no idea why my sugar level suddenly started going up in the morning. Starting to get a bit frustrated with Tresiba. At least I knew what to expect from Lantus…
It took me a while to settle on a dose that (mostly) works for me, but I do not have any results with Tresiba that are perfectly flat day to day regardless of activity to the extent some others report (probably also complicated by menstrual hormones which I think add some noise Tresiba cannot handle perfectly, but not to the extent that Jen seems to experience). I did find that a single unit, once I was close to where I landed, could make a difference in terms of fine-tuning. I also find that if I go from fairly sedentary to walking all day, my dose cannot handle that and I need to adjust with backing off basals, eating more, and/or adjusting my dose if it will be for an extended stretch of time.
I had to eat an extremely large amount of carbs to get my blood sugar up to normal… like 5 times as much as I would normally for a bad low. I was expecting to have a bad spike at some point, but I never even went above 180. You can see on my report that I went up for a bit around 7, and then plummeted right back down. That’s a 24 hour report, so it’s hard to tell, but I was struggling with lows for at least 3 hours. Since this is a long-acting insulin, I was worried it was going to happen all night.
If my dosage was just wrong, then maybe I can make this work, but I can’t deal with lows like that everyday. I’m switching back to 23, but if I struggle with highs every night at 23 and lows everyday at 24, then this insulin is a really bad fit for me. I’m probably being too hasty, but I haven’t been that concerned about a low in quite a awhile.
I do remember thinking I wasn’t going to find the right dose, but then landing on something that worked better than any Lantus dose had for me. That said, maybe it’s worth trying splitting your dose like @Jen did—I know part of the appeal is a single injection, but my guess is that even with a split dose, the flexibility on exact timing of each injection would be much greater with Tresiba.
Hopefully this is how it works out . I’m not yet ready to consider splitting my dose. If problems persist, I’ll probably try switching to later in the day before I try that. I might try it eventually though.
No highs last night . I haven’t been on 23 units/day for long enough for that to mean anything significant though. Tonight will probably be a better indicator of how I’ll handle this dose at night.
I did, once again, drop on the way home from work. This was a much more manageable drop though. I’m planning to go swimming today during lunch (25-30 min), so I’ll see if I experience a drop then. This will be a good test to determine if the time of day is the problem or if the walk home is.
I didn’t try any swimming, but I found when I was taking Tresiba I dropped when I commuted to and from work. I had to use glucose tablets (or other food) to manage the drops. (I had the same problem of dropping during “routine” daily exercise on Lantus.)
I’m not much of a swimmer at all but I do jog semi-regularly. With Lantus I’d have to snack w/o bolus before and sometimes during jogs to keep from dropping too much. Much less so with tresiba, for me…
The swim went well. I rose a bit while in the water, but was otherwise fine. This is generally what happened on Lantus too when I swam though. Now that I’m thinking about it, I don’t know if it’s the best indicator of how other forms of exercise will affect me under Tresiba. I don’t know why my blood sugar usually rose while swimming. It just did- despite my workouts feeling pretty intense. My workout today was intense! I feel awesome.
I’m going into the office tomorrow (teleworked today), so we’ll see if I drop again on the walk home. I didn’t usually drop on Lantus on the walk home unless I had also taken Humalog. I’m hoping for something similar with Tresiba. I haven’t been dropping on the walk into work, so that’s a good sign.
It’s good to hear your experiences with this on Tresiba, @Sam and @Jen. It’s interesting how people react so differently to the same medications.
You unknowingly answered your own question. Intense exercise can actually raise blood sugars, since it triggers the liver to release glucose for your body to use during exercise (except that doesn’t work so well when you don’t also produce insulin to go with it). @Eric can explain it in much more detail and has in a number of threads on exercise on the forum.
No highs the last couple of nights. I’ve actually struggled with lows both nights. I kept 23 units yesterday because I didn’t want to be too hasty. The lows last night were a real hassle though.
I didn’t end up walking home from work yesterday because I had that doctor’s appointment for Afrezza. I still dropped low at 5 pm.
I found I had to keep lowering the dose every day as I was dropping extremely low at night. The problem (at least I think) was that once I reduced the dose below a certain level Tresiba was not strong enough in the late afternoon/evening causing highs. I went back to my pump, couldn’t take it anymore, but hope it works better for you!
At night. When I tried in the morning I found I would get bad DP. It shouldn’t matter though according to the way it’s supposed to work, but since it does it tells me it does not live up to the hype (at least for me).
Oh okay. That’s interesting. I usually dose in the morning. I haven’t had a problem at all with DP (except for one day I guess, but that was an anomaly), but I haven’t figured out the right dose yet. The DP may come once I’ve lowered my dose to where I’m flat overnight.
If it does, then I may try switching the time of day and refine my dose again.
I found it was strongest a few hours after injection, really strong about 9-12 hours after, and then would wean off through the day - which is not at all how it’s supposed to work!
Yeah, that sounds frustrating. I’m actually having the opposite experience
It seems to be strongest about 9-24 hours after I’ve taken it. Alternatively, those could just be the times of day when I need less insulin. It’s hard to say!
That’s the thing, it’s hard to know if it’s the basal or our bodies causing the problems! At least with the pump I can make adjustments through the day, but of course I’ve already had site issues confirming my theory that every treatment sucks!
. I’m not yet ready to consider splitting my dose. If problems persist, I’ll probably try switching to later in the day before I try that. I might try it eventually though.
. I haven’t been on 23 units/day for long enough for that to mean anything significant though. Tonight will probably be a better indicator of how I’ll handle this dose at night.