Just out of interest, what’s wrong with Vermont maple syrup? Or is maple syrup the only thing we Canadians have of interest?
Yeah, the first few days was not enough. If you think about taking something every 24 hours and it lasts longer than 24 hours, on day 2 you will have more in your system than you did on day 1. But by day 3 the amount should be leveled out. Is that what you were asking about?
Yeah. Pretty much if I should expect that this dose will eventually build up to such a degree that it’ll be enough, or whether I should adjust the dose early since it (at the moment) clearly isn’t enough. I was curious if others switching from a pump to Tresiba ran high like this for the first day or two.
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How many times do I have to say it, it’s not a mongoose! Eesh.
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@Jen Don’t make corrections too quickly with any basal insulin. Just try to manage the break in period with correcting boluses.
Like I’ve said before, I titrated my Tresiba dose over the course of about a month, and only made four downward corrections in that time.
Patience!
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Yes, the first day was almost worthless for me.
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I would fight the urge to increase it for a little longer and just keep correcting. The people who seem to have found success with it are the ones who are able to do that… the people that end up chasing their dose around inside of its stabilization period seem to be the ones who decide it doesn’t work well…
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I think what I’m finding annoying is that even when correcting I’m not coming down into range.
So far today I corrected with extra insulin and came down to 10.5 mmol/L, but currently back up to 14.2 mmol/L. I just corrected again with extra insulin on top of the normal correction.
I’ll take the same dose of Tresiba tonight, but if I continue running so high tomorrow, I’m going to increase the dose tomorrow night.
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Well it makes sense that if your basal isn’t fully working yet because it takes a couple days to get up to full speed that bolus corrections would be less potent if your bg is continuously tending to rise…
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Yeah, it makes sense. It’s just highly annoying not to mention feels horrible. I could handle highs of 8-11 non-stop easily, but 14-21 non-stop is just…ugh.
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I wonder if you basically need to treat today like a sick day or one on oral steroids, where you just use a WAY higher correction factor.
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Well if we break this down mathematically, which I dont entirely believe in, we might see that you’d expect to use 15 extra correction units during the first 24 hours
I don’t really think that’s necessarily accurate, but worth just considering in the abstract…
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@jen - If I were doing this transition, I think I would make up the missing basal today with Fiasp shots. - For example - assume that the tresiba is only 1/2 active on the first day - so make up 50% of your basal by giving a fiasp shot every 2-4 hours that would equal the missing basal.
So something like 36 U/2 = 18U to make-up which would be 1.5 U every 2 hours or 3 U every four hours. For me I could easily cover the 1.5U with carbs as the Tresiba action picks up as the day goes on.
For the highs - I would just hit them hard. I usually use 2x my correction factor when I am above 10 mmol/l. For me about 10 mmol/1, I use 1 U to drop 1 mmol/l. Below 10 I use 1 U to drop 2 mmol/l
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This makes sense, and would be similar to running a 50% basal rate on the pump.
I do think maybe the highs have made me build up some insulin resistance, so maybe I do need to treat today like a sick day and be super aggressive. I’ll try that with my next correction (I need to correct a 13.2 mmol/L right now). The 24 hour mark is coming up in about two hours, so I’m assuming this will continue for some degree for longer than that.
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You could certainly take today’s basal shot now too… as long as you take it every day and with at least 8 hours in between it doesn’t really matter what time with tresiba, that’s what I’d do… that’d just help to get the second dose in play sooner… no good reason to wait til tonight
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Well, I just did a 12u food/BG bolus, so I’ll wait a few hours to see what that does, then I’ll do my next Tresiba dose.
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Second dose of Tresiba on board. I refrained from going crazy and did the same 36 units. 
My blood sugar is currently sitting at 11.2 mmol/L…so hopefully that will start dropping into range soon!
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Patience will pay off! I expect tonight to go more smoothly…
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Yeah…so if this were a private pump vacation rather than one I’m documenting on a public forum, I’d be on the verge of hooking up my pump right now, even just temporarily to get some additional basal insulin. Still running way outside my target range with no end in sight. I even took a walk this afternoon and thought the combination of that plus “dose two” might bring things down into range…
Maybe if I can get my BG down within range before bed I will get a beautiful flatline overnight…
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Well you sure aren’t gonna have a beautiful flat line before you get in range:)… still just steadily rising huh? I’d expect it to be to the point where it should start getting easier… that said you didn’t really know where to start your dose because pumpings just different than long acting basal, so it’s not unlikely at all that you’ll end up needing more
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