@Jen, for what it’s worth, I increase and decrease my Tresiba a bit with cycle changes (still figuring exactly when/how…but at least some of the time I seem to be getting it right), but that seems to work ok—I’d argue it’s reasonably good at making changes that work over the course of days, but it’s the within-days changes it has no capacity for.
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Yeah, with my cycle sometimes I’ll have a change over a couple of days, but sometimes it’s literally overnight. I didn’t believe it until I went on a CGM and saw that I really did go from 95% in range one day to 23% in range the next day with no other changes. That’s the part Lantus can’t handle, and I’m not sure how Tresiba would handle it since I’ve heard it takes three days for changes to kick in. And I’d also say most of the time my basal changes are more than a few units, more like 50% up or down of my basal dose.
Last night is a perfect example of where I used the temporary basal on my pump. I had a fairly low-low in the evening that I overtreated and then did a small correction for the resulting high, and woke up to my CGM alarming again around 1:30 AM. I treated the low correctly (using some corn syrup I keep next to my bed since I’m too lazy to get up and eat glucose tablets in the middle of the night), but using my diabetes sense, I decided to run a -20% temporary basal rate. I gradually rose during the rest of the night and woke up this morning at 5.9 mmol/L. Overall, with the basal decrease I took about 2.5 units less than I otherwise would have. I’ll probably lower my permanent basal rates again if I continue to run low today. It’s these spur-of-the-moment changes that I think I would miss just as much as the basal variations throughout the day (which, for me, my basal needs vary by about 40% at various times each day), as well as the coverage for hormones, exercise, activities, illness, and medications that I’d be very curious to see how Tresiba would handle.
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@Jen I’ve never been on a pump, always MDI. I’ve used Lantus, Toujeo, and now Tresiba. I can tell you Tresiba is far and away the best of the lot.
Switching from Toujeo to Tresiba took about two days to stabilize. I spent about four weeks longer to titrate my dose. But this is the first time I’ve actually experienced a true, flat, 24 hour coverage of basal.
Lantus and Toujeo both required twice daily injections and the associated several hours of overlap. Tresiba does seem to last all day.
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I would think that after a month, if adjusted properly and not too frequently (a sure recipe for frustration imo) you’d have a pretty good idea if its a good fit for you…
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