Did some research, looks like most people need to increase their dose when they switch from Lantus to Levemir (so it may make sense that someone on Lantus can use a 1:1 conversion to Tresiba whereas someone on Levemir may need to decrease their dose).
However, the Lantus to Tresiba conversion seems to vary. Officially, it looks like it’s supposed to be a 1:1 conversion, but people have reported in online forums that they’ve needed to take a little more or a little less. I haven’t found anyone reporting anything close to the increase my doctor recommended. I’m actually pretty annoyed about it now because I asked her if she was sure that it should be increased by so much, and she seemed very confident about it.
I guess we’ll wait and see if my annoyance is valid. I’ll probably just start with a 1:1 conversion now. Thanks for the extra warning
@Katers87, when we discussed this conversion with our endo, she suggested starting at 90% of the Lantus dose.
The other thing I would add is—since Tresiba needs 3 days to establish itself stably, when I was thinking through it, I suspected that one would run very high the first day or two. If you look at what happened with @Jen, she did go high a lot early on. So, when I think about how we will do it when we test Tresiba, I am thinking we will probably keep a 40% Lantus dose the first day. But that’s me
I switched 1:1 took last dose of Lantus evening 1 took first dose of tresiba evening 2… no problems whatsoever, to me that’s the best way… mixing and matching different basal doses and trying to guess how much of what to take and what’s doing what would be like juggling flaming chainsaws in my mind… you have a clear starting point with an understanding of how much Lantus you take every day… may well need to be adjusted up or down a bit after some time but why preemptively wander off into the weeds of wild-guessing?
Well, I certainly wouldn’t want to juggle any flaming chain saws
I’m also not particularly excited about running high all day though. Since I give Lantus in two doses, I think I’ll be ok. I did a Lantus dose this evening, and I’ll start my Tresiba dose tomorrow morning, so I’ll have some Lantus left on board for at least a portion of the day.
My anecdotal impression was the opposite—people seeming to need less. Could well be my own bias, since that was the case for me by a few units, and I recall a number of other people saying the same thing. I did 1:1, but because too much basal is worse than too little, IMO, I would recommend erring a little lower… I’m shocked that your endo recommended such a huge increase which seems like it could in no way be accurate for an ideal starting dose…
