# Degludec Tresiba



## Amity Island (Jun 28, 2017)

Hi everybody, this is my first post on here. 

Please could anybody share their experience of exercising whilst using tresiba. I have been informed that you can only adjust the dosage of tresiba once a week. How can this work if one day you need to lower your basal dose so you can exercise? I've just started tresiba but at the moment basal is too low and having to make many bolus corrections to keep things on an even keel. Just wondering how tresiba works with varying activity levels.


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## Copepod (Jun 28, 2017)

Welcome to the forum, Amity Island.
I'm really not sure how to make long acting insulins work for people who have very different levels of activity from day to day.
It's one of the reasons I wasn't keen to change from twice daily Humalin I when my consultant suggested Toujeo (disposable pens were the other reason)
What have you been using up to now?


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## Matt Cycle (Jun 28, 2017)

Hi

I was on Tresiba for around 6 months (after being on Levemir).  It's a fairly flat profile single daily dose long acting basal.  As regards exercise the issues I had with it were less flexibility compared to split dose Levemir and any dosage changes didn't seem to be very quick.  (Not sure who said you can only adjust dosage once a week but you'd best check with your diabetes team.  I changed mine whenever I was exercising or preferably the day before i.e. you've got to be a clairvoyant to know what you're going to be doing ).  As I mentioned the profile is fairly flat but the length of time it lasts didn't help me if I decided to exercise.  I decided it wasn't working well enough for me and my lifestyle so I changed back to split dose Levemir a couple of weeks ago, any dosage changes are much quicker and with the split doses it gives me the option of reducing it in the morning before exercise and then reducing that evening after exercise.


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## Copepod (Jun 28, 2017)

Amity Island said:


> Hi Copepod, thanks very much for such a quick reply, much appreciated. I was using lantus for my basal up until recently, but started exercising and it went a.w.o.l.. Up and down, had mild hypos during night and then it would run out before morning. I suppose it works provided you do regular exercise? Like daily.


Perhaps, but who on earth does the same amount of exercise every single day?!? It's simply not possible. So, I reckon the only solutions are either twice daily medium to long acting insulin as basal OR an insulin pump.


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## Matt Cycle (Jun 28, 2017)

What sort of distances are you looking at?  You may find you have issues at weekends (assuming you work Monday to Friday) but there's always a bit of trial and error in these things and ongoing adjustments.  T1 is like that - you think you have it sorted and then bam! something else.  I can't comment on Lantus as I've never used it but for me - Levemir and Tresiba were a straight swap in terms of total units but they're both made by Novo Nordisk.


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## Matt Cycle (Jun 28, 2017)

Amity Island said:


> Hi, it's only 5 miles each way, about 20-30mins at my pace. Cycle lanes all the way. Thought it better than sat in my car.



Good for you, that's 50 miles a week just going to work and back - definitely better than being sat in a car.  Plenty of bg testing as well, particularly in the beginning, will give you an idea of what's going on.  If you use a Libre they're great for things like this - checking your levels whilst on the move.


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## Copepod (Jun 28, 2017)

Amity Island said:


> Hi, it's only 5 miles each way, about 20-30mins at my pace. Cycle lanes all the way. Thought it better than sat in my car.


Definitely better for you and the environment to cycle those distances. I always cycle when I'm working at location 5 miles from home or when J can get train from station which is also 5 miles from home. It's not possible when I need to carry a boot full of pond dipping and woodland invertebrate nets, trays etc, plus hot drinks kit, crate of work gloves, huge tub of hand wipes, first aid kit etc!


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## TheClockworkDodo (Jun 28, 2017)

I changed from Lantus to Tresiba, and have found that I need less of the Tresiba, and that I need a more steady dose of it - with Lantus I was forever putting it up or down.  My Lantus dose varied from about 4-9 units, mostly depending on the weather.  My Tresiba dose has varied from 4-6 units, but after a bit of experimenting I think for me it's probably better to stick with 4 and deal with any temperature changes by increasing/decreasing my bolus doses.  I don't know whether that sort of thing would work with exercise - I don't really do enough to be able to tell (due to other illness which means exercise makes me ill!), I just eat a biscuit if I'm going to be gardening ...


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## Matt Cycle (Jun 29, 2017)

Amity Island said:


> Hi Matt thanks for your help, i'm new to all this exercise.  I noticed you cycle, although you look a bit more pro than myself LOL. I have tried the libre and it is very good, might get another one to get me started. Can you tell me me how you manage your insulin and carbs when you exercise? Say you were going to cycle for half an hour a moderate/easy ride. What would you do before? Reduce your basal that morning? Take only glucose (how much?) before hand to carry you through the 30 mins or some food which will last longer? Do you take any insuling with the carbs? I'm only talking ball park figures, to give me some idea what people do. Thanks



Definitely not pro - I'm more the budget end of the market.   Half an hour at moderate/easy pace I probably wouldn't do anything and just check my bloods and have some malt loaf or something if required.  I only get out once or twice a week for a ride so have to make it worthwhile - 2,3,4 or more hours.  I try and aim for a blood glucose level of around 7 (doesn't always work of course).  I would normally reduce basal in the morning (i'm still tinkering with the Levemir) and have my normal breakfast and NovoRapid and monitor as I go round using gels or energy drink if it drops too far, or banana, malt loaf etc for a more steady release energy release.  Don't use any NovoRapid on the way round with these carbs unless something goes drastically wrong and it goes up into the teens with no sign of dropping.  

Essentially I'm trying to replace the glucose I'm using.  Once back bloods can carry on dropping and through the night.  Will usually take extra carbs with reduced NovoRapid,  And again, may reduce the Levemir that evening depending on what bloods are saying.  As I said unfortunately it's a bit of trial and error but don't let it put you off.  I love getting out.

Runsweet is a great site for information on T1 and sports/exercise.

http://www.runsweet.com/


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## Bloden (Jun 29, 2017)

Hi Amity Island. I was having similar issues with Lantus so I changed to Tresiba in April. In general, my BGs are much more stable. For example, any afternoon/evening exercise with Lantus would sky-rocket my BG; the rise is much more subtle with Tresiba.

I'm trying to get back into daily exercising too - dog-walking after breakfast in my case - so let us know how you get on. I could do with a few pointers!


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## Ditto (Jul 2, 2017)

Wasn't Jaws off Amity Island?  Welcome to the forum.


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## Bloden (Jul 2, 2017)

Amity Island said:


> Hi
> 
> Hi, what dose of lantus were you on and what dose of tresiba are you now on?


I was on 12 of Lantus and I take 9 of Tresiba.


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## TheClockworkDodo (Jul 2, 2017)

Amity Island said:


> Hi, When I was on lantus 12u on days of exercise 21units when not exercising. But with tresiba you can't change your daily dose.


I was told when I was on Lantus that it took four days for any changes to take full effect, so I'm surprised you were managing to inject different amounts for days exercising or not exercising.  I've actually found changes to Tresiba take effect more quickly, though I don't normally change my basal more than once or twice a week anyway (no-one told me not to change Tresiba doses more than once a week!).


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## TheClockworkDodo (Jul 2, 2017)

I can't do anything strenuous, and I can never predict in advance how well I'm going to be on any given day, so I've never been able to reduce either basal or bolus beforehand for anything, in case I'm not up to doing it.  And I'd be unlikely to get to the next dose of bolus after doing anything remotely energetic without a hypo, so I couldn't rely on injecting less for my next meal.  So basically I have to remember if I feel up to gardening or something like that I just need to eat a biscuit when I go out and test as soon as I come in.


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