The first thing I’m always asked when someone hears why I’m taking a long-acting insulin as a person with type 1 diabetes is, “Why don’t you wear a pump?”
My answer is simple: I don’t like pumps.
I wore a pump for 7 years. And I’ve been taking long-acting insulin via multiple daily injections (MDI) for the past 11 years. My A1C is around 6.0 percent, and I’ll never shy away from another injection—even if it’s just a ½ unit—if that’s what it takes to maintain healthy blood sugar levels. (I even continued MDI during pregnancy! With great success and a healthy baby-girl at the finish line!)
Today, there are many long-acting basal insulin options, but until recently, only one of those options worked for me.
Levemir insulin has never worked for my body—for whatever reason, it’s just slightly more effective than if I were injecting a syringe full of saline. So, for years, that left me with one alternative—Lantus.
I’ve also tried the very new Toujeo, which seemed fantastic for the first 2 or 3 weeks until my blood sugar starting going haywire. There was so little rhyme or reason to the lows and highs. It was as if I had become the world’s dumbest diabetic overnight (until, that is, I started reading that others were having the same problem with Tresiba!).
I appreciate Lantus, certainly, but it has some incredible flaws (see below) that I’ve just had to deal with…because it was my only option.
As of last summer (2016)—when Tresiba was approved by the FDA in the United States—I now have more choices.
Here are 3 reasons why I thank my lucky stars that a bunch of scientists created this terrific insulin:
Lantus is a very acidic insulin and boy, does it burn! When I was pregnant and my doses were nearly double—at 30 units instead of 15— I dreaded my daily injection. I tried icing the area first so I wouldn’t feel it. I tried slapping the injection area right before or after to distract from the pain. Eventually, I had my husband administer the injection for me. The pain of the burn was so unbearable it made me want to pull the syringe out before the full dose was administered. There were times it was so painful, I thought I was going to hurl.
Maybe I’m especially sensitive, but even when my dose was back under 15 units the burning side-effect made me angry every night. Tresiba, on the other hand, doesn’t burn at all. It is a non-issue. And I am eternally grateful!
In those with higher sensitivities to insulin, you will typically notice a “peak” in the efficacy of Lantus insulin about 5 hours after the injection. If you’re trying to maintain near-normal blood sugars, and you go to bed with a blood sugar anywhere near 90 mg/dL (which is ideal for my long-term wellbeing) that means I’m going to end up at about 40 mg/dL around 3 a.m.
This happened to me constantly though I tried every approach I could think of to prevent it. Mostly I was left with the option of going to bed with a high blood sugar (around 140 mg/dL) so that the 3 a.m. peak brought me down without causing hypoglycemia. Obviously, this isn’t a very good long-term plan because I’m still spending a good part of the night well above 90 mg/dL. Tresiba, on the other hand, has no peak. It’s the most-steady, long-acting insulin I’ve ever been on. It’s reliable, it’s consistent…and did I mention that it’s steady? It’s awesome. I can go to bed at 90 mg/dL and wake-up at 90 mg/dL.
With Lantus insulin, you may notice your blood sugars start to rise about 18 hours after injection even though you really can’t take your next injection until about 24 hours after that last one. (In other words, if you keep moving it forward 6 hours, you’ll be taking your Lantus at drastically different times of the day every day—not an optimal scenario.) Levemir usually has to be taken in 2 doses, 12 hours apart…and Toujeo is a nightmare for reasons mentioned earlier. With Tresiba, however, it actually lasts in your body for up to two days! This means you have a little wiggle-room when it comes to taking your daily injection. More realistic for real life where your entire schedule doesn’t have to revolve itself around diabetes.
Overall, I’m also eternally grateful for Tresiba, because I felt very stuck with one option that was really providing sub-par results and a sub-par experience. Tresiba has made some very small but very important details of life with diabetes much, much better.