Tresiba, need dosing chart.

Discussion in 'Feline Health - (Welcome & Main Forum)' started by KAC2000, Apr 18, 2021.

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  1. KAC2000

    KAC2000 New Member

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    Oct 28, 2020
    After 10 months, I have finally found a new job. Number of hours worked each day can vary between 8 and 12 hours, plus 45 minute commute each way.

    I personally use Tresiba Flextouch 100 Unit Inj Nov.

    Since my work schedule will be so varied and I already have Tresiba, would like to know if anyone has a dosing chart for Tresiba.

    Thank you.
     
  2. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Last edited: Apr 18, 2021
  3. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Hi first off I think you need to set up your signature so members can see some info
    on your signature and spreadsheet for Buddy

    I will give you the links
     
  4. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  5. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  6. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    I have no idea about using Tresiba. I can tag a member that has used it in the past
    I also don't think there is a dosing chart for it

    @Sue and Luci
    Hi Sue do you think you can tell her about this insulin
    Thank you :cat:
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    There is a Tresiba forum that I've linked. There is not much information on the forum and it is not an insulin that appears to be widely used in cats. We have not had many members use Tresiba and from a quick scan of the literature, there's not a great deal of research on the use of that particular insulin in felines. It is a depot-type of insulin and as such, there may be some similarity to Lantus or Levemir.

    The best "general" method for dosing is Start Low Go Slow (SLGS). It's been adapted to several different types of insulin. The difficulty with Tresiba is that none of. us have experience with it (or I don't think there's anyone who does). It looks let @Sue and Luci tried Tresiba for a while and went back to Levemir.
     
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  8. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    The folks on the Tresiba forum were very helpful and had tips and advice on using Tresiba. Please post there and ask for help and suggestions. It didn't make much of a difference in Luci's blood sugars and I'd only purchased one pen, so we went back to Levimer.
     
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  9. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Thank you Sue for replying back :cat:
     
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  10. Ann & Scatcats

    Ann & Scatcats Well-Known Member

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    Dec 31, 2009


    Are you okay? Since you asked a week ago.

    The Tresiba dosing I could read out from the Tresiba info was "Although dosing at roughly the same time each day would make sense for most patients, having the flexibility to vary the time of day when needed could be positive for some patients. In addition, the daily injection time of degludec can be varied to extreme intervals of 24-40 hrs without compromising glycemic control or increasing the risk of hypoglycemia. Therefore, degludec represents an improvement over glargine or detemir that require dosing at the same time each day to maintain sufficient insulin levels in the body and to avoid hypoglycemia."


    I guess you should have a lower dose since it is a long acting, but those mentioned 24-40 hours duration for humans rarely last that long for cats.
    Perhaps Tresiba will give you are little sliding scale, if you work + commute those 10 hours one day and those 14 hours another day. I know the butt pain with that but Simba didn't have diabetes then ❤️


    Here is an account from Feb 2020 from @Sam & Esse in Tresiba forum
    https://www.felinediabetes.com/FDMB/threads/what-should-we-expect.226246/

    "It's so exciting that another kitty is going to be trying Tresiba! Looking at his spreadsheet, Zeke is a bouncy boy. Hopefully Tresiba will level out those numbers.

    I can only speak about Sam and mine's experience with Tresiba, and what held true for Sam might not for another cat ;) But it would certainly make things easier if it did lol!

    Firstly, I started Sam on a token dose, just in case of any allergic reaction. I fast-tracked his increases sooner than would be recommended over on the L,B&L ISG. :blackeye: Honestly, those first 2 weeks on Tresiba, it seemed like I was injecting him with bactine-scented water. It could be because of the rapid dose changes, or that I started too low, or that it took two weeks instead of the usual 6 days (for Lantus and Lev) for the depot to fill. If I recall correctly, when Jessica switched Conan to BID dosing, they encountered the same 2 week stall/treading water phenomenon. Not fun at all. If the two week lag is something usual with Tresiba, I would be hesitant to ever recommend it for a cat with a history of DKA/ketones.

    Second, if Zeke ends up following close to the same pattern as Sam... you'll always be shooting low numbers. I was not able to do the testing to back up my intuition, but my belief is that instead of having a smily-curve, Sam had what I called his Tresiba 'pout'. Near or at his nadir at pre-shot, a very gradual climb for the next nine hours, then a drop back down to nadir in time for his next pre-shot. Feeding him at +9 to +10 usually helped lower his pre-shot by 10-20 points as well. But I want to stress, it took time for this pattern to emerge. Once he got there, though, he really stopped throwing me surprise numbers :rolleyes: It could be argued that I didn't catch low numbers because I wasn't testing, though.

    Third -- please rethink setting Zeke's reduction point at 3x in the 30s once he starts Tresiba. My gut feeling is that Tresiba creates a huge, lurking depot that no one has the experience to understand right now. Sure, Tresiba is supposed to help prevent hypo episodes :bookworm: But once you get into that low-number territory? I'm afraid there's a monster depot only too happy to *keep* those numbers pushed down. Personally, I have a great fear of asymptomatic "low number events". There's been current research claiming that brain damage is being done even if there are no noticeable symptoms of hypo -- so why take a chance? When using the AT2 I kept Sam's reduction point at 67 -- except once, because I could tell he wasn't ready for a reduction yet. When I switched to the Arkray, I rather 'upped' his reduction point to below 60 -- not only because with my lack of testing I might have missed a lower number at +11 or +1, but because I wasn't willing to take a chance with the depot.

    :eek: The depot... Don't assume that skipping a shot will "drain the depot". You might notice the results of a skipped shot, oh, say a week later :p Because Tresiba works by constantly breaking off from the ends of its 'strands', I don't feel that its depot is as subject to variability as Lantus or Lev. It's sorta hard-core time-released... I thought of it as, I'm not shooting just this morning, I'm shooting all of today, tomorrow, and the rest of the week. And that single shot will be releasing the exact same amount of insulin on each of those days.

    A big plus, I loved drawing Sam's dose of Tresiba. I don't have much strength in my hands, so there was always a little air bubble in the syringe. However, a small tap on the syringe always moved the bubble to the top of the syringe -- and it never split! I know the Tresiba strands are microscopic, but I'd swear that Tresiba loved sticking to itself so much, it would never let air split it apart lol!

    So, in conclusion... don't freak if you don't see any improvement in Zeke's numbers the first two weeks. :nailbiting: Maybe freak if you don't see improvement after 3? During the transition time while the Tresiba depot builds, get ketone tests! Just in case. Give serious consideration to raising Zeke's earned decrease point; until you know how he responds to Tresiba, you might want to lower dose the first time he goes under 50. In a month or two, if he still fails reductions, then you might consider only lowering if he goes below 50 three times, or below 40 once.

    :bighug: I'm always constantly lurking on FDMB :cat: So if you have any questions, or ideas, or whatever, feel free to ask! It might take me a bit to write back. It takes me a lot longer to write than it used to, and I might not always be clear :oops: Just let me know I wasn't entirely clear, and I'll try again :cat:"
     
    Last edited: Apr 23, 2021
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