Tresiba

Is anyone using this new insulin yet? Both my GP and hospital doctor will not supply it. My feeling is that this is due to cost. As it has been passed by NICE surely it is safe. I have obtained Tresiba from a private consultation with an Endocrinologist.

An ultra long basal insulin, up to 40 hours, that's impressive..........

I would suspect as you its down to cost and getting things approved through the normal channels of the NHS.........might just be a matter a time...

why were you at a private consultation about your diabetes.....?

Unless you want to pay for it yourself I see no reason....

Thank you for your reply and thoughts.

I am 64 and have been struggling with this for 19 years. Hypos are the problem, usually at night and mostly I am aware of them or catch them just before they happen. I have obviously had Lantus and Levemir subsequently splitting the Levemir twice daily. It seems that I am "sensitive" to insulin. My family were convinced that I was still making insulin and that this was the cause. If I do anything out of the ordinary i.e, grandmotherly duties or simply chasing around the supermarket/housework I would drop low. My NHS doctor wrote to my GP about a pump. She talked me out of it (again I think it was a cost issue).

Last year my husband met someone who suggested a Consultant in London who had helped him and that I should try. The consultant arranged a C. Peptide blood test which proved that I am most definitely Type 1 with zilch insulin of my own. He prescribed Tresiba BUT he wanted me to use 2 different tablets (morning only) using insulin as usual for the other 2 meals. I am ashamed to say I do have the tablets but am afraid to take them as one of them is quite new with some rubbish side effects (so the internet says). The main problem pill is called Forxiga (Dapagliflozin). So, the only change I made was to switch to Tresiba. ...........that's the story.

Definite thumbs up to pump for insulin sensitivity...one of the main reasons I was put on pump and am loads better!

Hello Joza

Vickyp is right - a pump is an excellent tool to help with insulin sensitivity. I too am insulin sensitive and am on the waiting list for a pump. I find it a nuisance being insulin sensitive, my ratio is 1/2u to 1CP, so a tiny error either way with carb counting has massive effects. I am also physically active (not athletic status I hasten to add), and this makes control even more difficult. My basal is 3u Levemir twice daily. This works for me as I can reduce the dose when I have been particularly active. This is usually the evening dose (as I often exercise in the evening), which I reduce by 1/2u if I feel my BG level and degree of exercise warrants it. This usually prevents a nightime hypo and if I have been over cautious, I correct in the morning. Lantus or such a long acting insulin as Tresiba seems to be would therefore not be appropriate for my situation. Have you spoken to your Dafne team? Mine are very helpful, in fact it was they who first suggested I try a pump. I would have thought a pump for you would be cheaper long term.

I googled Forxiga, and it seems to be a type 2 drug. Why are they giving you that?

I was on various type 2 drugs before they realised I was type 1, and looking back at my figures it is clear they did nothing to control my diabetes. And you are right - the side effects are unpleasant. I am much better and feel much better now I am on insulin - even though my control is poor despite my best efforts.

As one grandmother to another, you owe it to your family to stay well, so please go back to your Dafne team and if they suggest a pump, then stick to your guns and don't be talked out of it.

When was on injections I too had a 0:5u:1cp ratio, except at breakfast when it was 0.5:1 then minus 0.5! With 5 units if levemir once a day! I am still on tiny ratios, which are lower than these but control is so much better, and I feel so much better and more in control!
The tiniest bit of extra exertion makes my go low, so know exactly where you are coming from. It was during my DAFNE course that they were suggesting a pump, so I spoke to consultant and within 2 months was given the pump, and life is so much better, I wouldn't go back to injections.
I would worry about a long acting basal and how my sugars would suffer from it. I champion the pump!

As the others have said, a pump would eliminate your sensitivity problems as tiny amounts can be delivered.

Bouts of unplanned activity can also be catered for with temporary basal delivery.....

with your current hypo problems you would be a perfect candidate and should get one funded no problem....

Unfortunately, it is a problem. My local borough does not offer a pump service. My GP could refer me to a neighbouring borough or even to the Royal London/Barts, but chooses not to. It absolutely has to be a cost thing. The NHS hospital consultant has written on a couple of occasions to the GP. I waited and waited and heard nothing. I went to my GP to see if the hospital letters had been received and was poo-poohed out, told it would not be such a good idea and, therefore, I have given up. Might just as well hit my head against a brick wall. I'm also beginning to realise that yes, the Tresiba's extra long action is possibly causing a problem.

Your GP should have nothing to do with the actual pump funding, that's your consultants job. Your consultant doesn't need your GPs permission.....

My GP takes nothing to do with my diabetes care....

I realize each place differs.......


The pump will be funded from your local PCT if your consultant says you need it.....

There is obviously a cost for the consumables, the insulin, tubing and reservoirs.......

If its a big problem I would change GPs....

I agree with novorapidboi - if there is another GP practice convenient enough for you I would advise moving - your current GP obviously doesn't care what is best for you and should not be ignoring the opinion of the more specialist consultant.

Have you spoken to the consultant who recommended the pump? I'm sure they wouldn't be impressed with the GPs attitude!! They may be able to 'persuade' the GP, or even suggest another GP who they have had good dealings with.

And a final suggestion is to threaten to approach the local papers - as much as I hate the whole negative attitude of the press towards the NHS it has been known to get things moving, and it does sound like this GP deserves a kick!

And please don't give up - you deserve to have the right treatment! Good luck x