More Even Coverage
The first reason is obvious and common–it helps provide better “coverage”. However, I take Tresiba and most providers do not encourage splitting the dose of that insulin due to its approximate 42-hour action profile. When I took one dose, I had an extreme drop in blood sugar at one point of the day and didn’t like that.
So, I was splitting it like this at first: 6-8 units in the morning and 3-5 at night. I check at random times, often at night and things seemed to be working very well. Then I discovered through trial use of two different CGM systems that I was dropping in the early morning hours while I was sleeping. Sometimes I would stay around 30 for an hour before waking up. Other times the graph simply indicated that I dropped to the 30s or 40s and then rose on my own (thanks lifesaving liver!) to about 60 or 70 by the time I got up.
Is this why I’ve been waking up really tired and groggy and with a headache for such a long time? Sheesh. Maybe I should just be grateful I’m alive…
Anyway, after that, I tried flipping the dose around giving the larger one at night and the smaller in the morning. This makes the drop happen around dinner for me–and it’s also a more moderate drop, I guess I need a bit more insulin in the afternoon as opposed to the middle of the night. It’s certainly safer than a blood sugar dip while I’m asleep and not plugged up to a CGM of any kind.
Not surprisingly, I’m much more chipper in the morning since I figured this out.
I share this extra bit in case anyone out there splits their dose and isn’t aware of nighttime lows–beware and check at different times during the night to make sure there are no consistent lows happening without your knowledge!
For Safety
As for the second reason I split my dose, it has to do with safety. Before I took Tresiba I took Lantus and I before I split the dose, I didn’t, and you know what happened to me, twice? I accidentally gave about 20 units of Humalog in place of Lantus. Both of these instances were awful and involved a ridiculous amount of grape juice. I can’t even smell grape juice today without gagging. The fear though, that was the worst part.
After that, when I started splitting Lantus, if I were to ever draw up Humalog to the dose of Lantus, I would be giving half that amount and I’d manage the emergency where I was instead of finding myself being rushed to the I’m-going-to-bankrupt-you-ER.
Tresiba requires less in terms of daily units of insulin for equal strength so if I ever goof up with Humalog again (I don’t plan to) then I will be giving at most, out of habit, about 6-8 units of Humalog or R insulin and I can handle either of those doses with glucose tablets that I always carry on me.
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