I used Tresiba for 2.5 years until my formulary changed in June and it is no longer covered. I now take Toujeo. I didn’t take basal insulin prior to the Tresiba, although I used NPH when I was pregnant 6 years ago.
I prefer the Tresiba hands down. It does last 42 hours, but you should take it at relatively the same time each day for the best effect, although it does give you wiggle room for a couple of hours without ill effect. I didn’t have any lows and my fasting BGS were pretty good. It doesn’t have a stacking effect like regular insulin does, but a single dose is supposed to release over the entire 42 hours so it takes a few days for the initial dosing to show its full effect and when you titrate up you should do it in 3-4 day increments. Personally I got about 36 hours of effectiveness before it gradually tapered out (There was a snafu with a refill once so this is how I figured that out). I used it in combination with Humalog and a weekly Trulicity injection. Tresiba was 56 units/day, Humalog averaged 40-45 units per day.
I don’t like Toujeo, I have to take about 1.5x as much to have the same effect as Tresiba and my fasting numbers were all over the place-I think because I was dipping low overnight. The previous carb coverage ratios and correction factors no longer worked so y Humalog dosage has also increased, especially in the morning. After a month and consultation with the doc we decided to switch out the Trulicity for Victoza which has improved things dramatically. Toujeo 75 units per day, Humalog 60-70 units per day, Victoza 1.8 mg.
If you decide on either make sure you use the pharma discount card because it will bring your copay significantly down.