Forgetting basal dose

Hello everyone, I am an MDI user (1 tresiba 15 units+ 3 humalog doses (6 units each), daily).
So I came across across one situation, when I realized in afternoon that I do not remember
taking tresiba medicine last night. Most probably I did not take it, but I am not sure. What
to do in this case. Can I just forget about this or I should take may be half of the usual dose
in afternoon itself. Are there implications if I did forget to take basal dose one day. Thanks.

Hi Ran!

The Tresiba website recommends that if you miss a dose, you should take it as soon as you remember. If that time is within 8 hours of your next scheduled dose, then delay that second dose until 8 hours pass.

1 Like

While Tresiba is a bit lenient in timing, any dose you missed was perhaps 15-18 hours ago. Tresiba lasts 42 hours so you might not want to take a full dose since a nontrivial part of the action time has passed. And you have some uncertainty about whether you actually missed the dose. I would suggest taking a slightly smaller dose to adjust for this. You could probably take 10-12 units and then return to your normally scheduled time. But as Lainey says, they recommend you not take a second dose until 8 hours has passed, presumably so that you see if you mistakenly stacked two doses.

Thanks Lainey, it is very helpful. In this link, many other queries also got resolved. 8 hour difference is must between two doses.

thanks for your reply. Usual time was 12 hours ago. A smaller dose seems ok to take at this point as I am not
fully sure about whether I took last dose. I should now note down every time I take insulin specially basal.

I remember many times having this problem when I was on MDI. It starts to become so routine that you don’t think about it… and then you suddenly can’t remember if you did or didn’t. Common enough problem that now some firms are offering solutions like this one, which may be helpful.

2 Likes

Timesulin appears to be a good device for exactly this purpose. Thanks for recommending this.

You can also use your body as a “canary in the coal mine”. Keep an eye on your BG (if you have a CGM, you’re set; otherwise, check BG every hour or something like that), and watch for a rise way beyond what would be reasonable, given normal patterns during fasting phase between meals.

If it shoots up, you know you missed your injection. Correct with fast-acting, and also take your basal dose.

Otherwise, you did take it and just forgot.

I usually take Tresiba at bedtime. When I forgot my insulin dose one evening, I took all of it the next morning, about 9-10 hours late. and then took my normal Tresiba dose at bedtime that night. I had no blood sugar anomalies due to that erratic schedule. Tresiba is very forgiving about varying your time of delivery. Like you a already discovered, the 8-hour separation between doses seems to be its only requirement.

If you did take your usual Tresiba dose and simply forgot it, I would do this: take another full dose when you remember and closely watch your blood glucose. If your BG levels are normal, then restart your usual Tresba dose that evening. If you start running lower BGs that normal, then delay your next dose until the following noon. And take the next dose, the next day in the evening. The key here is closely following your BGs to look for evidence of whether you took the dose you thought you actually did or you did not.

An insulin pump’s memory is great in this situation.

1 Like

Terry, this is because you are Tresiba Ready.

Were you among the unfortunate few that are, sadly, Tresiba incapable things would just not go so smoothly for you.

:grin:

Ran, in your case you were almost at the end of the 42 hour action of Tresiba in the afternoon. The instructions indicate taking your normal daily dose and leave 8 hours in between shots.

Patients who miss a dose of Tresiba should inject their daily dose during waking hours upon discovering the missed dose. Ensure that at least 8 hours have elapsed between Tresiba injections. https://www.tresibapro.com/clinical-pharmacology/duration-of-action.html

That commercial gives a good summary about the flexibility Tresiba gives with missed or delayed doses. I’ve never seen this ad before since I don’t own a TV.

By the way, I used Tresiba several months ago for about 90 days. I returned to the pump when I could not get my overnight BGs where I wanted them without causing basal lows later in the afternoon. Now I’m using Tresiba in addition to my pump, the so-called “untethered regimen.” My pump basal is cut way back because I have an underlying Tresiba basal foundation. For more than 12 hours each day my pump basal is only 0.1 units/hour. This regimen allows me to control my dawn phenomena with a pump basal profile delivering up to 0.6 units/hour in the early morning.

This is probably more of a nuisance than most people would put up with but I’m finding useful. And I had several Tresiba pens that I did not want to go to waste.

1 Like

Thirding the rec for Timesulin—it’s so awesome. Maybe not as essential for Tresiba, but as a Lantus user with split doses, it’s a lifesaver, since it’s really hard to remember whether you did the thing you do twice a day every day.

@Terry4, I’ve been intrigued by the testimonials in various discussions about Tresiba. It sounds like a significant step forward over current-generation long-acting analogs.

Really, though, I was just poking a little fun over the branding jingle, “Tresiba Ready” (sung), which I find not worth a penny, let alone the millions they surely paid for it. :grin:

I rather like the Tresiba commercial. I’d eat pancakes served by Betty any day! And I’m going to Freddy for my next haircut. Eddie will be delivering my new flat-screen.

We’ve got a box of Tresiba pens in the butter compartment of the fridge, and my daughter is Tresiba Ready! :wink:

1 Like

Well, I’d have a tough time if I was doing MDI, as I make all my decisions on the basis of advertising jingles, and Tujeo’s got Tresiba beat hands-down with their use of Earth Wind & Fire’s Let’s Groove:

Oh, and the costumes!!! :grin:

Okay, so confession time: Big EW&F fan. Saw them in concert when I was in High School in, like, 1978 or thereabouts.

I was embarrassed watching this video, by myself! :stuck_out_tongue_winking_eye: This was so way cool when I was in HS… what happened? How did it get so incredibly dorky?

I remember those times differently than they look through the lens of history. I still love EW&F, but this video had me laughing and blushing at the same time :blush:

2 Likes

Thanks, This seems very logical way to correct the missing dose. Checking sugar level and taking dose accordingly.

Thanks, Good option to consider. Taking full dose and check BG levels to not go low. I am about to begin using pump in few months for its many advantages.

Thanks, I learned about 8 hours difference on the site. It seems better to note after a basal dose is taken as I often forget even after taking it.

So, I realize this thread about missed Tresiba doses is almost three years old, but unfortunately it applies to me today.

My routine is 10 units of Tresiba at about 9:00 every morning, with Novolog for meals. Yesterday around 2:00 pm I realized I may have forgotten to take the Tresiba (5 am trip to airport), and so I took a smaller dose than usual, 6 units. So there had been 17 hours between doses. There must have been some stacking, because I spent much of last night being woken up by my CGM due to low blood sugar, in the 50’s. I would treat the lows, go back to sleep, then drift low again.
So here’s my question: When do I take my normal 10 unit dose today??