Switching from Levemir to Treshiba

I was required to switch as Levimir has been discontinued. I injected the same number of units (at night) I take with Levemir but woke up high, over 200, which is unusual. Please share your experience. I was eager to make the switch, as so many here have reported good results with Tresiba. Last night was my first dosing of Tresiba. Thoughts?

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I chose to switch from Levemir to Tresiba several years ago, and I am very happy with the change. You didn’t give enough info about your basal doses - how many times a day were you taking Levemir, and in what doses, and the same for Tresiba. It is hard to answer without knowing that.

For example if you were taking only one injection a day of Levemir, then you will find Tresiba to give a much longer lasting and consistent basal action. If twice a day, were you giving equal doses, etc.

As far as my changeover, I went from taking Levemir twice a day, 12 units morning and night. When I changed to Tresiba I knew I would need to adjust the dose, so I watched my fasting BG during the day and night for a couple weeks, and adjusted one unit per day until I found I needed only 20 units of Tresiba per day, which is the dose I still take. So 20 units of Tresiba to replace 24 units of Levemir daily. I think a somewhat lower total dose of Tresiba is common, but you need to calibrate that for yourself.

As far as adjusting Tresiba dose, you need to give each dosage change a couple days before deciding whether it needs further adjustment, because Tresiba is so much longer acting than Levemir. Levemir is usually considered to have an action of only about 12 hours.

So give your current Tresiba dose a couple days to see whether it needs adjusting, but do expect to adjust it - basal insulins are seldom unit to unit replaceable. My expectation is that once you get your Tresiba dose dialed in that you will be happy with the change.

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Jag1,
Thank you so much for your response. Of course I should have given you my basal doses: Levemir: 11 units at night, 4 units in the morning. With that dose, I sometimes went low during the night, but it was fairly unpredictable, so I didn’t worry about adjusting the dosing much.

I took 12 units of Tresiba last night (first night using Tresiba) because that is what my Endo dosed me for.

Thank you for the advice to give a few days and adjust the dose. I was both startled and alarmed to wake up to such high numbers. I will try 13 units tonight.

This forum is the best, informed users, well disposed to helping others. A rarity. Thank you so much.

That sounds like a good course of action. Good luck, and you’re welcome!

I have a similar situation, but my endo gave me recommendations, which I have followed, and have had only minor oddities. My twice daily Lantus was directly converted to Tresiba single dose (24-unit twice per day → one 48-unit injection)

A few things that have changed:

  • Humalog (H) changes: My need for H has decreased and I have had a few instances where my usual H injection has overshot, and I’ve gone low.
  • Breaking old habits: I made a mistake and injected one evening, making it two (2) shots in one day, which I then needed to compensate for with extra calories.
  • Numbers variability: There might be some issues with my BS going high overnight if I have had a late snack, which I now need to compensate for.

I am thinking about messaging my endo to tighten up my control, but first I will need to do some research, to see if I can handle this myself.

Levimir is active for up to 24 hours. Tresiba is active for up to 42 hours. Open up the info sheet that came with the Tresiba. Under section 2.2 one line says "The recommended days between dose increases are 3 to 4 days. " which suggests it takes a few days to build up the concentration of Tresiba in your body. This is confirmed by Section 12.2.

If your endo didn’t explain this difference between Levimir and Tresiba make a note to ask more probing questions in the future when they prescribe new medications. My endo will prescribe things without saying anything about how it works, side effects, etc so I know I have to read the info sheet and come to the next appointment prepared with questions before taking any new medication they suggest.

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Thank you, required reading from now on!

To add to the excellent posts above, what impresses me about Tresiba is how how flat my BG level is. While I am not into fasting, when I do, I have found my BG level stays flat in the 100-120 range. If I didn’t to eat, I think I’d be perfectly controlled.

Of course, all that is true only when not gettting sick, nothing stressful going on in life, not having an unusual amount of exercise, etc.

But overall, I am very pleased with Tresiba being able to provide basic, really flat control. The rest is up to how I eat and use my fast-acting insulin.

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