Taking the plunge with Tresiba

I plan to perform a few basal tests in the next few days and will report back.

Also, when you all inject your Tresiba, do you inject the full amount (e.g. 14u) or do you split up the dose into smaller units (10u/4u or 7u/7u) and inject twice?

I inject my full 11 units. I am not sure why you would split your dose into two injections.

@Marilyn6 I know of two reasons to split a dose, into two injections; each has a different purpose. Dr. Bernstein recommends not injecting more than seven units at a time, to aid in absorption. So, if you’re dose is 10 units, he’d recommend giving two, five unit injects. The other is many people will “split” their 24-hour dose of basal insulin, to aid in duration/peak. If their dose is a total of 20 units, they would give one dose at one time and another anywhere between six and 18 hours later, depending upon their needs.

Oh yes Tapastry, I took Lantus for years and would always split my dose up morning and night. I have found no need to split my Tresiba dose and enjoy only taking it once in 24 hrs, I had forgotten Dr Bernstein’s rule to not inject more than 7 units at a time. I sure don’t have a problem injecting 11 units in one dose. Thanks for the reminder though.

Hi Adam

I also started using Tresiba when needing a break from pump due to scar tissue. When I first started, I took all 18 units at once at 7am. However, I like to go cycling and I ride long-distance, so this quickly became problematic as Tresiba seems to last in my body a full 48 hours. I then started splitting my dose in half and taking 9 units at 7am and 9 units 7pm -that helped a lot for last minute bike rides - I was able to then cut one of the doses (e.g. just the a.m. dose) by 1-2 units.

For me, the problem with Tresiba was that after a few months, opposite of DP in that I’ve been crashing with low blood sugars around 2-3am no matter what and then often again around 6am. I tried changing the time of the evening and morning dose (e.g. 6pm or 9pm) but that didn’t help. What has worked best is to split the mix to an uneven split- e.g. now I take 10 units at 7am, and 6 units at 7pm. Much better for me and prevents my nightly crashes - no dawn phenomenon either.

Good luck!

I was also crashing at night; therefore, started to take my full dose (14u) at 6 am instead of 10 pm. Unfortunately, my morning sugars are now running a bit high.

Due to some frequent hypos at night (2-3 am), I switched the time I’m taking the Tresiba from 10pm to 6am. My sugars after dinner seem to be stable, but now I’m dealing with higher morning sugars. Last night at 11pm my glucose was 112 mg/dL and at 5am my glucose was 154 mg/dL. I do have slight DP, but only after waking. Also, I noticed on my CGM that I was creeping up all night (the same thing was happening at night when I took the Tresiba at 10pm). Maybe the Tresiba is starting to lose its effectiveness around 20 hours.

I’m on my third day of 14u in the morning. Therefore, will make a change in the next few days if I don’t see an improvement. Unfortunately, when I move the dose up to 15u, I have a bunch of hypos.

You could try 8U bedtime and 6U breakfast. if you aren’t getting 24hr and continue your basal test.