Timing of Tresiba injection to avoid overnight/AM lows

Hi there - I’m one of those rare birds that are taking a break from insulin pumping for upcoming holidays (going into Algonquin Park here in Canada to portage - and don’t want to muck up my Animas pump that even though it’s “water tight” - don’t want to risk it going wonky and causing concerns for both myself and my fellow portage mates).

So, I’m giving Tresiba a go as my basal or long lasting insulin (and Fiasp for my fast acting insulin for bolus / correction if needed). First 3 days were interesting, with adjusting to it being in my system, so was experiencing highs overnight … but now on Day 5 I’ve been waking up around 6 AM with low (I wear a CGM Dexcom G4). I’m wondering, to avoid the lows overnight, should I perhaps be giving the Tresiba shot at an earlier time, say around dinner time, rather than my usual 23h00? I really do NOT want to experience in bear country as I’ve been told … no juice boxes, sweets in tent at night … I’ll be jumping at the food bag in the tree … not a hope in hell I say.

Tonight I’m taking 1 less unit of Tresiba to see how that goes for next few days, but figured I’d just wing this question out to you all here.

If this experiment continues (I have another 2 weeks to figure this out) with having lows … I’ll just go back to Levemir, which in the past on pump breaks has been great by taking it X3 a day, and that way I have ability to adjust the amount of insulin based on my activity level - much like the insulin pump (that’s the only thing I’ve been missing lately with the pump, when a low comes, the ability to put the pump into a lower basal percentage mode).

Thanks a bunch for reading my words above!!

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Levemir seems like it might be a better insulin for pump breaks for the exact reason you stated.

As for the problem you mentioned, there’s a chance that taking it 2x a day will help. I took it 2x a day for awhile, but I switched back to once a day a little over a month ago. When I switched to 2x a day, it was with the intention of flattening out the peaks. It seemed to help a significant amount when I switched to 2x a day.

I’m not sure why I’m no longer having similar troubles now, but I suspect that my problems may actually have been a bit more complicated than I originally thought with hormones and perhaps temperature playing a role.


Ive tried Tresiba 3 times. I really wanted it to work. People who love it really, really, and I mean really, love it. Your experience sounds like mine though. I would drop all through the night unless I was eating something like pizza, steak or pasta. I kept reducing the dose to avoid these lows, but started to have an even worse problem, being that it seemed like Tresiba would shut off around 14 hours or so and I would have the worst highs I’ve ever seen. I don’t think my basal needs are complicated, my pump basically runs the same basal rate all day with a slight increase around 3am for DP. I tried splitting Tresiba and got more consistent coverage, but started to get terrible lows morning and night. Maybe I could’ve tried reducing the doses, but got too frustrated and went back to the pump and a split dose of Levemir when I don’t feel like pumping. I hope you can find the dose that works for you, but I suspect it isn’t a good fit for a significant number of type 1s.

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Hi there - thanks for that great reply. I’m still working around it … I refuse to give up yet … as I’m a determined little twit at times (and it makes for good blog writing later to help others). I thought perhaps the other equation in the whole bit with having highs/lows (not used to this with Levemir / pump) … is that this time I’m using Fiasp as my fast acting insulin. I’ve used it over the past year for corrections or last minute meals where waiting for the NovoRapid to do it’s thing … it was easier to just go that MDI route at those times when wearing my pump.

I see you take your tresiba at night.
My daughter used to take her tresiba at night around 9 p. M. She would consistently fall from 3 a. M. To 9 a. M. So she would have to go to bed higher to account for this.
She would also go higher from 3pm to 9pm. We recently just decided to switch her tresiba to morning dosing and are astounded at how well it has been working. The peak of the tresiba around 9-12 hours after injection seems to work well in the late afternoon and evening and her overnights are very very steady. I am very pleasantly surprised at how well it worked out.

Gave my butt shot this AM … I was up at 10 … maybe due to not having dosed last night … so will see how it goes for next 4 days … I have to start acting fast … since I am trying to ensure that I don’t go bonky wonky when I’m portaging in Algonquin Park with lows … I don’t mind being high so much (I don’t inhale ) … but it’s the lows that are the most dangerous for us as diabetics. We can usually correct a high blood sugar (and 10 is high for me) … but when it comes to MDI … you can’t just “stop” the insulin flow as easily as you can with a pump. Because I’m wearing an Animas that I don’t want to die on me while I’m in the water (I think I mentioned that above in original post … Animas pumps have been replaced due to water getting into them for one reason or another) … I have no other option here in Canada except for Omnipod / Medtronic … and neither I like. So hanging onto my pump as long as I can before it croaks due to it’s death date - plus I just bought the darn Vibe last Spring … and didn’t know that J&J was pulling out of the pump business.