Tresiba Basal Insulin

There has been a lot of buzzing lately about tresiba basal insulin. Even picking up the support of some big name doctors like Bernstein and Ponder. I’ve not seen much talk of it here yet. The manufacturers claim is that one shot can last several days— Bernstein has his patients using it more frequently…

Anyone here using it? Please tell us about it and how it’s comparing to other basal insulins you’ve tried.

Wil Dubois at DiabetesMine today favorably mentioned Tresiba:

And while it didn’t take 2015 headlines by storm, because it was soft-launched, Novo’s double-strength version of their next-gen Levemir insulin (called U-200 Tresiba) probably deserves to be the story of the year in this department, with a pen that can deliver the equivalent of 160 units in a single push. For type 2s and insulin-resistant type 1s, this could be the biggest news of the year. Oh, and there’s now a twice-as-powerful Humalog insulin, too.

I checked out the package insert sheet and found that it does have a small peak at 12 hours. I was surprised to learn that it takes up to 42 hours to completely leave the system. It appears that this 18 hour tail is not a problem. It recommends dosing once pr day.

Is it actually a “double strength version of levemir?” They have different names— levemir = insulin detimir while tresiba = insulin degludec. Also they advertise different action durations…

This differs from lantus / toujeo which appear to be simply more or less concentrated versions of insulin glargine…

No, I don’t think it’s a double strength Levemir. As Wil Dubois wrote, it’s a next gen (as in market replacement version).

Well I hope we can get some user feedback… Lots of new exciting things going on with next generation insulins…

Additional discussion on this thread: Insulin degludec (Tresiba)


Tresiba is the commercial name for degludec, which has been around in Europe for at least a couple of years. The FDA has been very slow to allow it in the States. I won’t get into the reasons for that because I’ve done that rant numerous times before. Suffice it to say that the motivations are more political than scientific.

Degludec has a pretty good baseline of experience to go by; just not here. It definitely looks like the real thing. If Bernstein, the ultimate empiricist, has his patients using it, that’s a pretty strong vote of confidence.

I just listened to Bernstein’s latest telecast. He is trying Tresiba with some of his patients as a once daily injection and is finding that it prevents the dawn phenomenon for them so far.

He also says that long term side effects remain to be seen, and may only become apparent over years (He refers to lantus and possible increased cancer risk becoming apparent over years).

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Yeah I watched the whole thing too… Did you notice he uses the terms “dawn phenomenon” and “honeymoon period” interchangeably a number of times, clearly unintentionally and incorrectly… Causes me some concern for him


Yes, i did notice some mistakes by him. Obviously unintentional. He is not a young man.

Not alibiing, but almost everyone I know commits conversational slipups, regardless of age.

Watched Bernstein December first forty minutes. He said he’d only prescribe if therapy wasn’t working because of no information about long term effects noting that lantus use has some cancer incident. The problem he’s used it for is high blood sugars at wake up. Sounds to me like a blind test of let’s try something else. On another subject he says there is no IT solution except if you wear a cgm watch and get into habit of looking frequently so catch lows in time. He went on about how people with some insulin production get good results on a pump because they have some insulin production not because of IT solutions. That’s what I think of when I see some of the great numbers. Another subject he says it is impossible to time the insulin to the carbohydrate. My results would confirm that. I might decrease carbohydrate intake.

Well I just got a sample of tresiba so hopefully I’ll be able to let you know my impressions… I wasn’t even actually looking for this, I had sent my doc a message saying I’d like to try levemir once a day instead of lantus because I need a significant amount of basal coverage in be mornings and afternoons, and seemingly none in the evening-- so I thought I could take advantage of the shorter duration of levemir----

He came back with “you don’t want that, you want tresiba instead” basically, which I don’t exactly understand his rationale,( because I thought my rationale made perfect sense) but will see how it goes and update

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Had a chance to talk to doc in more detail about this and he is absolutely ecstatic about tresiba— he said he’s not even prescribing lantus and levemir anymore unless the patient has been using it for a long time and insist on sticking with them. He insists tresiba is vastly superior.

I questioned him about the dosing as I was concerned I might be effectively stacking doses if they actually last two days and I am taking the same dose as I took of lantus every day-- he explained that’s not really how it works because you’re still just taking the same dose of U100 insulin every day and how long it lasts really won’t change the dosing-- he did caution me to not adjust doses more often than every 3-4 days as that will confuse the whole issue with a basal that lasts so long…

He was actually really excited about it and now I am too.

So, as you might have seen in my other discussion, i was prescribed Tresiba yesterday, and started it last night. i had been on levemir for a month before that, and my doctor told me i might have better results with it:

  1. it is way more stable than levemir, which, at low doses of 10-15 units, like i need it, doesnt even work 12 hrs sometimes.
  2. it works up to 48hrs or longer, so i dont have to take my basal shot at the exact time every day, he told me i’d be able to vary up to 2 hrs.
    He also told me that i might need somewhat less insulin than with levemir (24 units daily, i started with 22 units of tresiba yesterday).
    @Sam19 you might wanna be cautious on correcting your dose too soon, as it takes also up to 48 hrs or more for tresiba to enter your body, so dont wait the first 24 hrs and then already change dosage.

the only problem with it seems that it is very dull, so when you change your doses afterwards, it takes a few days to see the full effect.

but my doctor was also very positive about the insulin, working in europe he has already seen patients using it for at least 2 years, and says he puts patients only on that basal insulin if possible.


Sam - very nice. Please keep us in the loop. As mentioned before, I’m still (LOL) thinking of ditching my Omnipod and going with long acting basal to use in conjunction with Afrezza.


Our DD is on Treseba. It does work, but it does seem to have a period where it works more strongly (or perhaps this is her new adult basal pattern). If sleeping there is a drop from 6Am to 11 AM. We have given it different times, tried noon when she wakes up as she is on school vacation (this has worked best as the peak seems to coincide with the 6PM to 1:30 AM period where she needs more basal (she used to be on a pump). We have given it 3pm, 6pm and up to midnight. I think first thing when she wakes in the morning may be best for her. It is not supposed to peak but it has a long steady peak for her. I hope she has late classes as 11 am or 12 noon is a good time.

Talked to my endo this weekend and he had great things to say and he sent in a script for me. I’m gonna give this a try and go off the Omnipod for a bit while using Afrezza for bolus and corrections (that’s what i do anyway with the Omnipod simply for basal).


Very cool Mike, I’ll expect a full report

Cool to see this. I’ve heard the Tresiba and Afrezza will be the future for many diabetics, time will tell. You guys are not afraid of change. Good luck to you all.

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