I gave up on Levemir (and waiting for the Health Canada approval) last March and went for an Omnipod pump. It has been working well for me but may not be for everyone.
I would just switch to the Tresiba without perscrption if I didn’t have the pump but as @Scott_Eric says you need to be carefull with it, be comfortable with making the change, and test a lot or wear a CGM. If not wait for the doctor’s appointment.
Hi There.
I stopped using Tresiba about 10 weeks ago, after having started using it around October last year.
I loved the flatness of the Tresiba. What I didn’t love was the weight gain.
Just before I started using Tresiba, I had started eating Ketogenic / low carb diet, and had a rapid weight loss. Which was great! Then I started Tresiba (1st blue arrow) and the weight loss absolutely stopped. I didn’t connect it to the Tresiba because, well, I have always had a tough time losing weight. Then my weight started going up, despite ketogenic diet, intermittent fasting, and exercise. I’d been more strict with my diet than ever before in my life.
Then I had to switch back to levemir (due to a short lived pregnancy) - see second blue arrow. The weight gain stopped. Now I am continuing to work very hard (fasting, keto, etc), and weight is very slowly easing down now. The big up spike at the end of the plot was the day after a night out - that was when I found out the pregnancy was lost. The dip straight after that happened when I did a 4-day fast, which I started the day after that night. Interestingly the weight spikes and drops also seem to have toned down a bit…
Given the current response, I’ve no doubt at all that the weight gain was due to Tresiba. It is not acceptable to me to have to work that hard on my weight and diet and still be gaining! So Tresiba is now off my acceptable list (unless there is a famine and no food to eat, in such case, I, armed with Tresiba, could probably thrive on little more than fresh air and water).
I find Tresiba to be somewhat of an improvement over Levemir but not the miracle drug so many have made it out to be. I will keep trying and adjusting my dose, but so far it is dropping me low every single night and then causing afternoon highs.
I will ask my new Endo in November about Tresiba and weight gain. I gained on Lantus then switched to Tresiba. I have lost 14 pounds in 10 weeks going on Victoza and being able to cut the Tresiba from 19 units to 10 units per day. Curious how much Tresiba you were taking per day? Maybe Levimir would be better for me since I tend to gain weight rapidly with insulin, maybe Levimir causes less weight gain…
I was using about 18 units of tresiba, compared to current 20 units of levemir. So similar doses…
I think this is a YDMV (your diabetes may vary), and some people seem to do fine on tresiba weight wise, and others do not. Same may go for other insulins.
Update. We squeezed in to see her doctor who was willing to prescribe tresiba. Starting this weekend…I think we’ll start with 20% lower dose than levemir to be safe and increase from there if need be. Good plan?
I recently read a short document aimed at providing doctors with some general advice at switching a diabetic’s usual insulin due to a natural disaster like a hurricane. The general rule used is to switch to an insulin within the same general class, ie a rapid acting for a rapid acting or a long-acting for a long-acting. This tip-sheet then recommends starting with a 20% reduction in the replacement insulin dose and adjusting from there.
Your plan to use a 20% smaller dose is a safe one, I think. Good luck.
When I switched to Tresiba, I did it from an insulin pump. My total daily pump basal dose was 14 units and I ended up finding that 18-19 units of Tresiba worked for me.
Be aware that any change made to the Tresiba dose should be maintained for at least two days before making another dose change. Since Tresiba has a 42-hour action curve, it takes a few days to stabilize. This required some additional patience on my part but was worth it.
Excellent. Thank you. Yes, I’d rather start low and correct with rapid than start high and chase lows for days.
So we started with 25% less on tresiba than twice daily Levemir and I think a small increase will have us there. Loving it so far. Transition was very smooth. Our mountain ranges on the cgm have become lovely small rolling hills. So glad we finally have tresiba in Canada!
I can’t wait till it’s available in Canada 
It is in Canada. I’m in Ontario.
I’m worried Tresiba is going to be like Fiasp for me, where it was amazing at first but unreliable as time went on. It seems to stop working every day for about 4-5 hours around 16 hours after taking it. Has anyone else had this problem and found any solutions?
I experimented with Tresiba for five months last year. After three months or so I could not find a Tresiba dose that would both keep in range 3-8 a.m. and not drive me low in the late afternoon.
So I tried combining my pump with Tresiba using an “untethered” regimen. I kept my pump basal low, about 0.1 units/hour except during the 1-6 a.m. period where it delivered a small profile to add to the underlying Tresiba. This 0.1 rate was intended to avoid pump-set occlusions and keep the site absorption working.
The untethered protocol worked very well for me. By the way, this regimen is often used by people who want to disconnect from their pump for several hours at a time with no fear of DKA. Think people who work-out in the swimming pool and others enjoying a beach vacation.
Are there any reports of Tresiba doing that - being great at first, but becoming unreliable over time?
Seriously!! My doctor said it wasn’t here yet, but that was about 6 months ago…very exciting!! I’m going to ask for it at my next appt. I’m in Vancouver, but that’s only a few provinces away! Is there anyone from BC here that has been using Tresiba?
Health Canada approved Tresiba in late August. It won’t matter what province you’re in, it should be available.
Thanks Terry! It’s a good idea but I want to give MDI a go for a while since I never really have before. I’m kind of enjoying just carrying a pen around, never thought I’d say that! I switched back to Levemir last night, I just couldn’t take it anymore. I’m having the worst blood sugars of my life on Tresiba and it was getting worse by the day. It’s really disappointing given all the good comments I’ve read from others about Tresiba. I guess it just doesn’t work for everybody!
Your Tresiba experience is another reminder of the person to person variation of diabetes symptoms and treatment success. While we often recognize the truth of “your diabetes may vary,” we also often share many symptoms and treatment success. I find it’s always best to do the experiment to find what works for you.
I think it’s important for all of us who use insulin pumps to vet an MDI routine as a viable alternate treatment. Good luck with your return to a Levemir basal.
For me it was like magic in the beginning, now after 18 months its just normal. Might have gotten a lucky strech when i started.
It still is the best basal insulin for me, with a dose of 12 it keeps me steady most of the days, without wearing off before the next dose.
Its just not that miracle thing i thought it was when I started it almost two years ago.
Very excited to be starting Tresiba tomorrow evening! I’m sure it will take a few days to adjust and figure out how much I need, but looking forward to letting you all know how it goes 
