Tresiba Dosing

I’m trying Tresiba again, probably not for long, but because I would like to use up what I have left before it expires and had a few pump site issues lately. Mainly I think I like to torture myself and managing a complicated disease, career, relationship and training an energetic puppy isn’t enough of a challenge for me. When I’ve tried Tresiba before I found taking it in the morning would cause DP, taking it at night would cause it to be way too strong in the morning and too weak by evening, and splitting it would lead to 2 peaks. I’m considering taking the majority of the dose in the morning and then a small amount at night to “recharge it” if that makes any sense. I took 12 units this morning and will try 3 units tonight. Does anyone think this is sensible or have any input on what might help? I’m trying Fiasp pens instead of NovoRapid for the first time with MDI and curious to see how it compares to pumping Fiasp.

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In my experience this technique would be adding little benefit other than to complicate the issue… but if it works for you is what matters.

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You’re probably right but not sure how to solve the DP issue (which I think might be the Tresiba fading out at a time I need more insulin) and don’t want to use R, NPH, or Levemir at night (I’ve seen people suggest doing this) which I think would be too expensive and complicated.

Yeah I’m inclined to keep things as simple as possible, personally … what do you mean when you say you get two peaks with an even split dose?

I found it would be way too strong in my system and I would drop extremely low ~9 hours after each injection.

And reducing the split dose amount just wasn’t enough? Dunno, everyone is different… works really well for me with 1x daily. How high of spikes are you seeing with the dawnP?

I’d see spikes anywhere from 180 - 250 starting about 3-4am.

with 1 dose/day or 2?

That’s with 1 dose if I take it in the morning. If I take it at night it is too strong in the morning, and I drop into the high 2s/low 3s and overindulge on Reese’s puffs/Nesquick cereal (actually I’m not sure why this is a problem now that I think about it)!


I like your idea then. Let us know how it works out!

Let us know how the fiasp is!! I was going to talk to my doctor about it next week.

Oh I’ve been using it for a while, it’s great when it works. I’m hoping injecting it will be better than pumping because I find it has quirks using it as a basal and that it isn’t as effective on day 2 of a site onwards.

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I stupidly had beer and wings last night (first night of playoff hockey), so it wasn’t the best way to test out my theory. This is what I was talking about where pumps have an advantage, a meal like that hits me so many hours later that it is impossible to go to bed and wake up in range. I’ll try using Regular next time and see if that works, I have a vial of Humulin R in the fridge. My results were comparable to what I would expect if I didn’t square wave on my pump though, so I think the Tresiba dose was correct. Does anyone have experience using R for wings or similar meals?

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I think @Sam19 is experimenting with Regular. He may have some tips.

Glad to hear the Tresiba dosing wasn’t incredibly off! Might take a few days to really see the true effects anyway though.

I’ve been using Regular (or “Toronto”, as the Novo version is called up here) pretty successfully. It works pretty well to approximate square wave pump boluses. I need to get better with dosing it, but I’ve never been great at getting extended boluses right to be honest. I’m using 2 shots of Levemir for now though, it’s much more predictable than Tresiba is for me for whatever reason. Maybe Tresiba just isn’t compatible with some people. I’m sure I’ll plug my pump back into me soon anyway, but it’s fun to experiment!

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I tried splitting the dose for my first few months using Tresiba. After that I tried just dosing in the morning when I get up. I found there was no difference for me. I inject 16-18 units daily, largely depending on amount of exercise.