Tresiba - overnight highs?

Does anyone else experience overnight highs with Tresiba? I’ve been on it for 5 months, woke up with a flat line every morning. All of a sudden 8 nights in a row, my numbers climb steadily and I’m woken by my CGM alarm around 2-3am to dose insulin for the high. Why would this be happening? I don’t eat after 7pm and I eat light. I inject around 10pm. I tried increasing units. I tried a new pen, I even tried a new pen from a different batch, still getting overnight highs. Any suggestions? Thank you.

I take Tresiba once a day around 6PM.

I find it has a “lull in activity” in the 6PM-10PM timeframe and then picks up strong again 2AM-6AM. This works out well for me because I need the “pick up strong” in the early morning hours again.

I think this kinda corresponds to your 10PM shot and 2AM lull.

If at the same time, the previous days Tresiba is strongly fading out, then I think this is the lull you and me are seeing.

Below is tresiba activity graph. In the perfect world the lull from 0-4 hours after injection would be filled by the remaining activity from the previous day’s shot. It might sometimes work this way but other times I think this overlap is less effective.

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Wow great info thank you! Tonight I’ll begin taking my shot at 6pm and see how it goes. Would be nice to sleep through the night. Thank you thank you :slight_smile:

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I just started Tresiba 1week ago the first few nights were awesome then it started I was high till 4 then it started to work. I take my bedtime insulin at 10 moved it to 8 nothing the same. So last night I did it at 8:30 did some cardio to help speed it up epic fail low all night I’m so confused on what to do.

I was told Tresiba takes a few days to stabilize so make changes slowly and give it a few days before changing again. I recently had overnight highs. I changed my shot from 10pm to 8pm and it helped a little but still had overnight highs. I slowly increased my units 1 by 1. From 8 to now 11 units over the course of about 10 days. Last night finally I did not have a high and woke up with a 113. I’m not much help myself being no expert but wanted to explain my recent challenge and what worked for me. Good luck with things.

I take 50 units at bedtime that’s seems like a lot to me and should work but I’m not giving up on it

I take my 14 units of tresiba in the morning, around breakfast. I don’t really have highs or lows during the day, since I’m eating throughout the day and take novolog before meals when needed. I just make sure I have somewhat of a high card snack before I go to bed, so my BS doesn’t bottom out.

What’s interesting is the graph is taken at 0.4u/kg, an amount I’ve never been able to get close to without extreme hypos at night. I wonder if anyone has done research on the duration at different dosages.

I know, typical TDD’s are often in the 0.5u/kg ballpark, and basals (rule of thumb) are half that. A lot of tudiabetes members who are frequent posters have substantially smaller TDD’s than that (but I’m not sure we’re really “typical”).

I have been doing OK with once a day Tresiba dose that is in the 16-18 units ballpark. This is actually a reduction from my previous Lantus 20 units a day (split two ways because I never felt Lantus was very flat either). I take it in the evening and have a nice broad boost in its absorption around the dawn hours which works well to defeat dawn phenomena. It works really well for that. When I first switched to Tresiba it felt like the basal was running out of gas in the late afternoon but after several months it feels about right.