Tresiba

Treatment Insulin
1

I am new to tresiba. I have seen lots of posts by people who have indicated it’s a steady insulin. I have been on it almost a week, and have found my sugar levels are all over the place. I started with 12 units and am up to 18 with still high blood sugars. How many days should you stay with a dose before you move to a higher one?

2

I used Tresiba for about four months last year. Since the duration of Tresiba is documented at 42 hours it takes at least a few days for the dose to become steady. I tried to keep two days in between changes. Three would probably be better. If you move too fast you may overshoot your mark and have to deal with some low BGs.

Give it time. If you slowly increment the dose you will find the one that works for you. I think it’s a great insulin. If I go off the pump, even temporarily, I will use Tresiba.

Have you read any of the many discussions we’ve had about Tresiba over the last year or so? There’a a wealth of information there. Just click on the magnifying glass icon in the upper right side of your screen and type in Tresiba as the search term.

3

It is good to be conservative when making initial decisions about basal doses and then making adjustments. Usually a doctor will start you off and assist you in making decisions with an initial dose. It is pretty common to start with a dose like 10-12 units which basically does nothing. You then adjust it upwards until you find the right dose. And many doctors are conservative, changing doses as little as 10% at a time. And since the starting dose is often very conservative (perhaps as little as 1/4 or 1/3 what you will eventually need), it can take a few weeks to really start to see results. And as @Terry4 says, it can actually take as much as a week for the cumulative effects of Tresiba to truly reveal themselves.

4

The same thing happened to me. I tried Tresiba this fall for over a month. My blood glucose was either too high or too low. I never found the appropriate dose to steady my levels. I was disappointed as so many people seem to have great results with it. I switched back to Levemir, and my levels got back on track.

5

I just wish the pharmacy benefit managers and the insurance plan sponsors who support them would understand that various insulin formulations are not interchangeable commodities. I guess when you’re blinded by the business bottom line, you’re not persuaded by something that’s obvious to anyone who’s lived with insulin for any length of time.

1 Like
6

Thanks Terry4 for your response. Last night I was low all night long and kept getting alerts from my Dexcom CGM. I eventually woke to a 42. My sugars all day yesterday within target but I ate no carbs the entire day, just to see how my basal was. I am going to give my current dose one more day and see where I go. May need to cut back to avoid those middle of the night lows (which have been typically high).

7

Hi Karla,
If you don’t mind, can you take a step back and tell me a few things that are not referenced in the post?

  • What you were using before Tresiba? Or is it your first insulin?

  • For your basal requirements, how does the nighttime compare to the daytime?

  • What prompted the move to Tresiba? Was it an Endo recommendation because they thought it would be better than what you were using?

Tresiba is an interesting option, but it is simply one tool that can be used. It might be the best thing for you, or it might not be. It just depends on many factors.