I feel I am in between an 8 unit dose and 9 unit dose based upon exercise. If i use 9 units on days I exercise , I go low in the night. If I use 8 units , I go high during the day. How would you manage your basal if you are in between two different amounts?

Can you get a pen that does half units? Then, use 8.5 units.

Talk to CJ114. He knows how to get pens that give fractions of units. I have a Novolog pen which doses 1/2 units, but my Tresiba pen is full units.

When I am between units, and have to take too much insulin, I eat something before bed. I need to talk to CJ114 too.

Tresiba is only available in pre filled disposable pens in u100 and u200.

To the OP… That’s just a fact of life… do the best you can to balance diet exercise and insulin… it’ll never be a perfect balance no matter how precisely you dose it

How far in advance do you know your exercise schedule? Tresiba lasts longer than 24 hours so maybe you could adjust the dose that is more than 24 hours in advance.

I wouldn’t recommend it. Tresiba is a steady state insulin… that’s it’s whole idea and the one thing that makes it work incredibly well… trying to juggle around different doses of it entirely defeats its purpose and appeal…

With Tresiba’s 42-hour duration, you just can’t make agile basal adjustments like that. What you could experiment with is adding some food at bedtime that could help protect you from lows. I would be tempted to dose with 9 units and on days you exercise add a spoonful of peanut butter at bedtime.

It’s much easier and safer to deal with a high during the day than it is to manage a night-time low.

You do need some discipline to do this, however. I find it easy to overdo eating peanut butter!

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Here is what I ended up doing with Tresiba (I am MDI): I adjusted my basal dose so I would not be dealing with lengthy and hard to correct lows during/after heavy exercise. If I go a few days without enough exercise, the basal dose is obviously 1-2 units too low but I use correction bolusses to prevent the highs. These correction bolusses are a PITA but it beats the alternative of having to worry about lows much of the time. It took a lot of trial and error to dial in my Tresiba dose like this but (for me) it works great.

As others have said, there’s really no way to micro-manage Tresiba basal on a day to day basis because of its long duration. Only other tidbit I’ve learned about Tresiba is there is a seasonal adjustment that some users benefit from.

I wish I knew how to get ahold of a pre-set pen with half units!

Thank you all for your helpful suggestions!