Changing insulin from Levemir to Tresiba

[TheScribbler]

I have very recently moved from Levemir to Tresiba. Previously I was on 16 units of Levemir in the morning and 16 at night. I was told that I would probably need around the same total daily dose as for Levemir, but was recommended to start on a daily injection of 25 units of Tresiba every morning, and then slowly increase the amount if needed.

I found that 25 was way too high, with constant hypos. So was 20. Even 15 was too high, producing a lot of hypos, so I’m currently trying 10 units a day. This seems to be a lot better, though I understand it can take a few days for BG levels to settle down, because Tresiba lasts so long.

I have a call booked with my diabetes nurse next week, and I’m sure we will sort the right dose out. I’m just interested to know if others have had similar issues when moving from Levemir to Tresiba.

 

[Westley]

I wrote recently here about my experience with this switch: https://www.diabetes.co.uk/forum/th...now-that-levemir-is-going.210644/post-2783736

How long are you leaving between dose adjustments? The official advice is to leave 3-4 days between changes to see the full effect.
I know how persistent the lows from too much Tresiba are though - I think the flatness it gives (which is generally great) can make hypos particularly stubborn. Because of this I'm learning to be quite conservative whenever increasing the dose, but I'll take bigger steps when decreasing it because I know I can do top ups with extra bolus for a few days if I overshoot.

 

[Tony337]

Hi
Good post for me as i'm changing from levemir after christmas and was considering Tresiba.

Tony

 

[Introverted_And_Proud]

I've been on Tresiba for over a year or two now. Was on Levemir before that. When I first switched to Tresiba, I was using between 8 - 10 units of Levemir every 24 hours, so I stuck to the same dose for Tresiba and injected it every 24 hours, per my consultant's instruction. First two days I saw no changes. But by the third day, I suffered a couple of hypos and quite a few dips in my levels. Ended up having to slowly dial my units back through trial and error until I found 5 - 6 units is usually okay for me. Still having some issues with it, but my levels are a little more stable than they were before.

In my case, I've suspected that my struggle with high doses of Tresiba is because of my injection patterns. Each injection of Tresiba is estimated to take between 2-3 days to kick in and then lingers in the body for another 42 hours. Because my consultant told me to inject the Tresiba every 24 hours, a lot of my injections end up overlapping, meaning there's more background insulin lingering in my body compared to when I was using Levemir, which tapered out after a full 24 hours. So, that might be something you need to watch out for.