Tresiba versus Levemir

Hi all— hope everyone is well. I have been putting off switching to tresiba which my endo feels is a more consistent, even long lasting insulin for the nighttime. I’ve been on Levemir for awhile and I guess I’m a creature of habit because I am a bit nervous to switch. I am running out of Levemir so I am going to have to switch over. My tresiba script has been filled and waiting for me to do the big switch. Any feedback, concerns or general knowledge of Tresiba versus Levemir? Thanks in advance.

Hi @Mlp1124. It’s good you’re reaching out for experience and feedback - which I can’t give because I don’t use either of those insulins.
Never let something like that keep me from commenting, however😉! From time to time an insurance may change their preferred formulary but you can usually keep it if your doctor can show necessity. If your doctor wants to switch you over because s/he feels it is a better one to use, and you’re really not comfortable with it, you have the right to say you prefer to stay with the one you’re using right now. Sometimes it helps to know the specifics about what the doctor thinks is better - that may make you more comfortable with the decision.

I switched from Lantus to Tressiba for a little while. On Lantus I would experience a drop overnight so I was driving my blood sugar up before bed and my doctor and I thought maybe Tressiba would help me smooth things out. Which it did not. My blood sugars overnight were very unpredictable on the Tressiba, but I think it was due to difficulties I was having in accurately dosing my Humalog for dinner, not so much the Tressiba. It was nice, though, not having to worry so much about taking it within the same 2-hour window every night.

A few months later I started using an Omnipod and that transition, from Tressiba to pump, was AWFUL. None of the nurses doing the training seemed confident in when I should stop taking the Tressiba or if I should take some extra Humalog as the Tressiba wore off. They all knew what to do with Lantus or Levemir, but were clearly confused by the Tressiba’s 48-hour lifespan. They told me to stop taking it 2.5 days before starting the pump but not to take any extra humalog to cover that last night before my pump start appointment. My blood sugar just kept rising after my last Tressiba dose and I felt terrible the whole time. On my own, the night before my pump start, I decided to boost my mealtime Humalog doses up by 10% and my blood sugar still didn’t come down. I think it was in the 500’s when I went in for my appointment and started to come down as soon as I started the pump. I can’t tell you what a relief that was. So that’s my one caution with regards to trying Tressiba. If you decide to start using a pump, make sure that you work out the timing and Humalog dosing carefully. Or maybe switch back to Levemir for a little while first.

glad you didn’t dka on that one. I don’t take what any doctor, even my endocrinologist says without it all making sense to me first. glad you’re ok.

Thanks, @joe. I’ve been really lucky when it comes to DKA. I think I’ve only tested positive for ketones 5 times, max, in my lifetime and each time I was sick with a fever but able to to treat it myself (or my parents were). Even when my glocometer’s reading “hi” I still don’t test positive for ketones. My pump transition was still pretty scary, though. And you’re right, I should have trusted my gut. I called twice to confirm the instructions, but still didn’t think they were right.

I was actually on vacation and visiting my cousins 3 hours away from home the weekend before my pump start (that was all planned out before I found out when the pump classes were happening). I had just made the drive and been there about an hour when all of a sudden I fainted. My cousin was great, instantly handing me a spoonful of honey and fetching my Libre reader from my bag. Turned out my blood sugar was a little over 200 at the time, so I’m still not sure why I fainted (I’ve never reacted that way to a high blood sugar, let alone one that mild). Then things just kept getting worse from there. One of my cousins drove me to a pharmacy right before it closed to buy ketone strips and one of them wound up coming back with me and staying until after my appointment. I felt really guilty about ruining my visit but also really glad to have had them with me.

Thank you for the reply. I have read some more reviews on it and it appears horrid. Unfortunately it seems Levemir isn’t covered unless pregnant so I have to go back to Lantus which at least I’ve used in the past.

Thank you. Glad it worked out. I am going back to lantus I think. Insurance makes this so much more difficult than diabetes already is.

I’m sorry your insurance is limiting your options. :disappointed:

I’ve had insurance switched their preferred medication before - insulin or otherwise - but they will consider letting you remain on the one you’re accustomed to if your doctor provides documentation as to why you require it. Mine has done it a couple of times and I was able to keep the one that worked for me.