Tresiba Experience... not sure yet

I’ve been on insulin pump therapy for about 10 years or so. I love it.
My endo suggested for me to try Tresiba, as it’s a new ultralong basal insulin, with flexible dosing schedule, etc. etc. etc.

So I tried it. She suggested I start at 18 units/day. I didn’t want to push it TOO hard too fast (rather not spend all day caring for lows). So I tried 12 units to start.

Days 1-3, 220-240 basal baseline. Hours of fasting to prove this.
Days 4-5 190-230 baseline (upped to 14 units Day 5).
Day 5 I injected my last dose of Tresiba and it BURNED like a mother… not sure, maybe went around/in a capillary or something…

Day 6+ dropped Tresiba and went back to pumping.

Got off my pump for a week, felt really awesome


  • Needle sticks suck (especially low dose Tresiba, every 2 hours a new injection of Humalog)
  • It seemed to DULL Humalog in my body?
    TDD on pump: 20 units/day
    TDD on 12 units Tresiba: 24 units/day (12 Tres. 12 H.) and STILL lowest BG only 170?
    (very confusing as my TDD BASAL on my pump is 16 units/day… weird)
  • I would have to be upwards of 30 units or more to achieve really nice numbers.
  • Left big blotches of red swellings on my Tresiba injection sites (only pump problem is insertion scaring that usually goes away within a few days of taking the site out)

For now… I am on the Animas Vibe, taking ~20 units/day and maintaining 120 bg avg. I’ll take that for now. Moving onto UHC’s pigeon-holed, dictator-ed Medtronic pump soon (Animas just fell out of warranty (RIP :cry:))

Going to get the 630g… I heard Auto mode in 670g is a f**king nightmare.

Oh and of course I forgot:
When dosing with insulin pens (Tres. and H), I noticed that getting a full and accurate injection is next to impossible. I literally tried everything (priming it before, inserting it and holding down the plunger, waiting 6-8 seconds) and yet STILL I see a increasing bauble of insulin at the tip when I take it out of my skin.
What’s up with that? No thank you inaccuracies…

That certainly was an interesting - horrible? - experience Trevor @ketoeater. I’ve heard really good results some people have using Tresiba but those reports were from people who had been using other long-term or background insulin.

When I got my first pump the doctor told me to set my own basal rates and bolus ratios and also suggested that I set those values to give me no more than 70% of my usual daily usage and then adjust from there. Turns out with a pump I would need about 25% less insulin than with MDI and background. And the best feature of a pump is accurate delivery in fraction of units.

Do you have any scar tissue from pumping? I have been pumping for 13 years and I feel like I am running out of clean tissue to use…

Trevor @ketoeater, certainly I have scar tissue - but very little if any from using pumps during the most recent 15 years. I changed to a pump, after 47 years of shots because of scar tissue. My rational was, one insertion every three days as opposed to six or more shots EVERY day.
I’ve identified 12 areas on my body that work real well as pump infusion sites and I carefully rotate; yes, I keep a calendar and write down the site # and consult that calendar to make certain I haven’e used it recently - twelve sites mean reusing the same area happens, at most, every 39 days.

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What are those 12 areas? It seems the only really good sites are on my upper abdomen near my ribs. I tried my upper buttocks, but they seem to leak. I was on my legs for awhile until they started to not really work anymore. Thoughts?



These are the most common sites (follow the link)

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I’m saving my arms for CGM, so, I’m trying to get creative with the infusion sites. I’m going to try using my lower back area, even though, I can’t see it well to insert. Fingers crossed. I just worry of getting it caught when changing or using bathroom.

I have another idea. I wonder if you might have better success pumping with a different formulation of insulin.
My endo gave me a vial of Apidra and Fiasp to try on Friday. Theyre both supposed to have a shorter duration, and the Fiasp is supposed to have a quicker onset.
So why I think this might help you, I wonder if the faster absorbtion would work to counteract the scar tissue you have. Supposedly they just put niacinamide(Vitamin B3) in it to stimulate the injection site.
So far Ive only used the Fiasp and Im still trying to get it dialed in. I need 135% the basal rate, and a similarly increased carb and ratio. But, the active insulin time is just shy of 2 hours versus 2:45 for novolog in my body, and its onset is so fast I can take it at the beginning of my meal without incurring spikes instead of 15 minutes before.

A different insulin might also reduce future scarring, especially if the scarring is from the insulin sitting unabsorbed and these insulins absorb faster.