Tresiba, made simple.
Tresiba is insulin degludec, an ultra long acting basal insulin that comes as U-100 or U-200. It lowers glucose and must be matched to the exact concentration, device, dose, and time. The rule patients most often miss: know whether your pen is U-100 or U-200, and keep at least 8 hours between adult doses. A Mississippi pharmacist wrote this guide for you.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeYour 60 second Tresiba safety checklist
- Check the label every time.Tresiba comes as U-100 and U-200 FlexTouch pens and a U-100 vial. The pen window already shows actual units, so never convert. Read the full insulin name and concentration before attaching a needle or drawing a dose.
- One dose each day.Adults may inject once daily at any time. Children should use the same time every day. Regular timing is easiest and safest. Write your exact dose and time in your insulin schedule.
- Prime the pen and never share it.Prime FlexTouch with 2 units. After the counter returns to zero during injection, keep the needle in the skin and count slowly to 6. Use a new needle every time. Never share a pen, syringe, or needle, even if the needle is changed.
- Rotate healthy sites.Repeated injections into lumps or thickened skin make absorption unpredictable. Show any lump, pit, or thick area to your pharmacist or clinician.
- Prepare for low blood sugar.Insulin can cause severe hypoglycemia. Carry fast carbohydrate and keep prescribed glucagon available.
- Never guess after a missed dose.Adults may take a missed dose when discovered if at least 8 hours will separate doses. Pediatric patients must call the clinician. Never double.
What Tresiba is and why your doctor gave it to you
Tresiba is the brand name for insulin degludec, available as U-100 or U-200. It is an ultra long acting basal insulin, which means it works in the background between meals and overnight.
- Diabetes in patients 1 year and older. Tresiba is FDA approved to improve glucose control in patients 1 year and older with diabetes.
- Flexible timing for adults. Adults may use it once daily at any time of day, as long as at least 8 hours separate doses. Pediatric patients use it at the same time daily.
The simple version: Tresiba forms a slow release depot under the skin for long background coverage. Your dose is individualized based on your diabetes type, glucose results, food, activity, illness, kidney or liver function, and other medicines.
How Tresiba works
Insulin acts like a key. It helps glucose move from your blood into your muscle and fat cells, and it reduces extra glucose released by your liver.
The timing of that action depends on the insulin. A basal insulin like Tresiba creates background coverage. A mealtime insulin is timed around food. They are not interchangeable.
The medicine cannot tell whether you ate, exercised, got sick, or accidentally repeated a dose. That is why glucose checks, exact timing, site rotation, and a written low glucose and missed dose plan are part of the treatment, not optional extras.
Your dose
Your Tresiba dose is personal. It may change with your glucose patterns, food, activity, illness, steroid use, kidney or liver function, and other diabetes medicines. Only the clinician responsible for your care should change the prescribed dose.
Check U-100 versus U-200 every time. The pen displays actual units, so do not calculate or convert anything.
With the FlexTouch pen: attach a new needle, prime with 2 units, dial the prescribed dose, inject, and count slowly to 6 after the counter reaches zero. Use a U-100 syringe only with the U-100 vial.
Do not mix, dilute, use in a pump or vein, or transfer pen insulin to a syringe. Do not use the U-200 pen for a person who needs a dose the device cannot dial. And never share a pen, syringe, or needle.
Timing, and what to do if you miss a dose
Adults may inject Tresiba once daily at any time, but at least 8 hours must separate consecutive injections. Children should use the same time every day. Regular timing is easiest and safest.
Inject under the skin of the thigh, upper arm, or abdomen, and rotate sites.
If you miss a dose:
- Adults who miss a dose may inject it when they discover it, then continue the regular schedule, as long as at least 8 hours separate consecutive injections.
- Pediatric patients should call the healthcare provider for instructions.
- Do not double.
- Check your glucose more often, and check ketones when your diabetes plan directs.
Side effects, what is normal and what is not
You may notice when you begin treatment:
- Low blood sugar: shaking, sweating, hunger, fast heartbeat, dizziness, confusion, blurred vision, or weakness. If you are awake and can swallow, follow your written plan. A common plan is 15 grams of fast carbohydrate and a recheck in 15 minutes.
- Mild redness at the injection site. Rotate sites.
- Some weight gain or fluid retention.
- Glucose changes while your body adjusts to a new insulin or concentration. Monitor more often as directed and do not stack corrections too close together.
Call your doctor or pharmacist promptly if you notice:
- Repeated glucose below your action threshold, or low readings you cannot explain.
- Glucose that stays above your call threshold despite following your correction plan.
- Moderate or large ketones, especially with type 1 diabetes.
- A wrong insulin, wrong concentration, or wrong dose error, even if you feel well.
- New injection site lumps, pits, or infection, or unpredictable glucose after changing sites.
- Rapid swelling or shortness of breath.
- Vomiting, poor intake, fever, or steroid treatment that disrupts your usual plan.
Get urgent help or call 911 if you have:
- Unconsciousness, seizure, or inability to swallow during low glucose. Give prescribed glucagon, place the person on their side, and call 911.
- Trouble breathing, face or throat swelling, or a severe allergic reaction.
- Possible diabetic ketoacidosis: vomiting, belly pain, deep or rapid breathing, fruity breath, confusion, or high glucose with significant ketones.
- A serious insulin overdose, or glucose falling fast that cannot be kept in range.
What to be careful with
Many medicines and life changes alter insulin needs. Review every change with Fairview and your diabetes team.
Other glucose lowering medicines can add to your low blood sugar risk. Beta blockers, clonidine, and some other medicines can hide the warning signs of a low, such as fast heartbeat or tremor.
Steroids, some antipsychotics, decongestants, and illness can raise glucose. ACE inhibitors, salicylates, alcohol, and some other medicines can sometimes increase low glucose risk.
Thiazolidinediones used with insulin can worsen fluid retention or heart failure. Alcohol can cause delayed low glucose, especially without food.
You do not need to memorize every interaction. Before starting, stopping, or changing another medicine or supplement, tell your pharmacist that you take Tresiba.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
Availability and insurance coverage can change. Fairview will check whether an FDA approved lower cost alternative, a manufacturer savings program, an insurance exception, or another cost saving option is available for your specific prescription.
What should be checked
Tresiba does its work quietly, so your numbers and your technique both need regular attention.
Your care team should follow, now and then:
- Your CGM or meter glucose patterns, including lows and highs.
- Your A1C and your individualized time in range goals.
- Your injection sites and technique.
- Kidney and liver changes that may reduce your insulin needs.
- Your weight, swelling, food intake, activity, and illness.
Your pharmacist should, now and then:
- Confirm your exact insulin, U-100 or U-200, and device at every fill.
- Review your pen technique and priming steps.
- Check your glucagon supply, meter or CGM backup, ketone supplies when prescribed, and expiration dates.
- Check your medicine list for anything that changes insulin needs.
Your monitoring plan depends on why you take the medicine, your dose, your other conditions, and your other medications.
Special situations
If you become sick or cannot eat.
Do not stop basal insulin on your own. Check glucose more often, check ketones when directed, drink fluids, and call for vomiting or out of range readings. Mealtime decisions require your written sick day plan.
Travel.
Carry insulin and backup supplies in your hand luggage. Protect them from freezing and heat. Get a written time zone plan before you travel.
Pregnancy and breastfeeding.
Insulin is often used during pregnancy, but needs can change quickly. Coordinate closely with your obstetric and diabetes teams.
Kidney or liver disease.
Insulin needs may fall as function worsens, which raises low glucose risk. Monitor more often and let your clinician adjust the plan.
Driving and machinery.
Do not drive with low glucose. Check before driving when your plan directs, and carry fast carbohydrate.
Using a CGM.
Confirm with a meter when symptoms do not match the sensor or the device tells you to check. Record your insulin time and avoid stacking corrections.
Storage.
Unopened: refrigerate at 36°F to 46°F until expiration, or keep at room temperature up to 86°F for up to 56 days. Do not freeze. An in use FlexTouch pen or vial can be refrigerated or kept at room temperature up to 86°F and discarded after 56 days. Protect from direct heat and light, keep the pen capped, and remove the needle after each use.
How Fairview helps Tresiba patients
When you fill Tresiba at Fairview, here is what you get. This is normal care for us, not something extra.
At your first fill:
- We confirm the medicine, concentration, schedule, and treatment purpose.
- We demonstrate the FlexTouch pen, including priming and the count to 6.
- We review your low glucose plan and interactions.
- We help identify insurance barriers.
At every refill:
- We check for new medicines and ask about side effects.
- We help prevent refill gaps and review lab or appointment needs.
- We reinforce correct administration and look into cost changes.
When something changes:
- We review any new medicine and contact your prescriber when needed.
- We help you prepare medication information for surgery or travel.
- We discuss side effects and counsel an approved caregiver.
Questions people ask about Tresiba
Adults: once daily at any time, with at least 8 hours between doses. Children: at the same time every day.
Related guides
Have a question about your Tresiba? Ask a pharmacist who knows it well.
The Tresiba safety lesson: verify the exact insulin, know whether your pen is U-100 or U-200, and keep at least 8 hours between adult doses. Keep a written schedule, monitor your glucose, carry fast carbohydrate, and make sure someone knows how to use your glucagon. Fairview can demonstrate your exact device, review storage and travel, and help coordinate questions with your prescriber. Moving your prescription to us takes one phone call.