Tresiba vs Levemir: Choosing the Right Path for Diabetes Control

Let’s talk about Tresiba vs Levemir, the main diabetes control instruments. The main difference between Tresiba and Levemir lies in their duration of action. Tresiba provides a longer duration of insulin action compared to Levemir, offering more extended coverage for blood sugar control. In this article, we will delve into the intricacies of these two insulin medications, understanding their mechanisms of action, comparing their efficacy and safety profiles, and providing practical tips for using them. So, let’s dive into the world of diabetes management and explore the differences between Tresiba and Levemir.

Understanding Diabetes and Insulin

Before we explore the specifics of Tresiba and Levemir, let’s grasp the fundamentals of diabetes and the role of insulin in the body. Diabetes is a chronic medical condition characterized by high blood sugar levels due to the body’s inability to produce or effectively use insulin. Insulin is a hormone produced by the pancreas, responsible for regulating glucose absorption into cells to provide energy for bodily functions. Without sufficient insulin or its proper utilization, blood sugar levels rise, leading to various complications.

The Introduction to Tresiba and Levemir

Tresiba and Levemir are long-acting insulin analogs designed to mimic the natural insulin production in the body and maintain steady blood sugar levels. They are both administered through subcutaneous injections, providing a sustained effect over an extended period. The introduction of these long-acting insulins has revolutionized diabetes management, offering greater convenience and stability for individuals with diabetes.

Tresiba vs Levemir: Mechanism of Action

How Tresiba Works

Tresiba contains insulin degludec, a modified insulin analog with an ultra-long duration of action. Upon injection, Tresiba forms small, soluble multihexamers in the subcutaneous tissue, creating a reservoir of insulin. From this depot, insulin degludec is slowly and consistently released into the bloodstream, providing a continuous glucose-lowering effect for up to 42 hours.

How Levemir Works

Levemir, on the other hand, contains insulin detemir, another long-acting insulin analog. Once injected subcutaneously, Levemir binds to albumin in the bloodstream, forming a depot. The bound insulin detemir is then gradually released into circulation, maintaining blood sugar control for up to 24 hours.

Tresiba vs Levemir : Onset of Action

The onset of action refers to how quickly the insulin begins to lower blood sugar levels after injection. Tresiba and Levemir differ in their onset characteristics.


Tresiba has a gradual onset of action, meaning it takes some time to start working. After injecting Tresiba, it may take several hours before it begins to lower blood glucose levels effectively. This slow and steady onset is due to the formulation of insulin degludec, which is designed to form small, soluble multi-hexamer units under the skin. These units then release insulin into the bloodstream at a constant rate, providing a sustained effect over an extended period.

The slow onset of Tresiba can be an advantage for some individuals, especially those who need a more consistent blood sugar control throughout the day and prefer less frequent injections.


Levemir, on the other hand, has a relatively faster onset of action compared to Tresiba. It starts to work within a few hours after injection, which is quicker than Tresiba’s onset. The faster onset is attributed to insulin detemir’s unique formulation, which allows it to be absorbed into the bloodstream more rapidly.

The faster onset of Levemir may be beneficial for individuals who need insulin action to begin more promptly after injection. However, it also means that Levemir may not provide as prolonged a blood sugar-lowering effect as Tresiba.

Tresiba vs Levemir: Duration of Action

The duration of action refers to how long the insulin continues to lower blood sugar levels after injection. Both Tresiba and Levemir have different durations of action, which can impact dosing frequency and insulin regimen.


Tresiba stands out for its exceptionally long duration of action. Once it starts working, Tresiba can continue to lower blood sugar levels for an extended period, lasting up to 42 hours in some individuals. This prolonged action is a result of insulin degludec’s unique ability to form a depot in the subcutaneous tissue, from which it is slowly released into the bloodstream over time.

The extended duration of Tresiba allows for greater dosing flexibility, as it can be taken once daily or, in some cases, even every other day. This flexibility can be advantageous for individuals with varying schedules or those who prefer fewer injections.


Levemir’s duration of action is relatively shorter compared to Tresiba. While it can still provide glycemic control for up to 24 hours, its effect does not extend as long as Tresiba’s. As a result, Levemir usually requires twice-daily dosing for most individuals to maintain stable blood sugar levels.

For some patients, the need for twice-daily injections can be a drawback, especially if they prefer a more simplified insulin regimen. However, Levemir’s predictable action can make it easier to adjust dosages based on specific daily routines and meals.

Efficacy and Effectiveness: Tresiba vs Levemir

Tresiba’s Benefits

Tresiba’s ultra-long action profile offers distinct advantages for diabetes management. Its prolonged duration ensures that individuals experience consistent glucose control throughout the day and even beyond 24 hours, reducing the risk of hypoglycemia. Moreover, Tresiba’s flexibility in dosing time allows patients to adjust injection timings without compromising its efficacy.

Levemir’s Benefits

Levemir, though not as long-acting as Tresiba, still provides stable glucose control for an extended period. Its duration of action covers a full day, making it a suitable option for patients who prefer a once-daily dosing regimen. Levemir’s consistent and predictable effect aids in preventing blood sugar fluctuations and enhances overall glycemic control.

Safety Profile: Tresiba vs Levemir

Ensuring the safety of any medication, especially when it comes to managing a chronic condition like diabetes, is of utmost importance. Both Tresiba and Levemir are long-acting basal insulin options that have undergone rigorous testing and evaluations to establish their safety profiles. However, as with all medications, there are specific safety considerations to keep in mind.

Common Side Effects

Both Tresiba and Levemir may cause certain common side effects related to insulin therapy. These side effects are typically mild and tend to occur at the injection site. Some of the common side effects include:

Injection Site Reactions: It is not uncommon to experience redness, swelling, or itching at the injection site after administering Tresiba or Levemir. These reactions are usually temporary and should resolve on their own.

Hypoglycemia: Hypoglycemia, or low blood sugar, is a potential side effect of all insulin treatments. It may occur if the insulin dose is too high, if meals are delayed, or if there is an increase in physical activity. Symptoms of hypoglycemia include shakiness, sweating, dizziness, and confusion. It is important to recognize and treat hypoglycemia promptly by consuming a fast-acting carbohydrate source, such as glucose tablets or juice. Various drugs are also used for effective glycemic control.

Allergic Reactions

In rare cases, some individuals may experience allergic reactions to insulin, including Tresiba and Levemir. Signs of an allergic reaction may include skin rash, itching, swelling, severe dizziness, or difficulty breathing. If any of these symptoms occur after insulin injection, immediate medical attention should be sought.


Hypokalemia, or low potassium levels, is another potential side effect of insulin therapy. This condition occurs when insulin promotes the movement of potassium from the bloodstream into the cells. While hypokalemia is uncommon, it is essential to monitor potassium levels, especially in individuals at risk, such as those with kidney impairment.

Weight Management

Weight gain can be a concern for some individuals on insulin therapy. Both Tresiba and Levemir may cause weight gain, although the extent of weight gain can vary from person to person. Factors such as diet, physical activity, and individual response to insulin can influence weight changes. It is essential for patients to discuss any weight-related concerns with their healthcare provider and explore strategies to maintain a healthy weight while managing diabetes effectively.

Risk of Nocturnal Hypoglycemia

Nocturnal hypoglycemia refers to episodes of low blood sugar that occur during sleep. Due to Tresiba’s prolonged and stable action, it may be associated with a lower risk of nocturnal hypoglycemia compared to Levemir. The extended duration of Tresiba’s effect can help maintain more stable blood sugar levels overnight.

Tresiba vs Levemir: Cost Comparison

When deciding between Tresiba and Levemir, the cost is an important factor to consider. Levemir costs around $33/ unit  while Tresiba costs around $37 per unit. The price of these long-acting basal insulins may vary based on insurance coverage, location, and discounts. Patients should explore their insurance plan’s details and check for generic options or patient assistance programs to minimize expenses. Alongside cost, evaluating benefits like dosing flexibility and glycemic control is crucial for optimal diabetes management. By weighing both factors, patients and healthcare providers can make informed choices that best suit their needs and financial well-being.

Tresiba vs Levemir: Choosing the Right Insulin for You


The choice between Tresiba and Levemir largely depends on individual preferences, lifestyle, and treatment goals. Some patients may find Tresiba more suitable for its longer action and reduced hypoglycemia risk, while others may prefer the simplicity of Levemir’s once-daily dosing. Consulting a healthcare provider is crucial to determine the most appropriate insulin regimen for each patient.

Tresiba vs Levemir: A Comparative Analysis

To summarize the key differences between Tresiba and Levemir:

  • Tresiba has an ultra-long duration of action (up to 42 hours), while Levemir’s action lasts up to 24 hours.
  • Tresiba offers a lower risk of hypoglycemia, especially during the later hours of its dosing interval.
  • Levemir provides stable glucose control with once-daily dosing, making it a convenient option for some patients.

Tresiba: Pros and Cons


  • Ultra-long duration of action for consistent glucose control
  • Reduced risk of hypoglycemia, particularly during the later hours
  • Flexible dosing schedule for increased convenience


  • May be more expensive compared to other insulins
  • Requires proper timing and injection technique for optimal efficacy

Levemir: Pros and Cons


  • Stable glucose control with once-daily dosing
  • Convenient and easy-to-use
  • Lower risk of weight gain compared to some other insulins


  • Higher risk of hypoglycemia, especially with inconsistent dosing times
  • Shorter duration of action compared to Tresiba

Practical Tips for Using Tresiba and Levemir

Regardless of which insulin patients choose, proper usage is essential for effective diabetes management. Here are some practical tips:

  • Consistent Injection Timing: Stick to a regular injection schedule to ensure steady blood sugar control.
  • Rotate Injection Sites: Alternate injection sites to prevent lipohypertrophy and ensure optimal insulin absorption.
  • Monitor Blood Sugar: Regularly check blood sugar levels to track the effectiveness of insulin therapy.
  • Carry Supplies: Always have insulin, syringes, and monitoring equipment on hand, especially when traveling.
  • Lifestyle and Dietary Considerations: Adopt a healthy lifestyle and follow a balanced diet to complement insulin therapy.

Lifestyle and Dietary Considerations for Diabetes Management

Managing diabetes goes beyond insulin therapy. Embracing a healthy lifestyle, including regular physical activity and a well-balanced diet, plays a pivotal role in blood sugar control. Reducing the consumption of sugary and processed foods while increasing the intake of whole grains, fruits, and vegetables can greatly benefit individuals with diabetes.

Tresiba vs Levemir: Bottom Line

In conclusion, both Tresiba and Levemir are valuable options for diabetes management, each with its unique advantages. Tresiba stands out for its ultra-long action and reduced risk of hypoglycemia, while Levemir offers simplicity with once-daily dosing. The choice between the two depends on individual preferences, lifestyle, and treatment needs. It is essential for patients to work closely with their healthcare providers to find the most suitable insulin regimen that aligns with their specific circumstances.


Is Tresiba and Levemir interchangeable?

Interchanging insulin medications should always be done under the guidance of a healthcare provider. While Tresiba and Levemir are both long-acting basal insulins, they have different onset and duration of action. Switching between them without proper supervision may affect blood sugar control. Consult your doctor before considering any changes to your insulin treatment plan.

Is Tresiba the best insulin?

The effectiveness of insulin varies from person to person, and there is no one-size-fits-all answer to which insulin is the best. Tresiba is a highly regarded insulin option with a long duration of action, providing dosing flexibility for some individuals. However, the best insulin for you depends on your medical history, lifestyle, and response to treatment. Work with your healthcare provider to find the most suitable insulin for your diabetes management.

What insulin can replace Levemir?

If switching insulin from Levemir is necessary, your healthcare provider may consider other long-acting basal insulin options like Tresiba (insulin degludec), Lantus (insulin glargine), or Toujeo (a concentrated form of insulin glargine). However, it’s crucial to discuss the transition plan with your doctor to ensure a smooth change in insulin therapy.

Which is better Lantus or Tresiba?

Lantus and Tresiba are both effective long-acting insulins with slight differences in onset and duration. The choice between the two depends on individual needs and preferences. Some patients may find Tresiba’s longer duration and dosing flexibility more suitable, while others may prefer Lantus for its stability and track record. Your healthcare provider can help determine the best insulin for you.

Is Levemir being discontinued?

There are no official reports of Levemir being discontinued. However, pharmaceutical product availability may change, so it’s essential to stay updated by consulting your healthcare provider or checking with the manufacturer for the latest information.

Why take Levemir at night?

Levemir is often prescribed to be taken at night because of its duration of action. By taking Levemir at night, the insulin can work throughout the day and provide coverage for the next 24 hours, reducing the risk of nocturnal hypoglycemia and supporting stable blood sugar levels.

Is it better to take Tresiba at night or in the morning?

Tresiba can be taken at any time during the day, providing flexibility for patients. Some may prefer to take it in the morning, while others choose to administer it at night. The decision on when to take Tresiba depends on individual schedules, lifestyle, and preference for managing their diabetes effectively.

Does Tresiba cause weight gain?

Weight gain can occur with any insulin therapy, including Tresiba. However, individual responses to insulin regarding weight can vary. Maintaining a healthy lifestyle, including a balanced diet and regular exercise, is essential for weight management while on insulin treatment.

Which long-acting insulin is best?

The choice of the best long-acting insulin depends on individual factors such as response to treatment, lifestyle, and medical history. Tresiba, Lantus, Levemir, and Toujeo are all effective options. Work with your healthcare provider to find the most suitable one for your specific needs.

Which is stronger Lantus or Levemir?

“Lantus or Levemir being “stronger” can be subjective and depends on individual response to insulin. Lantus and Levemir have different characteristics, and their effectiveness may vary from person to person. Your healthcare provider can determine which insulin is more appropriate for you based on your diabetes management goals.

When does Levemir peak?

Levemir has a relatively flat and consistent action profile, which means it does not have a pronounced peak. Instead, it provides a steady release of insulin over an extended period, offering reliable glycemic control.

When is the best time to take Levemir?

The best time to take Levemir can vary depending on individual needs and lifestyle. For many patients, taking Levemir at night is common to support stable blood sugar levels throughout the day. However, it is essential to follow your healthcare provider’s instructions for dosing and timing.

Do you gain weight on Tresiba vs Lantus?

Weight gain can occur with both Tresiba and Lantus, but individual responses to insulin treatment may differ. Factors such as diet, exercise, and other lifestyle habits can also influence weight changes. It’s essential to work with your healthcare provider to address any concerns about weight management while on insulin therapy.

What is the new faster-acting insulin?

Fiasp (insulin aspart) is one of the faster-acting insulin options available. However, the development of new insulin formulations is an ongoing area of research, and there may be other options in 2023. Consult your healthcare provider for the latest updates on insulin therapies.


  • American Diabetes Association (ADA):
  • Centers for Disease Control and Prevention (CDC):
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

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