Thanks to my insurance, I’m switching from (my beloved) Tresiba to Levemir. I used Levemir while pregnant with my son - it was the first basal I used - but I’m not sure how it compares to Tresiba as far as dosage goes? Online I’m seeing it’s a 1:1, but when I go by weight with Levemir, I get 5ish units, and I’m currently on 4u Tresiba. So…start with 4, and go up from there if I’m too high? When should I start the first dose, since Tresiba lasts so long (I take it at night, usually around 11)?
I’m going to just make up an answer for what I’d do, although I’ve never used either of those.
I’d wait for signs that the Tresiba is about out of my system (i.e., a rise that looks like insufficient basal) and then I’d take a half-day of Levemir. If you’re on 4u Tresiba per day, I guess that means 2u Levemir twice per day to start. Surf while waiting for things to stabilize as the Tresiba finishes up and the Levemir takes hold, and then after a day or two start adjusting the morning or evening Levemir dose depending on what your BG is doing during the day and overnight.
So there’s one idea. Now maybe someone who has actually done it can state a better answer.
If you are only using 4 units of Levemir a day, you are going to have to split it into 4 doses to get 24 hours of coverage. This is not the right insulin for what you need. You will only get 6 hours of coverage at your dosage.
At your dosage, Levemir and Tresiba are not even remotely close to being the same thing.
You can generally get insulins like this overturned with an insurance appeal. An insurance company might try to argue that NovoLog and Humalog are basically the same. But Tresiba and Levemir are not close at all. This should be an easy win for you on appeal.
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Would it be the same for Basaglar (the other insulin my insurance covers)? You may remember, my insurance insists on you trying things and proving it doesn’t work (like R before covering Afrezza) in order to go with something not on their formulary… 
Basaglar is basically Lantus.
Basaglar or Lantus would give you longer coverage than Levemir, but probably not 24 hours. You would probably be left short about 4-6 hours, so you would probably need to split it into morning and evening doses.
But the advantage of Basaglar or Lantus in your situation would be that you could make adjustments easier. You could change it daily instead of there being a longer ramp up and down for dose changes like with Tresiba. If you have varying basal needs, it might be okay.
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So far I’ve not noticed any varying basal needs, but 2 shots/day would be preferable to 4…
If you want to be able to get Tresiba, do one shot a day of Basaglar and record your BG rising at 18 hours every day. Do that for a few weeks and have your endo appeal it. Would be very easy to fix.
Otherwise you are letting the insurance company dictate your treatment instead of your doctor. And regardless of what you are doing, that is a bad thing to do.
If Basaglar works for you, that’s great. Stick with it. But let it be your choice, not your insurance company’s choice.
Right. I was planning to do one shot of Levemir a day then tell my doc after a week that it’s not working. I just have a feeling they’ll want me to try Basaglar, too…since both are covered options.