Values are estimated ratios relative to day 10; clinical steady state is defined as >90% of the final plateau level.1
A flat and stable profile
Tresiba® concentrations remained stable from day to day at steady state1,2
Tresiba® concentrations in adults with type 1 diabetes


A smooth and steady release provides continuous coverage for longer than 24 hours3,a
- The recommended time between dose increases is 3 to 4 days (the same amount of time it takes to reach steady state)3
- Total and maximum exposure at steady state are comparable between Tresiba® U-100 and Tresiba® U-200, when each is administered at the same units/kg dose3
The only basal insulin proven to last at least 42 hours—that won’t taper off at the end of the day1,3,a
Duration of action of Tresiba®


- Adult patients who miss a dose of Tresiba® should inject their daily dose during waking hours upon discovering the missed dose, then continue with their regular dosing schedule. Ensure that at least 8 hours have elapsed between Tresiba® injections.
- If a pediatric patient misses a dose, they should contact their health care provider for guidance and monitor blood glucose levels more frequently until the next scheduled dose.
Tresiba has the longest half-life of any basal insulin3,4-9,b


bThe mean half-life of other basal insulins: insulin glargine U-300: 19 hours5; insulin detemir: 5 to 7 hours depending on dose8; NPH: 4.4 hours.9
c13.5-hour half-life for insulin glargine U-100 is based on 0.4 U/kg dose.
The clinical significance of these PK/PD differences has not been established.
PK/PD Study 11,2
Population: Adults with type 1 diabetes.
Study design: Randomized, double-blind, parallel-group, single-center trial evaluating the day-to-day within-subject activity and glucose-lowering effect of Tresiba® U-100 (n=27) vs insulin glargine U-100 (n=27) under steady-state conditions. Patients received Tresiba® U-100 or insulin glargine U-100 (0.4 units/kg) once daily for 12 days. The euglycemic clamp was performed on days 6, 9, and 12 of treatment and blood samples were taken throughout each clamp period.
Primary endpoint: To evaluate the within-subject variability of the PD response between Tresiba® U-100 and insulin glargine U-100 based on the area under the glucose infusion rate curve (AUCGIR) during 1 dosing interval (0-24 hours) at steady state.
PK/PD Study 24
Population: Adults with type 1 diabetes.
Study design: Randomized, double-blind, 2-period crossover, single-center trial comparing the PD and PK properties of Tresiba® vs insulin glargine U-100 (N=66) under steady-state conditions. Patients received Tresiba® or insulin glargine U-100 at one of 3 dose levels (0.4, 0.6, and 0.8 U/kg) once daily for two 8-day periods (switching to Tresiba® or insulin glargine U-100 before second period). Blood samples to assess serum concentrations were evaluated on days 6 and 8. A 42-hour euglycemic clamp was performed on day 8 of both treatment periods, after the last basal insulin dose.
Primary endpoint: To evaluate the PD and PK properties of 0.4, 0.6, or 0.8 U/kg of Tresiba® and insulin glargine U-100 at steady state.
PD=pharmacodynamic.
PK=pharmacokinetic.