Provide your opinion and hear from your peers

When it comes to choosing a basal insulin, many factors come into play. Complete this 4-question survey, and see how your answers compare with insights from experts and your peers.

Question 1 of 4

Since Tresiba® provides patients with a proven A1C descent,1 when you prescribe a basal insulin other than Tresiba®, what is the main reason?

Tresiba® has a different molecular design and was engineered to provide a steady rate of absorption, giving it a 42+ hour duration of action that won’t taper off at the end of the day.1,2,a

“When I prescribe a basal insulin, I'm looking for an insulin that lasts 24 hours, that you don't have to take twice a day, and that you can take any time of the day.”

Steven Edelman, MD
Professor of Medicine in the Division of Endocrinology, Diabetes and Metabolism, University of California, San Diego

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.  

aAfter the last of 8 once-daily injections (0.4 units/kg).  

Your patients may now be covered for Tresiba®, as it is the Lowest Brand Co-pay on the majority of Commercial and Medicare Part D plans nationwide, and has a savings card.3,a

“Patients are always concerned about cost, and I think having some savings options available to them makes a difference.”

Stephen Brunton, MD
Executive Vice President, Education for the Primary Care Education Consortium

aCommercial coverage consists of Exclusive, Preferred, Lowest Branded Co-pay, and Covered without Restrictions. Eligibility and other restrictions apply. 

 

With Tresiba®, you can choose between 2 formulations: U-100 and U-200. Unit dosing remains the same, no matter which pen you prescribe.

“Here is a basal insulin that comes in 2 different concentrations. There's a U-100 and a U-200 formulation, and the pens are nicely color coded.” 

James R. Gavin, III, MD, PhD
Former president of the American Diabetes Association

You may be familiar with a certain basal insulin, but Tresiba® is the only basal insulin that gives adult patients the option to change day-to-day dose timing if needed.

“One of the things I like about Tresiba® is it has some dose timing options, so that way [if a] patient forgets to take the medication, they can take it later in the day, as long as there is an 8-hour difference between the 2 doses. That gives them some comfort and gives me some comfort.”

Stephen Brunton, MD
Executive Vice President, Education for the Primary Care Education Consortium

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.1

Question 2 of 4

Do your patients occasionally miss or delay their basal insulin dose?

If life gets in the way of a scheduled dose, once-daily Tresiba® provides continued efficacy.1,a

“I like that Tresiba® has some dose timing options, so that way if an adult patient forgets to take the medication, they can take it later in the day, as long as there is an 8-hour difference between the 2 doses.”

Stephen Brunton, MD
Executive Vice President, Education for the Primary Care Education Consortium

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.1

aTresiba® was studied at alternating once-daily dosing intervals of 8 to 40 hours in adult patients.

Even for diligent patients, life can get in the way of a scheduled dose. Once-daily Tresiba® is the only basal insulin that gives adult patients the option to change day-to-day dose timing if needed.a

“The extended action of Tresiba® and any-time-of-day dosing help if my patients miss or need to delay a dose.”

James R. Gavin, III, MD, PhD
Former president of the American Diabetes Association

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.1

aTresiba® was studied at alternating once-daily dosing intervals of 8 to 40 hours in adult patients.

Question 3 of 4

Do you consider the device when prescribing a basal insulin?

Tresiba® FlexTouch® may be right for your patients, as it has U-100 and U-200 formulations. Unit dosing remains the same, no matter which pen you prescribe.

“One of the really nice things about Tresiba® is it comes in both U-100 and U-200 pens. For those patients that need more than 80 units, I can prescribe them U-200 (which has a 160-unit maximum dose) so they don’t have to give themselves 2 injections to get the appropriate dose.”a

Stephen Brunton, MD
Executive Vice President, Education for the Primary Care Education Consortium

aDose determined on an individual basis. The mean end doses across Tresiba® clinical trials ranged from 19 units to 70 units.1

 

It may be time to get to know Tresiba® FlexTouch®. It has no push-button extension and has U-100 and U-200 formulations. The U-200 pen delivers 2 to 160 units in a single injection.1

“I like it because when you dial the dose, the extension plunger doesn’t come way out. And for the U-200, I like the fact that you can give up to 160 units at one time, because many of our patients may require more than 80 units at a time.a,b

Steven Edelman, MD
Professor of Medicine in the Division of Endocrinology, Diabetes and Metabolism, University of California, San Diego

aTresiba® FlexTouch® U-200 is dialed in 2-unit dose increments. 

bDose determined on an individual basis. The mean end doses across Tresiba® clinical trials ranged from 19 units to 70 units.1

 

Question 4 of 4

To whom are you most likely to write a prescription for Tresiba®?

Tresiba® may also be an option for your insulin-naïve patients. Once-daily Tresiba® was engineered to provide a steady rate of absorption, giving it a 42+ hour duration of action that won’t taper off at the end of the day.1,2,b

“For all my patients with diabetes, my first objective is to find a treatment that can help them lower their A1C. I also look for treatments that address practical concerns [like storage and dosing considerations] as well.”

Michael Heile, MD
Primary Care Physician, The Family Medical Group, Cincinnati, OH

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.1

aDose determined on an individual basis. The mean end doses across Tresiba® clinical trials ranged from 19 units to 70 units.1

bAfter the last of 8 once-daily injections (0.4 units/kg).

Tresiba® is also available in a U-100 pen that has 1-unit dose adjustments for patients who require less than 80 units per injection.1

“U-100 and U-200 are the same insulin. It's just that they're in different concentrations and the pen does the math for you. Use U-100 if you have to really micromanage unit by unit. If you want more than 80 units per injection,a,b use the U-200.”

Michael Heile, MD
Primary Care Physician, The Family Medical Group, Cincinnati, OH

aDose determined on an individual basis. The mean end doses across Tresiba® clinical trials ranged from 19 units to 70 units.1

bTresiba® FlexTouch® U-200 is dialed in 2-unit dose increments. 

 

Tresiba® may also be an option for pediatric patients, and patients with type 1 diabetes. Once-daily Tresiba® is the only long-acting insulin indicated for type 1 and type 2 diabetes in children as young as 1 year of age.1

“You can prescribe Tresiba® for both pediatric and adult patients with type 1 and type 2 diabetes.”

James R. Gavin, III, MD, PhD
Former president of the American Diabetes Association

aDose determined on an individual basis. The mean end doses across Tresiba® clinical trials ranged from 19 units to 70 units.1

Tresiba® can be prescribed to a wide range of patient types with diabetes. Tresiba® is indicated to improve glycemic control in patients 1 year of age and older with diabetes.

“If I bring it up properly, typically a patient’s reaction to changing insulins is a good one.”

Michael Heile, MD
Primary Care Physician, The Family Medical Group, Cincinnati, OH

aDose determined on an individual basis. The mean end doses across Tresiba® clinical trials ranged from 19 units to 70 units.1

 

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Background information

Have you ever prescribed Tresiba®?

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See below for more information on the topics covered in this survey.

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See below for more information on the topics covered in this survey.

Previous Question

Selected Important Safety Information

Contraindications

  • Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients

Warnings and Precautions

  • Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens
  • Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed
  • Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening

Indications and Usage

Tresiba® (insulin degludec injection) is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus.

Limitations of Use

Tresiba® is not recommended for treating diabetic ketoacidosis or for pediatric patients requiring less than 5 units of Tresiba®.

Important Safety Information

Contraindications

  • Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients

Warnings and Precautions

  • Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens
  • Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed
  • Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment
  • Accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors, always instruct patients to check the insulin label before each injection
  • Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including Tresiba®
  • As with all insulins, Tresiba® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Closely monitor potassium levels in patients at risk of hypokalemia and treat if indicated
  • Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Tresiba®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered

Adverse Reactions

  • Adverse reactions commonly associated with Tresiba® are hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, and weight gain

Drug Interactions

  • Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and close monitoring of blood glucose. The signs and symptoms of hypoglycemia may be reduced or absent in patients taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine)

Please click here for Prescribing Information.

 

References:

  1. Tresiba [package insert]. Plainsboro, NJ: Novo Nordisk Inc; December 2016. 
  2. Heise T, Korsatko S, Nosek L, et al. J Diabetes. 2016;8(1):132-138.
  3. Fingertip Formulary, April 2017.