Levemir vs. Tresiba: Comparing Insulin Injections

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS

Levemir and Tresiba are two long-acting insulin medications. They treat diabetes.

Millions of people have diabetes or prediabetes. Diabetes results from your body being unable to produce enough insulin or not having enough insulin sensitivity. An insulin injection helps the pancreas function normally and helps control blood glucose levels.

When glucose is controlled, diabetes symptoms and complications are reduced. Injections like Levemir and Tresiba help with this. They can last in the body for longer than some other medications.

What is Levemir?

Levemir is a long-lasting insulin medication. It helps your blood sugar stay steady over time. This includes overnight and between meals.

Levemir is a subcutaneous injection. This means it is given into the skin with a small needle. Levemir is used in adults with type 1 or 2 diabetes and children with type 1 diabetes. These are used with a Levemir FlexTouch pen.

Levemir is a biologic medication. Its active ingredient is insulin detemir. Biologic medicines are made using living cells. Because of this, there is no generic brand of this medicine.

The Side Effects of Levemir

All medicines come with a list of possible side effects. Levemir has common, mild, and serious side effects. If any side effect is bothersome or becomes severe, contact your doctor or pharmacist.

Common Side Effects

Common side effects can be temporary. They can last a few days or weeks. They can include:

  • Itching at the site of injection
  • Skin rash at the site of injection
  • Reaction at the injection site
  • Hypoglycemia (low blood sugar levels)
  • Lipodystrophy (skin dents, pits, or lumps at the injection site)

Mild Side Effects

Some of the mild side effects include:

  • Headache
  • Sore throat
  • Upper respiratory infection
  • Back pain
  • Abdominal pain
  • Weight gain

Serious Side Effects

While not common, serious side effects should not be ignored. They can include:

  • Hypokalemia (low potassium level). Symptoms can be:
    • Fatigue
    • Confusion
    • Muscle weakness
    • Muscle cramps
    • Shortness of breath
    • Increased thirst
    • Irregular or rapid heartbeat
  • Allergic reaction
  • Severe hypoglycemia

What is Tresiba?

Tresiba is a subcutaneous injection medicine. It helps manage blood sugar levels in children over age 1 and adults who have diabetes, type 1 or 2. Tresiba can be administered with a syringe or with a FlexTouch pen.

The active ingredient in Tresiba is insulin degludec. It works continuously throughout the day to keep blood sugar levels healthy. This is also long-lasting insulin.

Because Tresiba is also a biologic drug, there is no generic form. Biologic drugs cannot be exactly copied.

Tresiba is not approved for treating diabetic ketoacidosis.

Side Effects of Tresiba

Tresiba can cause various side effects. Most people will only experience mild side effects if they take medications. If your side effects last longer than usual, contact your pharmacist or doctor.

Common Side Effects

Some of the more common side effects can include:

  • Headache
  • Reactions at the injection site
    • Redness
    • Swelling
    • Itchiness
    • Pain
  • Low blood sugar (hypoglycemia)
  • Common cold or other upper respiratory infections
  • Swelling nasal passages and throat (nasopharyngitis)

Rare Side Effects

These don’t happen often but can occur:

  • Allergic reaction
  • Weight gain
  • Swelling in the hands, arms, feet, or legs (peripheral edema)
  • Skin pitting or thickening around the injection site (lipodystrophy)

Mild Side Effects

Side effects that can be mild can include any of the above and the following:

  • Diarrhea
  • Nausea
  • Vomiting

Serious Side Effects

If any of these side effects occur, call your doctor right away:

  • Having too little potassium in the blood (hypokalemia). Symptoms of this are:
    • Fatigue
    • Thirst
    • Constipation
    • Muscle twitches
    • Excess urination
    • Muscle cramps
  • Severe hypoglycemia
  • Allergic reaction

Levemir and Tresiba Precautions

All medicines have precautions you should know before you take them. Your doctor should know your history but always discuss these with your doctor beforehand. Your doctor will weigh your benefits and risks when prescribing a medication.


These are precautions you should be aware of before taking Levemir:

  • Allergies: Let your doctor know if you have any allergies including to any medications, foods, dyes
  • Drug interactions: Several medications can interact with Levemir. They range from mild interaction to serious interaction
  • Other interactions: Ethanol
  • Other medical problems:
    • Congestive heart failure
    • Diabetic ketoacidosis
    • Infection
    • Stress
    • Hypokalemia
    • Emotional disturbances
    • Illness
    • Kidney disease
    • Liver disease
    • Hypoglycemia


Tresiba has the following precautions:

  • Allergies: Allergies to this medicine, other medicines, or any other types of allergies.
  • Drug interactions: There are many potential drug interactions. Discuss your current medications with your doctor before taking this.
  • Other interactions: Ethanol
  • Other medical problems:
    • Liver disease
    • Congestive heart failure
    • Kidney disease
    • Hypokalemia
    • Hypoglycemia
    • Diabetic ketoacidosis

Levemir vs. Tresiba: Comparison

These two medicines are very comparable.

Here are the similarities:

  • Novo Nordisk manufactures both of these medications. This company helps meet the needs of people living with serious chronic diseases. They have innovative medicines and delivery methods.
  • They are both long-acting insulin medications.
  • They both treat diabetes.
  • Both of these are injected into the skin.
  • They are both biologic drugs with no generic form.

There are a few differences:

  • Duration
    • Levemir is classified as long-lasting. It has a duration in the body of up to 24 hours.
    • Tresiba is classified as ultra-long-lasting. Once administered, it lasts more than 42 hours in the body.
  • A 2016 study showed that insulin degludec (Tresiba) has a lower risk of nocturnal confirmed hypoglycemia than insulin detemir (Levemir) in people with type 1 diabetes.
  • Cost for 100 units/mL:
    • Levemir is about $514 for a supply of 15 mL
    • Tresiba is about $315 for a supply of 10 mL

How Can The Rx Advocates Help People Save Money on Their Monthly Prescriptions?

Diabetes is a serious, chronic disease. It affects the way your body turns food into energy. Most of your food is turned into glucose (sugar) and released into the bloodstream. When the glucose is too high, your pancreas releases insulin.

Insulin releases the sugar into your body’s cells to use as energy. However, a person with diabetes doesn’t produce enough insulin or their body is insensitive to it. This means there is too much sugar in the blood. This can lead to very serious health problems.

When this happens, your doctor will figure out the medicine that will work best for your situation. Even with insurance, these medicines can be expensive.

Our goal is to help customers afford their monthly medicines. Our patient assistance program helps customers with discounts on Levemir and Tresiba. The only extra cost is for our services. Medications are delivered at no additional charge.

Diabetes medicine is not optional. We help people save money every month on Levemir and Tresiba. If you need help paying for medications, please contact us today.

  1. Novo Insulin. What is Levemir? September 2022. Available at: mynovoinsulin.com.
  2. Novo Insulin. Find your reason for taking control of your blood sugar with Tresiba. September 2022. Available at: mynovoinsulin.com.
  3. Medical News Today. Levemir (insulin detemir). April 15, 2022. Available at: medicalnewstoday.com.
  4. Medical News Today. Levemir side effects: What you should know. January 8, 2022. Available at: medicalnewstoday.com.
  5. Medical News Today. Tresiba (insulin degludec). May 14, 2022. Available at: medicalnewstoday.com.
  6. Medical News Today. Tresiba side effects: What you should know. February 6, 2021. Available at: medicalnewstoday.com.
  7. Novo Nordisk. Driving Change to Defeat Diabetes. September 2022. Available at: novonordisk.com.
  8. Health Guide. Tresiba vs. Levemir. July 4, 2022. Available at: healthguidenet.com.
  9. Mayo Clinic. Insulin Detemir (Subcutaneous Route). August 1, 2022. Available at: mayoclinic.com.
  10. Mayo Clinic. Insulin Degludec (Subcutaneous Route). August 1, 2022. Available at: mayoclinic.com.
  11. Centers for Disease Control. What is Diabetes? July 7, 2022. Available at: cdc.gov.
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