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Mild side effects Examples of mild side effects that can occur with both Tresiba and Levemir (when taken individually) include: hypoglycemia (low blood sugar levels) hyperglycemia (high blood sugar levels) upper respiratory infections, such as the common cold flu-like symptoms (vomiting, chills, fever, abdominal cramps) headache injection site reactions, such as pain, redness, itchiness, or swelling around the area of your injection lipodystrophy (skin thickening or pitting around the injection site) weight gain swelling in your legs, feet, or ankles Serious side effects Examples of serious side effects that can occur with both Tresiba and Levemir (when taken individually) include: severe hypoglycemia (very low blood sugar levels) hypokalemia (low level of potassium in your blood) severe allergic reaction Effectiveness Tresiba and Levemir are both FDA-approved to help manage blood sugar levels in people with type 1 and type 2 diabetes