Hi!
I’m a T2 on MDI, Ozempic, and a few oral drugs.
I sometimes forget my Toujeo. How should I continue the next day, in other words, with what dosage of Toujeo?
Thanks.
M.
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Don’t forget. Not cool. Don’t change your Toujeo dose. Take a blood sugar and get back to us.
Find a way to insure that you inject the Toujeo consistently at the same time every day. I don’t think you ought to be adjusting your dose the day after missing a dose. That day with higher blood glucose levels has passed.
These long insulins need consistency to work well.
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My BG was a little high, nothing dreadful, so I injected an appropriate amount of Novorapid. I’ll measure again in a few minutes.
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BG is fine now. Thanks, everyone . I do try to remember my medical rituals every day, but I’ll try a little harder.
Thanks again.
M.
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Hi @MapleSugar,
I don’t have any advice on this particular occurrence, but I do have some advice to prevent this from happening again.
If you get a big pill holder, you can put the pen needle inside for each day. That will help you remember.
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What a great idea @Eric2 When I was MDI before I had a big sign in the way going out the door to remind me. When I had to give my dog a shot twice a day I got an alarm clock with two alarm settings.
My solution now is I have an alarm set on my phone with a unique tone set twice a day to remind me to take it.
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Some things to know about Toujeo:
When starting Toujeo it takes about 8 days of daily dosing to reach a steady state.
When changing the dose of Toujeo it takes 3-4 days of dosing at the new amount to reach a steady state.
So by missing a dose you can expect to have higher BG for about 3 days. The effect will ramp down then ramp back up. Sounds like you have a good handle on bolusing to correct for the lower basal insulin and the higher BG it can cause.
I tried Toujeo once. Took me a while to understand the info sheet that comes with the pens. Hope this helps.
Edit: Maple + Novorapid = Canadian! Sorry I’m a slow American. Here is the Toujeo info sheet for Canada.
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There’s those that have and those that will, so don’t beat yourself up! The Toujeo website in essence says, “Call your doc!” and without discounting that advice, it might be worth using whatever “portal” you have to send them a note and ask.
I’m on a pump now, so don’t use long acting, but recommend setting an alarm (if you have one do it on your watch or universal system if on Apple devices). When I was on Lantus, I split my dose morning and evening, so you may need to set two. You can use “reminders” or set a repeating calendar event(s).
I’ve always found good advice here, FUD, TCOYD and others. Here’s what Dr Edelman at TCOYD offers:
What to Do When You Forget a Basal Insulin Dose
Typically, most people take their basal insulin (Lantus, Tresiba, Toujeo, Levemir, NPH) either in the morning or at night. Some folks split their basal and take some of it in the morning and the rest at bedtime. If you are on a once-daily basil insulin regimen and you remember that you forgot your dose of insulin and you are within 3 or 4 hours of your normal time, you can go ahead and take it late.
If you are on once-daily basal insulin and you are past that 3-4 hour window, then give half of your normal dose and continue the full regular dose at the next regularly scheduled time. You obviously need to keep a close eye on your glucose values in case your numbers creep up too high or drop down too low.
If you are on a split basal (two injections per day) regimen, then I recommend just watching your glucose closely up until your next dose and continue normally. In essence, you would be doing without that basal dose so you may need to give yourself a small correction dose (or doses) of your mealtime insulin up until the next dose. Having a CGM will help you decide if you need any correction doses, and if you do not wear a CGM then you should do more frequent glucose testing with your meter.
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You apparently live in a completely different world. I can call my HMO’s local “diabetes institute”. There is a very small chance I could get to talk to one of the DEs, social workers, or whatever. They would patiently explain to me that I am garbage, with no further detail. The doctor is pretty good, but there’s no chance I’d get to talk to him, but I have an appointment with him in a few months. No kidding.
@Eric2 ,
I have my own plan for ‘forcing’ myself to remember the injection, but it sometimes slips. And my giqnt pillbox is already full.
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Looks familiar but I use a basket
I have my oral meds in Apple health which gives reminders and when you record the time taken.
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This is a great topic. I’m T1 so I take a long and fast acting insulin. Wish it was pills but beggars can’t be choosers. It is easy to forget to take your dosage and maintain a routine. I might be the only 30 year old this happens to but I swear the only thing I can remember is to forget. I think I would forget myself if I wasn’t attached to me.
And people please don’t change your dosage. I tried that once with fast acting insulin and next thing I knew I woke up in the hospital! There are no scenarios where it is advisable. Please just dose normally and let it get back in range at it’s own pace.
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A type 2 here on on insulin pump. I was MDI. Only one of the pills in the basket is for T2DM - Metformin. The rest are a statin, a very low dose Ace inhibitor to protect my kidneys, a prescription drug to mange hypertriglycerides and a multivitamin.
Oh. I left out thyroid as I have Hasimoto’s like a lot of us with diabetes.
Sorry that’s been your experience! I’ll usually get a response in a day or so to messages, usually from staff vice doc, but sometimes the doc. That said, getting an initial appt is difficult; I just waited 3 mos for an appt with a gastro, was on a wait list for a local Endo for a few as well. I keep reading things about the need for a T1 team (Dr, NP, CDE, etc.)…not here in DC area! Any “team” will likely be your own creation, no integration, lucky if they have systems that allow seeing each others info/tests. I’m sure it exists somewhere, I just haven’t found it.
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Would putting an alarm on your phone help? I do that for my nighttime meds.
@Jane16 ,
It might work, but it would drive me crazy. I hate those kinds of audible alarms!
Pick a fun ringtone? I usually turn off early because I remember. Have pump now so only necessary for other meds. Good luck. Jane
Jane Cerullo
I have a white board in my kitchen. I have trulicity Thursday as a note. Since I face it a lot it is a great reminder. My pills are in a pillbox next to where I sit. We check with each other if we took our pills. I also leave open my empty pill box slot,as a back up to know it is empty. Good luck. Nancy50
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