I have used Tresiba, but not Toujeo. Previously I used NPH and Lantus. The move from Lantus to Tresiba was amazing! I took Lantus 2x daily, and when I started Tresiba it was only 1x daily. The timing on Tresiba is very forgiving. I had 10 and. 12 hour offsets from my intended injection time with no negative issues. For me, Tresiba seems to work 34 to 38 hours with an extremely small almost imperceptible tail and spike. It definitely made fine tuning my Humalog easier.
I switched from Lantus to Tresiba and find Tresiba to be much smoother (no 3 AM lows like I had with Lantus). I am once daily in morning with Tresiba and have no stacking problems whatsoever. It took a while to fine tune the dose with Tresiba so if you try it be patient.
I used Tresiba for 2.5 years until my formulary changed in June and it is no longer covered. I now take Toujeo. I didn’t take basal insulin prior to the Tresiba, although I used NPH when I was pregnant 6 years ago.
I prefer the Tresiba hands down. It does last 42 hours, but you should take it at relatively the same time each day for the best effect, although it does give you wiggle room for a couple of hours without ill effect. I didn’t have any lows and my fasting BGS were pretty good. It doesn’t have a stacking effect like regular insulin does, but a single dose is supposed to release over the entire 42 hours so it takes a few days for the initial dosing to show its full effect and when you titrate up you should do it in 3-4 day increments. Personally I got about 36 hours of effectiveness before it gradually tapered out (There was a snafu with a refill once so this is how I figured that out). I used it in combination with Humalog and a weekly Trulicity injection. Tresiba was 56 units/day, Humalog averaged 40-45 units per day.
I don’t like Toujeo, I have to take about 1.5x as much to have the same effect as Tresiba and my fasting numbers were all over the place-I think because I was dipping low overnight. The previous carb coverage ratios and correction factors no longer worked so y Humalog dosage has also increased, especially in the morning. After a month and consultation with the doc we decided to switch out the Trulicity for Victoza which has improved things dramatically. Toujeo 75 units per day, Humalog 60-70 units per day, Victoza 1.8 mg.
If you decide on either make sure you use the pharma discount card because it will bring your copay significantly down.
I switched from Lantus to Toujeo a few months ago. The only difference I can see is that I find Toujeo slightly more convenient because of the much smaller volume. Faster and smoother injections.
I definitely prefer tresiba, I kind of miss changing doses based on activities, but that was lantus and levemir which for me only lasted 12 hours, and was twice daily, or multiple hyperglycemic corrections. Once daily with tresiba although like john58, it took me a little while to figure out the right dose…its definitely stronger for me, so I am using less and eating less hypoglycemic granola bars which was one of the goals. Toujeo is more concentrated lantus, so in theory, you’ll probably find yourself still needing 2 shots and dropping every 6 hours…