Are these 2 insulins equal unit to unit? I’m switching and I’m not sure if I am supposed to take the same number of units of Toujeo as I normally take with Lantus. What do you think??
Units are standardized. 1u of toujeo = 1 u of lantus in terms of how much medication it is, it is just a different amount of liquid volume. (With the toujeo being 1/3 the liquid volume per unit)
So yes unless your intention is to adjust your dose, you would take the same number of units.
Thanks!!
While a unit is technically a unit you may find that your basal needs with Toujeo are actually different than with Lantus. It is known that smaller volumes of injections absorb better, that would on average suggest that with Toujeo you might need less of a dose. I would recommend consulting with your doctor on how to start out with Toujeo and how to adjust to a proper dose. Doing a basal test is always advised.
Would the logic that smaller doses absorb better extend after the first couple days? When clearly the same amount of basal insulin entering the body must equal the number exiting the body? “Better” absorption with smaller doses seems like a relative concept with basal and maybe is more meaningful with bolus-- where the speed of absorbtion is measured over a couple hours vs many?
Anyway not trying to delve too far into the weeds. The short answer is 1u lantus is supposed to = 1u toujeo
Good morning
I switched from Lantus to Toujeo a little more than a year ago. I was told by my endo you almost always use up to 20% more Toujeo than Lantus. I started out using my normal basil amount (13u per day) and did need to up it to 15u per day. I love Toujeo, no more split doses, no late night lows! I hope it works well for you.
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From my research, a more concentrated insulin absorbs slower than a identical insulin in U100 strength. If you look at the graphs between U100 Tresiba versus U200 you’ll see a blunting of the small spike that U100 has. Not sure where you read you opposite Brian but it would be good to know.
Let me find a graph to keep myself honest as I’m going by memory. :slight_smile
You may be right. My experience with Tresiba U-200 is that I need significantly less daily basal than I did with Levemir. I don’t know whether that relates to the question of the difference between Lantus and Toujeo.
This is where i saw that info at. So it basically flattens out the profile of it. Which is why U300 Toujeo works much longer than Lantus I assume since its the same insulin.
I think the important concept though is that after the first few days there will be the same number being injected into the body as are leaving the body regardless of how long it lasts, as long is the duration is longer than the tIme between injections— at that point isn’t it all just academic?
Maybe that threshold is crossed with toujeo but not with lantus ?
This graph perhaps explains why higher concentrations last longer, but it doesn’t say anything about the effectiveness (perhaps measured by the AUC). My point was that a smaller volume absorbs better than a bigger volume and that may lead to needing a smaller total daily basal dose.
Here’s the thing that complicates this for people with functioning beta cells… There is a degree of “substitution” that takes place, so the effect basal levels of exogenous insulin has on T2s can be quite variable, and non-linear from person to person.
When doing drug trials on long-acting insulins they have non-diabetics in the control group. A perfectly normal person can take a low-dose basal injection daily with no effect at all – their pancreas just excretes less insulin.
I personally experience this as a T2 – I have my basal set to 0.05U/hr on my pump most of the day because my own pancreas can handle the job. I can turn it up at high as 0.5U/hr (10x) without any impact on my BG.
What my pancreas CAN’T handle are the increased basal needs in the morning and the evening, where I have to crank it up to 2U/hr for several hours.
And, of course, the large amount necessary when digesting a meal…
The first-order approximation of the efficacy – glucose clearing effect – is the area under each of those plots. They all look roughly the same to me.
Of course, the body doesn’t work this simply, so that rough approximation will be incorrect in any precise way. For example, the efficacy of insulin is affected by the BG level itself, so the more concentrated insulins allowing BG to hang around at higher levels early on could blunt the overall effect, requiring more overall in terms of unit quantities to achieve the same result.
DISCLAIMER: This is all speculation. Informed, but still speculation.
For concentrated insulin that isn’t true is what the graph shows. A higher peak initially means faster absorption. He specifically says in the presentation “higher concentrated insulin means slower absorption”.
But I do see your point, it applies to same insulin concentrations measured against each other. So a smaller dose of U200 vs a larger dose of the same U200 would get absorbed faster.