My Endo gave me some samples of Toujeo Basal Insulin to try. Has any type 1’s tried it yet? If so, what’s the difference between this and lantus and/or levemir? Thanks!
I have not. Sorry i cannot help.
Toujeo is a triple strength version of Lantus. If you take more than 50 units of Lantus at a time this insulin might be a good match for you. But if I recall, you are pretty insulin sensitive which might make this a poor fit since you will have more difficulty adjusting. There are various claims about it being flatter than Lantus, but I think that is likely to be very dose dependent. If you take a small dose of Toujeo it may be even less flat than Lantus. Give it a try and see.
And just so you know, the street price of Toujeo is the same per unit as Lantus and all the modern basal insulins (a pen will be 3 times more expensive than Lantus). It won’t immediately be covered by insurance so be prepared for sticker shock if you accept the change to Toujeo.
I’ve been using Toujeo instead of Lantus for a couple of weeks. My daily basal dose is 24 units. My blood sugars have been harder than usual to manage, but I haven’t tracked it carefully enough to know why. I’ll keep logs for the next week. I have a weird suspicion that the Toujeo is slowing down the Novolog meal bolus absorption time to almost 7 hours. But no evidence. Just some crazy unexplained highs and lows. Stubborn highs for hours after a meal and then terrible crashes seven hours later. Three times a day, all week long. It’s exhausting actually. Could be hormonal, might not be the Toujeo, but I’m wearing a Dexcom G4 so I can keep pretty good logs and let you know how it goes in the future.
Hi my name is Cat. I’m glad I found this topic. I have issues with the Toujeo. I was just put on Toujeo today, 55 units in the morning. I was on Humulin R (U500) insulin for several years (maybe 6 or more) and lately it was causing my glucose levels to drop and be erratic. I also had to take it three times a day, on top of the Novolog to cover corrections and meals.
Anyway, my glucose numbers have been horrible today. Started off at 360 and when I last checked around 2.15 PM they were 240. They have not been out of the 200s all day. I know this is the first day, but it is a horrible first day!! Lol! I’ve talked to my endocrine’s office and they have told me to check my glucose levels every 4 hours, record the numbers and whatever food I have eaten, and correct with the Novolog. I’m supposed to do this for 2 to 3 days and see how it goes. I hate to say it but I have better things to do than be tied to my meter. I carry that meter with me everywhere but I’ve constantly set alarms to check my glucose levels today. And am I supposed to do this overnight? I hope not because I have horrible problems sleeping as it is so don’t want to make it worse.
I’m sorry for ranting but I just don’t know about this new insulin. I know the concentration isn’t as strong as the Humulin R (U500) but I’m not enjoying this ride. This is one roller coaster I want off of. Lol!!! Thank you.
@Sarah66 Wow really? Aren’t you ultra insulin sensitive? I would have thought you’d be near the opposite end of the spectrum from toujeo… It is basically the same as lantus but 3x stronger— 30 units of lantus = 10 units toujeo, etc
My impression was it was pretty much for highly insulin resistant people.
You should have some patience. It may take several days for the Toujeo to reach full levels in your system even if you have the dose right. With a basal, it is usually good to make a change and then observe things for a couple days.
Thank you Brian!!
I think I’m just being cranky. With my glucose levels elevated to where they are, it’s hard and kinda frustrating. Plus, when my glucose levels are elevated I do get cranky. So 2 + 2 does equal 4!!!
And Sarah66, I’m insulin resistant, if you are insulin sensitive, this is definitely NOT the insulin for you. I’ve been a diabetic for 18 years and have been through various stages of diabetes, being diagnosed as a Type 2 and now they are saying I’m a Type 1. I’ve always been insulin resistant, and could never manage to keep the glucose numbers low enough to even function. Bu once I was put on the Humulin R (or U500), which is more concentrated than the Toujeo, things changed and my numbers got better - quickly. I loved it and was able to function.
It’s weird that your endo would put you on this if you are insulin sensitive. Maybe a wicked low dose??? Maybe because it’s long acting??? How has it been going since you started it???
this stuff is U300. I wonder when the lawsuits will begin when people start going into insulin shock? I would expect that a fair number of people would simply take the same dose of this stuff that they took of, say Lantus, not paying attention to the fact it is U300.
Phoenizbound— I was on the U500 for a long time and had to take that 3X a day. This U300 is killing me. Just checked my glucose levels at 2.25 AM and they were 396. I can’t live like this much longer. I really can’t. I mean I’ve had my glucose levels elevated but this is nuts!!! And I swear the U500 was not as bad as this. Or maybe my memory wants me to think that because I’m having such a horrible time and I’m uber cranky. LOL!!!
They are selling Toujeo in pens with the units adjusted for the concentration. Nice for them as they can sell only the expensive pens and offer no vials. But supposedly if you were taking 100 u of Lantus you would just use the 100 U dose of the pen (which is actually 33.3 u of the U300).
100 units of Lantus?? I take (when I’m not using my pump), roughly 18 units of Lantus and I’m around 220 lbs and a pure Type 1. I’d go broke next month when I go on Medicare, if I had to buy insulin the quantities to sustain a 100 U/day dosage!
100 u is a very common Type 2 dose. I have heard from someone taking 300u before being put on U500.
The biosimilar(s) should be here in another year, though we don’t know the pricing. There is also Tresiba coming. Hopefully the competition will limit some of the greed.
Did you know that we are discussing this on the T1/LADA forum? If I posted on the T2 forum, then I wouldn’t have mentioned the fact that 100U a day is a lot of insulin. I know those people sometimes have some ridiculous amounts of resistance.
Diabetes is diabetes. The plain fact is that the normal range of TDD in T1 is 0.5 to 1 IU/gk/day which means that an adult male may well take more than 100 U/day even if they are not insulin resistant. I would suggest that a TDD of more than 100 U per day is probably not uncommon in adult T1. There are factors which also cause higher doses of insulin to be less efficient. On of the arguments that has been made that smaller injection volumes will make it more efficient, thus a daily basal bolus of 50 U/day would only require a third of the volume in Toujeo and because of better absorption the required dose might even be smaller (say 40 U/day).
I hold little hope for biosimilars. The insulin makers are arranging to control biosimilar sources biosimilars insulin will likely to be sold only at a modest discount over the market leaders. And the pharma industry seems to have colluded to increase the cost of U-500 by like 500% and to reestablish a price point for insulin not based on the form factor being sold (vial, pen, etc), rather based on comparable cost per U. That means a pen for Toujeo would cost 3 times the cost of a Lantua pen.
My general caution to the T1 community (actually to everyone) is to be wary of pressure to move to Toujeo unless there is a really fundamental reason for the change. Otherwise it is likely your change will result in no improvement in your outcomes but a tripling of revenue into the pockets of pharma.
100U of ONLY basal insulin for non-insulin resistant T1??? I find that incredible, to say the least. For any type of diabetic who is very insulin resistant, I would agree; otherwise I disagree. OR, if you really want to claim that 100U is not “uncommon”, maybe you are including people who go to every buffet in town on a regular basis for both lunch and dinner?
Agree completely re diabetes = diabetes. It’s a spectrum of insulin deficiency and insulin resistance and any person can find themselves at any place along that spectrum, and ones place along the spectrum can change in time. At or near the insulin deficient end of the spectrum we sometimes, not always, see coexistent autoantibodies, we sometimes, not always see younger people at that end of spectrum, but we can also see them at any other point along the spectrum. At or near the insulin resistant end of the spectrum we sometimes, not always see other coexistent things like obesity, but can see them anywhere else on the spectrum as well. I believe that the categorical type thinking that has led us to clearly label “this is type 1” and “this is type 2” have been generally a bad thing for the cause of both advocating and understanding diabetes throughout the world. It’s these unfortunate tendencies to subdivide and categorize health conditions that’s led to reduced access to treatments for certain sub groups, etc. But that’s just my thoughts I’m not a scientist or a doctor.
I hope you’re wrong about bio similars but am afraid you may well be right.
To the extent these rules hold any water (and for many of us they’re wildly off base) at 1U/kg/day a 200 pound man (90 kg) would be taking a total daily dose of 90 units, which would include basal and bolus, so 100U of basal alone would still be considered quite high.
I’m shocked that more of you who are T1 haven’t chimed in to refute claims that 100U of basal per day is “not uncommon”. Or do many of you know that but don’t like to argue?
I agree phoenixbound. I’ve had to give myself over 100U of Levemir when I was on it. (That was years ago.) I had to look it up but I was taking something like 80U in the morning and 40 at dinner. The morning shot had to be broken up into two shots.