Doc gave me a free sample of the Toujeo pen to try. I usually use Lantus (which works great for me; no problems with unsteady coverage), however I’m out of that prescription and insurance won’t cover it anymore so I’m giving this Toujeo thing a shot before I decide what I’m going to do.
My doc said that the dosage should be exactly the same as Lantus, but Toujeo’s website said it’s likely to be higher. But they don’t give any indication of how much higher. Does anybody have an idea as to what kind of dosage calculation I should attempt? I usually take 13 units of Lantus.
Full disclosure: I have no personal experience with Toujeo.
That caveat having being issued, my general approach to all things diabetes is empirical. I don’t let guidelines determine my management; I get real world numbers (about me, not the next person) and let the numbers tell me what really works.
Were I in your exact situation, I would begin with the same dosage. I would keep records and, after several days or preferably even a week, review my log and decide whether the amount needed to be tweaked upward or downward. I would keep doing that until I arrived at the dosage that produced the right results for me (as opposed to my neighbor, some well meaning doctor’s opinion, or the people in some averaged study).
The Toujeo package insert says this about a study of T1Ds and the change from Lantus to Toujeo:
Patients treated with TOUJEO used 17.5% more basal insulin than patients treated with LANTUS.
I would concur with @David_dns’s recommendations using personal experimentation. Confusing this situation is the fact that Lantus is U100 insulin and Toujeo is U300 insulin. Toujeo is techincally three times more concentrated insulin formula than Lantus. It appears, however, that the 1:1 conversion from Lantus to Toujeo is a good place to start.
Keep good records and you’ll learn what works best for you. Please report back here what you discover.
Fair enough - that was my plan but I’m on vacation and seeing some people I don’t get to see often enough and after a morning spike on Day 1 of Toujeo, I was starting to get worried I’d be a high blood sugar zombie and no fun to be around
The spike earlier could’ve just been due to traveling and changing time zones; now in the afternoon it seems pretty level. I will report back later on though!
I recently switched and ended up adding about 25% to get an equivalent dose… (26 Lantus to 33 Toujeo). My doctor said he had almost a 50-50 split between patients who switched… half of them were fine with a 1:1 dose, the rest of us were needing an extra ~20% or so.
(To be fully fair to Toujeo, I got a Lantus-induced ‘crash’ about 6 hours after injecting, so my 26units was the middle ground dose between ‘enough to cover most hours with a correction here and there’, and ‘not so much that the crash was debilitating, just annoying’, so my Lantus dose was artificially low.)
I switched from Lantus to Toujeo just about a year ago. I went from 13 units on Lantus to 16 on Toujeo. Like any insulin switch there was an adjustment period. I’m loving Toujeo, no split doses or unexpected lows. I sure hope the change is going well for you.
Well, unfortunately I can’t give much of an accurate update since I’m pretty sure I’m getting a cold/flu/something not fun and my sugars have been running high for the past 2 days or so. The first few days on Toujeo seemed just fine - same dosage as Lantus, not much difference in my blood sugar readings. I bumped it from 13 to 15 today and I’m still needing almost twice as much humalog as usual, so I may bump it again soon if this continues.
