Switching to Toujeo

[Sprogladite]

My DSN has got me switching onto Toujeo (likely from tomorrow) and have been doing a lot of reading up about it. It sounded fab as she was describing it, flat profile, less risk of hypos etc etc but I have yet to find any evidence of anyone anywhere having success with it! I'm being switched as Lantus causes severe hypos every night without fail and it's been a 4 month slog to try and get switched, but I'm less keen if I'm just going to run into more problems! Also struggling to see what the difference between Toujeo and Lantus is other than Toujeo is just "more concentrated Lantus"...

Has anybody on here switched onto and had success with Toujeo?

EDIT: I should add, I am allergic to Levemir and so DSN isn't willing to try me on Tresiba (which is what I wanted) as they are both made by Novo

 

[shannon capon]

Hello I have recently been switched to toujeo and can honestly say it is working for me im newly diagnosed like march this year but can honestly say its done wonders ive had a lot less hypos since

 

[mikeyB]

There isn't any difference in the profile of Lantus and Toujeo, so I can't see the value in switching to be honest.

Can I ask, when you say you are allergic to Levemir, what symptoms did you get?

 

[Sprogladite]

Hello I have recently been switched to toujeo and can honestly say it is working for me im newly diagnosed like march this year but can honestly say its done wonders ive had a lot less hypos since

Thanks, less hypos is what I'm aiming for so that's reassuring. Were you switched from a different basal or was Toujeo the first one they put you on?

There isn't any difference in the profile of Lantus and Toujeo, so I can't see the value in switching to be honest.

Can I ask, when you say you are allergic to Levemir, what symptoms did you get?

Toujeo is supposed to have a flatter profile supposedly but I'm struggling to see how if it is just 'concentrated Lantus' tbh. When I inject Levemir I get a lumpy, itchy rash at the injection site that lasts for hours. No breathing or concerning problems but it is very uncomfortable!

 

[mikeyB]

Shame, really, because I almost completely abolished night time hypos with split dose Levemir. Tresiba theoretically eliminates the problem by being ultra long acting, but would you be allergic to that? The way to find out is not by injecting it, for sure. You can tell by putting a drop of the insulin on your forearm, and just drawing a needle across your skin so as to lightly break the skin but not draw blood. This not something to do on your own, but with the diabetic nurse. If there is absolutely no reaction, then you could try an injection without any great worry. If you do get an itchy blister, then the door is closed on that insulin.

 

[Sprogladite]

Shame, really, because I almost completely abolished night time hypos with split dose Levemir. Tresiba theoretically eliminates the problem by being ultra long acting, but would you be allergic to that? The way to find out is not by injecting it, for sure. You can tell by putting a drop of the insulin on your forearm, and just drawing a needle across your skin so as to lightly break the skin but not draw blood. This not something to do on your own, but with the diabetic nurse. If there is absolutely no reaction, then you could try an injection without any great worry. If you do get an itchy blister, then the door is closed on that insulin.

That's a good idea, thank you - I will ask the nurse when I report back on how I'm doing with Toujeo. I am a little concerned because everything I'm reading says dose should be the same as Lantus dose when you make the switch and that its a 1:1 conversion but DSN wants me to go down by 3 units which doesn't seem right to me. Her logic was that it's more concentrated and I probably need to come down anyway because of the night time hypos, but when I lower the lantus dose I then run high in the day which is the whole reason I'm looking to switch in the first place!

 

[Rosiecarmel]

Toujeo is insulin glargine. Lantus is insulin glargine. It's the same insulin but Toujeo is more concentrated. I was initially put on Toujeo but I was having so many night time hypos. I changed to Levemir so I could split it, and take the lower dose at night which has worked wonders.

I hope Toujeo does work for you. I think your DSN was probably being cautious telling you to go down a few units especially since the night time hypos.

I haven't heard of Toujeo having a flatter profile than lantus but maybe it does although it is literally exactly the same. Just concentrated. My DSN told me that Toujeo was created mainly for people that take large doses as its so concentrated. Maybe that makes it flatter? Who knows. Good luck with it though 🙂

 

[Sprogladite]

Toujeo is insulin glargine. Lantus is insulin glargine. It's the same insulin but Toujeo is more concentrated. I was initially put on Toujeo but I was having so many night time hypos. I changed to Levemir so I could split it, and take the lower dose at night which has worked wonders.

I hope Toujeo does work for you. I think your DSN was probably being cautious telling you to go down a few units especially since the night time hypos.

I haven't heard of Toujeo having a flatter profile than lantus but maybe it does although it is literally exactly the same. Just concentrated. My DSN told me that Toujeo was created mainly for people that take large doses as its so concentrated. Maybe that makes it flatter? Who knows. Good luck with it though 🙂

Thank you @Rosiecarmel 🙂 I am reading a lot of conflicting info but the Toujeo website claims to "release gradually around the clock with no pronounced peak or wear-off between doses." which presumably is where the allegedly lessened hypos is meant to come from. I'm not 100% convinced but I don't have a lot of alternatives at this point lol!

 

[Rosiecarmel]

Thank you @Rosiecarmel 🙂 I am reading a lot of conflicting info but the Toujeo website claims to "release gradually around the clock with no pronounced peak or wear-off between doses." which presumably is where the allegedly lessened hypos is meant to come from. I'm not 100% convinced but I don't have a lot of alternatives at this point lol!

Well, it's worth a try! There are a few other options such as Tresiba, which Mikey suggested. There are also porcine and bovine insulins but they're not the easiest to get hold of and I think lots of DSNs are wary of them. Usually they're only prescribed if you're allergic to human insulin. Also if you're vegetarian they're a no go.

Have you considered a pump too? You can seriously fine tune your insulin requirements to 0.1units on many pumps!

 

[Sprogladite]

Well, it's worth a try! There are a few other options such as Tresiba, which Mikey suggested. There are also porcine and bovine insulins but they're not the easiest to get hold of and I think lots of DSNs are wary of them. Usually they're only prescribed if you're allergic to human insulin. Also if you're vegetarian they're a no go.

Have you considered a pump too? You can seriously fine tune your insulin requirements to 0.1units on many pumps!

Yes I was wanting Tresiba but DSN doesn't want to try me on it as I'm allergic to Levemir and Tresiba is made by the same people. I'm going to do as Mikey suggests and get DSN to do an allergy test for Tresiba if Toujeo doesn't work out (and I'm not holding my breath at this point lol) - if that's a no go then I'd consider a pump but I'm not thrilled about having something permanently attached to me tbh. I do have a libre but it's so small and it's not the same because I can take it off whenever I want without, you know, dying LOL. I go horse riding regularly too and the thought of falling off onto a pump really scares me but if I need to I'll cross that bridge when I come to it. I don't fall off very often but when I do it tends to be bad - last time I broke 2 ribs, time before that had a trapped nerve in my spine and couldn't ride for 9 months! There were several years between those but you get the point lol x

 

[Lucy Honeychurch]

I was on Toujeo and suffered night time hypos and high levels in the day. I'm now on split doses of Levermir and eliminated night hypos and better bs day readings. I hope it works out for you, good luck.

 

[Sprogladite]

I was on Toujeo and suffered night time hypos and high levels in the day. I'm now on split doses of Levermir and eliminated night hypos and better bs day readings. I hope it works out for you, good luck.

That's exactly what is happening to me on Lantus and I'm really struggling to see how Toujeo will fix this for me! I think I will try the Toujeo but keep campaigning for Tresiba. DSN is away this week but I'm going to start forcefully suggesting an allergy test for Tresiba from next week I think. If my levels continue to play up on Toujeo like I think they will that will just give me even more backup hopefully. Thanks for the well wishes, I'll keep everyone updated 🙂

 

[Copepod]

I refused my consultant's suggestion to change from twice daily Humalin I to Toujeo. I was willing to consider until I asked if I could use my same pens, and was told Toujeo only comes in disposable pens. I don't like the environmental waste, plus boxes of pens take up far more space in fridge than cartridges.

 

[Sprogladite]

Well, I bit the bullet and did my first dose of Toujeo last night. I had a hypo at 3am (2.8), woke up at 9.9, and was 12.8 by the time I got to work. Have done my morning insulin with correction and will see how this goes...not impressed so far!

 

[Rosiecarmel]

Remember to give it a few days. It can take a couple days for any changes to basal insulin to take effect (hence why basal testing with lantus is tricky)

 

[Sprogladite]

Remember to give it a few days. It can take a couple days for any changes to basal insulin to take effect (hence why basal testing with lantus is tricky)

I will, I don't have any choice really as my DSN is on holiday this week lol! I'm just emotionally at the end of my tether now. I cannot remember the last time I had a full night's sleep thanks to night time hypos!!

 

[Sprogladite]

Day 2 on Toujeo: yesterday the morning was same as always, high (15.something) pre breakfast then crashed down to 4.0 before lunch, behaved in the afternoon at 6.3 - 6.7 for all afternoon, all went to pot last night though. Spent the night at 15, very steadily throughout the night. Woke up to 15.3, just tested again and am 16.6 with +1 ketones to boot. Done an injection and drinking gallons of water to dry the sahara in my mouth/flush out ketones. Feeling pretty fed up tbh.

 

[mikeyB]

Well, all you can tell your DSN is the hardly surprising news that Toujeo is behaving exactly like Lantus. I've said this elsewhere, but it was only produced because the patent on Lantus was running out.

Tresiba works in a different way to Levemir, but it would appear that skin reactions and anaphylaxis are one of the commoner side effects, so that skin test is vital.

If you can't tolerate these long acting insulins, then try animal insulins for sure, but if this situation isn't a slam dunk reason for a pump, then I don't know what is. You're not likely to harm it or yourself falling off a horse😉

 

[Sprogladite]

Well, all you can tell your DSN is the hardly surprising news that Toujeo is behaving exactly like Lantus. I've said this elsewhere, but it was only produced because the patent on Lantus was running out.

Tresiba works in a different way to Levemir, but it would appear that skin reactions and anaphylaxis are one of the commoner side effects, so that skin test is vital.

If you can't tolerate these long acting insulins, then try animal insulins for sure, but if this situation isn't a slam dunk reason for a pump, then I don't know what is. You're not likely to harm it or yourself falling off a horse😉

Thanks @mikeyB i appreciate the advice. I'm definitely going to insist on the allergy test for Tresiba, and if that's a no go then I'll push for a pump. Just don't understand why I can be OK on basal/bolus for 20+ years without issue (including during a pregnancy) and then for it all to go nutty for ansolutely no reason!

 

[Kaylz]

Thanks @mikeyB i appreciate the advice. I'm definitely going to insist on the allergy test for Tresiba, and if that's a no go then I'll push for a pump. Just don't understand why I can be OK on basal/bolus for 20+ years without issue (including during a pregnancy) and then for it all to go nutty for ansolutely no reason!

Sorry love your just weird! 😉 xxxx