Toujeo or not toujeo, that is the question...

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Peely66

Peely66

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Relationship to Diabetes
Type 1
So first appointment with DSN for years, having fallen through yet another net and not seen a consultant either (but all irrelevant to the main point of my post).

First thing mentioned was a change of insulin if I'm interested from Lantus to Toujeo. Any thoughts?

I'm not sure I'm having any issues that I've noticed with Lantus and understand that Toujeo has a much flatter and prolonged profile.

Couldn't resist the Shakespearean pun...which I was muttering to myself as I left the hospital.
 
I switched from Lantus to Toujeo a few years back and it was a big improvement for me. Lantus was losing effectiveness for me after approx. 20hrs, causing blood sugar spikes in the evening or early nighttime. It took me a while to tweak the Toujeo dose - this is not an exact swap.

For me, the Toujeo profile is very flat during the night now - see attached.
 

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Andy HB said:
Whether tis nobler in the mind to suffer the blood sugar swings and lancets of outrageous fortune..

(Sorry, no other thoughts than that, l'm afraid).
Click to expand...

Or use arms as sites for seas of sensors and by opposing end them. To jab, to scan no more.....

Know nothing about changing insulin.
 
So - what proof have either you or the DSN got that your bodily need for insulin remains flat for prolonged periods? How long has it been since you did a Basal test?
 
I switched a couple of years ago and another benefit of Toujeo is that it is three times 'stronger', so to inject 30 units, it only injects 10 ml. Less volume helps with Lipohypertrophy ( I assume). The pens are still set up for 'UNITS' but inject less.
 
I know this is a bit scratchy… but “how about trying a different insulin?” seems to be one of the main options open to diabetes clinics, because it’s easier than the imponderables of actually trying to get whatever insulins you are taking to work better.

To my mind, unless you’ve identified a specific thing that you’d like to improve, and the profile of the new insulin looks likely to help with that - I’m not sure the faff of swapping to a new one and tinkering with the doses would appeal to me.

Having said that, suggested insulin swaps often do work really well for forum folks, so what do I know!
 
Robert459 said:
I switched a couple of years ago and another benefit of Toujeo is that it is three times 'stronger', so to inject 30 units, it only injects 10 ml. Less volume helps with Lipohypertrophy ( I assume). The pens are still set up for 'UNITS' but inject less.
Click to expand...

Ah that’s interesting @Robert459 - I hadn’t realised that Toujeo was a u300 insulin (3x as concentrated as standard u100s).
 
I'm not inclined to swap at the moment...particularly as since my little chat with her I've tweaked a couple of things that I'd sort of forgotten about or got in a muddle about and had 70/80/90 % in range. Mainly to do with timings and corrections. So if it's not broken why fix it.
 
I agree, if it ain't broke...
 
everydayupsanddowns said:
Ah that’s interesting @Robert459 - I hadn’t realised that Toujeo was a u300 insulin (3x as concentrated as standard u100s).
Click to expand...
I had read that before and it made me think that it is probably more suited to Type 2 diabetics or Type 1s with insulin resistance. The information I read all seemed a bit vague though. I think if you were a normal Type 1 with no significant insulin resistance or very insulin sensitive then it would not be appropriate or at the very least you would want a half unit pen and I am not sure there is one. No way would I swap to it..... but then I absolutely love my Levemir.
 
I struggled with Lantus, so had a couple of years adjusting morning an evening doses, but never got the perfect basal test. Just for fun after discussion with my consultant we decided to try Toujeo. She did a few calculation based on my Levemir doses, and told me the dose to use on a daily basis, naturally much lower then Lantus or Levemir.

Since I lost weight I now take just take between 10 to 12 in the morning, and can now do a basal test that runs perfectly, an use much less Fiasp. A dose of 12 tends to make me go low in late afternoon, so 10 is my regular dose.

It gives me better control than either Lantus or Levemir, I love it, though with my gastroparesis using Fiasp means I can't prebolus before a meal, I just keep an eye on my BG using the Dexcom G7, then when i inject the appropriate dose of Fiasp, I get no peaks, The Toujeo keeping the level when I injected the Fiasp until the meal has passed through my weird guts.

In reality, the gastroparesis will mean I'll get a pump next time I see the consultant, but it's good practice using Toujeo.
 
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