Toujeo or Degludec instead of Lantus

[charleym]

Hi,

I've just been turned down for a pump at the MDT meeting, said I need to see the dietician (already done), consider changing my basal-bolus routine (do they think that wasn't tried first?) and change my insulin.

Toujeo or Degludec have been suggested... anyone had good results with one or the other in comparison to Lantus? The Lantus just doesn't seem to work and dietician said she'd expect me to be half of what I am on.

Also, who can change it? Next consultant appointment isn't until August and DSN is on holiday so no reply. I'm sick of feeling ill and just want it sorted now.

Mixed feelings though as if insulin change works I won't be offered a pump anyway. Job, stress etc that were cited as reasons to have one by consultant don't appear to have even been considered

Charley

 

[Jeremy_Wood]

Hi @charleym

I switched from Lantus (Glargine) to Tresiba (Degludec) earlier this year. I'd been on Glargine for about 12 years and found that it was getting rather inconsistent for me. I used to take it (26 units) in the evening and by 4 or 5pm the next day my blood sugars were rising. I spoke to my DSN about it and she said that this is fairly common. Apparently Glargine doesn't actually last a full 24 hours.

When I switched to Degludec I saw an immediate improvement. Degludec lasts something like 42 hours and give a much flatter profile. No more afternoon spikes and fewer nighttime lows. I couldn't recommend it enough!

I also changed my fast acting from NovoRapid to Fiasp. Fiasp works much faster (begins working after about ten minutes rather than an hour!) and dies off faster. Basically it's much more responsive and has made a massive difference to post-prandial spikes and correction speeds. Again, I couldn't recommend it enough.

The best person to talk to about this is your DSN. Give them a call and they should be able to get you on it pretty quickly.

J

 

[novorapidboi26]

Sorry to hear you were knocked back for a pump.....

do you know what the issue is with your control.......? is it a specific time of the day you need to target....if so, a longer acting basal might not actually do the job....

I would hang in there and try all the things they want you to as they will then have no choice to give you one eventually.....

 

[charleym]

Sorry to hear you were knocked back for a pump.....

do you know what the issue is with your control.......? is it a specific time of the day you need to target....if so, a longer acting basal might not actually do the job....

I would hang in there and try all the things they want you to as they will then have no choice to give you one eventually.....

Mornings are the biggest issue due to being high. Kept just getting told to increase lantus and in the end had to get a libre sensor I could prove that caused hypos all night. Also huge spikes after meals.

Am taking on average about 20 units Novarapid a day and 38 units of lantus and understand it's usually more of a 50/50 split.

E.g today was on 7.3 this am (and felt like I'd had hypos overnight). Ate 32g carbs 4 hours ago with 5 units Novarapid. Now at 1pm I'm on 13.4

 

[novorapidboi26]

Mornings are the biggest issue due to being high. Kept just getting told to increase lantus and in the end had to get a libre sensor I could prove that caused hypos all night. Also huge spikes after meals.

Am taking on average about 20 units Novarapid a day and 38 units of lantus and understand it's usually more of a 50/50 split.

E.g today was on 7.3 this am (and felt like I'd had hypos overnight). Ate 32g carbs 4 hours ago with 5 units Novarapid. Now at 1pm I'm on 13.4

So you have increased the Lantus to as much as you could in order to wake up the same as before bed?

A split basal dose would allow you to target overnight and during the day separately, so smaller doses and therefore more efficient...

If you done that that would mean that you would need to go back and test/adjust your insulin/carb ratios as well....

there may the risk of dawn phenomenon also, but a 7.3 this morning seems reasonable.....all you need to confirm/deny that is a 3 am test.....that kind of seems like old school now with the libre about....lol...

If you haven't tried all the above then there is more you could do to get the results however don't stop trying for the pump....