Insulin Quantities Confusion

[Markj4913]

I have type 2 Diabetes Insulin dependent and have suffered for 14 Years.
For a very long time now my treatment in respect of Insulin is as follows;

Novarapid 3 times a day - 34 Units each time Breakfast Lunch and Dinner
Lantus 100 Units/ml - 108 Units of an evening each day.

My Doctor after some changes in my levels (high) has changed my Insulin to Toujour but 300Units/ml

She instructed I attend my nurse to discuss quantities.

I attended yesterday and the nurse advised that my actual dosage should stay the same at 108 Units of the new insulin EVEN THOUGH it is 300 Units/ml .

This confuses me surely the insulin is stronger ? How can the doseage be the same. The Nurse is checkign but I am a little concerned. Any ideas please.

Thanks

Mark

 

[Antje77]

Dosage stays the same in units but are less in volume. When you use a pre-filled pen you dial up the units. With a U300 pen you simply get 1/3 of the amount of insulin that you would get with a U100 pen.

 

[Markj4913]

Dosage stays the same in units but are less in volume. When you use a pre-filled pen you dial up the units. With a U300 pen you simply get 1/3 of the amount of insulin that you would get with a U100 pen.

Lol Thank You for your response. Now Im totally confused ! It must be me.

So with a U100 pen I take 108 Units
With a U300 pen i take 108 Units but I get a third of the insulin so Shouldn't i take 3 times as much...

Thanks

 

[Antje77]

Lol Thank You for your response. Now Im totally confused ! It must be me.

So with a U100 pen I take 108 Units
With a U300 pen i take 108 Units but I get a third of the insulin so Shouldn't i take 3 times as much...

Thanks

Ah, I'm sorry, with the U300 pen you get 1/3 of the amount of fluid than with a U100 pen for the same amount of insulin units. However, the fluid contains 3 times as much insulin so you end up with the same amount of insulin units, only less fluid. The pen is different from the U100 pen.

 

[urbanracer]

@Markj4913 ,

Have a look at the manufacturers recommendations for changing insulins.

https://www.toujeo.com/what-is-toujeo-insulin

If you still have doubts then go back to your health care provider.

 

[Antje77]

If you still have doubts then go back to your health care provider.

Good idea. Exept if I had believed my health care provider I would have taken only half my dose when starting Tresiba U200. I asked my pharmacy too when picking up my script, and the pharmacist also insisted I should only take half the units I took with Lantus. Luckily the leaflet was quite clear and to be completely sure I telephoned NovoNordisk. They explained to me, I explained to my HCP and she won't make the same mistake with the next person who switches to a stronger insulin.

 

[AFM]

Go back to your doctor and get him or her to explain the dosage to take, as your starting to confuse me as well, don't leave until you understand the dosage

 

[novorapidboi26]

Ah, I'm sorry, with the U300 pen you get 1/3 of the amount of fluid than with a U100 pen for the same amount of insulin units. However, the fluid contains 3 times as much insulin so you end up with the same amount of insulin units, only less fluid. The pen is different from the U100 pen.

Is this a new thing? Never heard of this arrangement with insulin's....

 

[Alison54321]

Is this a new thing? Never heard of this arrangement with insulin's....

Not new. I remember when I was first diagnosed they had different strength insulins. However, they were ended because it could get confusing, if I recall correctly.

 

[Alison54321]

Last time I had a hospital appointment I'd had a nasty hypo with Lantus, at night, and the doctor talked about very long acting insulin. I think Toujeo is in that category. I didn't switch, I just changed injection site, and split the Lantus.

It seems to be that the Toujeo is higher strength, but much slower release, so according to their website you should take the same dose as you had been doing with Lantus, because although it's higher strength, it releases the insulin much more slow, and is supposed to create a much steadier curve.

So it seems the nurse is right that you take the same dose as for Lantus. But my advice would be the same as other people's, go back and talk to them, and don't leave until it' quite clear what the dose should be.

Reading this. They suggest that you can start with the same dose as for Lantus. But, because it's slower acting, the first few days your blood sugar might be a bit higher, then it should settle down. Correcting with fast acting for the first couple of days, might be needed.

http://products.sanofi.ca/en/Toujeo-RMP-HCP.pdf

Don't forget to read the leaflet about the side effects, but I'm sure you'll be fine.

 

[Resurgam]

Think in units - the insulins are different strengths, but you inject the same number of units, not the same volume of the liquid.
Suppose you needed to have the equivalent of two lumps of sugar - if someone brought you a cup of tea with four lumps of sugar you would drink half the cup, if only one lump then you would need to ask for more sugar or a second identical cup - all different amounts of tea, but the same amounts of sugar.