Hi Celsus,
Haha!
Ok, diagnosed 9th Jan this year, aged 37. I’m currently on Toujeo 9 units at 9pm every day and usually 3+ units of Novorapid before each meal, depending on carb count, of which I am sticking to as strictly as possible, i.e. working out carbs for each meal. I snack on almonds and occasional rice cakes with peanut butter. Drink about 6 cups of coffee a day (which don’t appear to have any effect on my bg’s). I started a Lantus regime in hospital but changed to Toujeo after painful injections and lumps and blood from Lantus. Toujeo took about a week to settle down. This last week has been fantastic, waking at 7.0 and going to bed at 7.0 (or thereabouts).
Excellent MountainTom,
I understand then that you are a hyper insulin sensitive T1 like myself!
And I do actually then still stay on the insulin regime you just recently abandoned yourself, as I am still happy and on the NovoRapid 5+3+3 units and Lantus 11 units regime. But from Lantus and to the Toujeo model is not that big a step, though I do recognize of course its like 3 times more concentrated in terms of serum effect per unit. BUT, the biggest difference is the serum onset time difference between these two glargine insulin types!
The onset time (to max peak serum effect) is around 2 hours for the Lantus, while it is around 6 hours for the Toujeo. Which fits perfectly for your 9pm injection time and then "BAM!", your 3am hypo...
I used to be on more or less the same old style regime as you follow now and when changing to the long 24h acting kind of insulin, one was negligent to think any peak really would appear or matter at all. Its a flat curve for 24 hours, right?
Well, no not 100% accurate actually.
So I personally switched many years back to take my one daily shot of the long acting insulin at the same time as I take my morning insulin. This way you are always awake and have an active day during all the 'small peaks' that your different insulin shots may throw at you. And the onset peak of the slow acting is now just a small bump on the big one you already get from your fast acting insulin you take for your breakfast.
And I have not had one single night episode of hypo since I changed to take my long acting in the morning.
I would strongly recommend it to anyone who like you and me only need one daily shot of the long-acting insulin for Type1.
PS: I just sent you a private message as I noticed your proportionally high level of active basal rate insulin units versus your daily intake of bolus insulin units. Typically they should compare almost 1:1 !
All readers here may not be aware that the Toujeo is a concentrated glargine, that has 3 times the serum effect per unit versus the Lantus glargine. So your daily rate of inulin intake looks like this:
Fast acting: 9 units.
Long acting: 27 units.
That to me looks very surprising, all except if you eat almost no carbohydrates in your food?
And would also add to explain your night hypo issue.