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Changing From Lantus To Toujeo

Discussion in 'Type 1 Diabetes' started by Bassiette, Sep 18, 2018.

  1. Bassiette

    Bassiette Type 1 · Well-Known Member

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    Hello i have increase in fasting blood glucose levels my hba1c is 6.0 my dr said to me i can use toujeo but i found it's different from lantus it has 450 u at 1.5 ml while lantus 100 u /1ml should i reduce the dose as my doctor said i should use the same dose ??
    And if. Anyone know another substitute for novorapid as im in Egypt and can't find it here ??
     
  2. EllieM

    EllieM Type 1 · Well-Known Member

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    Were you on a very high dose of lantus? My understanding is that toujeo is 3 times the strength of U100 insulin so I'd naively assume you'd take one third the volume.... Is the dr a diabetic specialist or a GP?
     
  3. EllieM

    EllieM Type 1 · Well-Known Member

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    That's a very good hbA1C for a T1.
     
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  4. evilclive

    evilclive Type 1 · Well-Known Member

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    Toujeo comes in pens calibrated to give the correct dose. So you should take the same dose in units - ie if you took 10 units of Lantus, take 10 units of Toujeo by dialling the pen to 10. Ignore the difference in volume (*).

    (this assumes you previously worked in units rather than ml - anybody using a pen will be doing that)

    (* yes, the toujeo pen will dispense 1/3 the volume for the same number of units. But you don't need to think about that at all.)
     
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  5. Cumberland

    Cumberland Type 1 · Master

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    Toujeo has to a certain extent worked for me whereas Lantus, Levemir and Humulin did not

    I wish you well with your switch
     
  6. alphabeta

    alphabeta Type 1 · Well-Known Member

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    Actually you might need more Toujeo than Lantus, that's what is written on the leaflet. Instead of NovoRapid, there is Novolog, Humalog, Fiasp, Apidra... they differ slightly but they are all mealtime insulins and all belong to the same family. I use Humalog personally.
     
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  7. Bassiette

    Bassiette Type 1 · Well-Known Member

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    I have been used it for 5 days in 1st day was perfect but at the rest my BG was above 200 mg/dl i took meal just before sleep with Novorapid for sure is the used penfill maybe corrupt or what ??
     
  8. Juicyj

    Juicyj Type 1 · Moderator
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    Toujeo is a much stronger concentration than Lantus so do not take the advice given in taking equal amounts, this is dangerous, follow your consultants advice please before changing your dose.
     
  9. evilclive

    evilclive Type 1 · Well-Known Member

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    Toujeo only comes in pens calibrated in units, so it's quite hard to dial up the wrong dose.

    Yes, if you're injecting with a syringe, or if you dismantle the pen and put the cartridge in a pen not designed for it, you need to take a lot of care, but with the original pen, equal amounts in units really is equal dose.

    I think the idea that "this is dangerous" is quite wrong.
     
  10. Juicyj

    Juicyj Type 1 · Moderator
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    It’s not wise to be giving another member advice about changing their dose, firstly it’s against forum rules as we don’t allow members to advise this and secondly it’s a different concentration regardless of its pen format, around a third stronger than Lantus so your advice is incorrect.
     
  11. evilclive

    evilclive Type 1 · Well-Known Member

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    I've not been suggesting changing the dose - the dose has been suggested by the doctor : "my doctor said i should use the same dose". We're just discussing what you need to do to achieve that - and the answer is to do what the doctor and the toujeo leaflet says, and ignore the concentration, just think about the number of units.

    That dose will be in U, not ml, as all insulin dosed in pens is these days.

    Re "about a third stronger" - actually, no, it's 3x the strength, 300u/ml vs conventional 100u/ml. But if you try and think about that, that's where things go wrong. The pen takes care of the different strength for you, and if you try and think about the volumes, life can get confusing and dangerous.

    So no, my advice is not incorrect. I do know what I'm talking about - I've got the pens in the fridge, I've been through this, and I also don't have any trouble with the concepts involved. To repeat it : Stick with the U numbers, don't think about the concentration, use the pen it comes in rather than anything else, and it'll be fine then.

    Now as for tweaking the dose a little higher as per the leaflet to cope with the higher BGs - I've not engaged in that discussion. Personally I had to take a little more Toujeo than Lantus (as in 1 or 2 U in 17 or so) - and I worked that out myself, because I don't see the doctors frequently enough to change things as fast as they need to. But that's got nothing to do with the concentration and dosing, it's about the slightly different effect it has on the body.
     
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  12. Jaylee

    Jaylee Type 1 · Moderator
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    Hi @Bassiette ,

    Been trying to get my head round your conundrum.. New basal insulin? (& 5 or 6 days of use.) not always an easy adjustment..
    OK. Basal test. Find out what's happening starting with what the doc advised. Here's a link. https://mysugr.com/basal-rate-testing/

    @evilclive , Yep the pen will indeed be calibrated. You will have to bear with me. :)
    I just can't understand if the A1c was respectable for the OP, why the change of basal?

    Bassiette, maybe you.could give a little more detail? How much Lantus were you initially on to achieve your A1c?
    (Let's put aside what you maybe bolusing for...)
    From your profile it also suggests you take "Novomix." You may need to revise this too.
     
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