Humulin N Vs toujeo - confused at told to change

[grantg]

DSN called to say to swap me from toujeo to humulin n. The reason stated is it only lasts max 16 hours Vs toujeo max 72 hours.

They are wanting me to change as they think it might help with lows from exercising.

No change of dosage still to take first thing in morning...

How exactly would shortening the time time the dose is administered help with lows after exercise surely it would hasten any possible lows as releases in a quicker timespan?

Very confused at what appears to me be lack of logic.

Other part which I'm puzzled is have to mix it prior as comes cloudy?

Doesn't make sense to me

 

[grantg]

Forgot to attach graph

 

[EllieM]

That seems a little strange to me too. If it only lasts 16 hours are you supposed to take it twice a day? (Or maybe you are still producing some of your own insulin so you don't need 24 hour coverage???)

I can see an argument that a shorter acting insulin will allow for more variation in dosage amount, so dosage changes will act more quickly?

Also, as far as I can make out, toujeo is a stronger insulin than humulin N,, 300 units per ml rather then 100 units per ml. Has your team decided that you need less insulin? (Which would make sense if you are getting lots of hypos.)

Toujeo insulin dosage: Forms, strengths, how to use, and more

Toujeo is a prescription drug used to help manage blood sugar in type 1 and type 2 diabetes. Learn about the drug’s dosages, forms, strengths, and more.

www.medicalnewstoday.com

Humulin N dosage: Forms, strength, how to use, and more

Humulin N is used to help manage diabetes. Find out about recommended dosages, how to use the drug, and more.

www.medicalnewstoday.com

Other part which I'm puzzled is have to mix it prior as comes cloudy?

As I remember (possibly incorrectly) from my days of cloudy insulins, you just shake before injecting. Are you using a pen or a syringe?

As for the graph, is that hypo happening in the evening?

Are you taking short acting insulin as well?

Could you email your DN with your queries?

(Sorry for all the questions.)

 

[grantg]

No short acting insulin at all now. Was after diagnosed taking 5 units novarapid with all meals, after I whined about lows after around a month changed to carb counting 1to10 ratio tried that I think for 6 weeks complained about lows so was told 1to20 ratio for then told to stop couple weeks ago. Long acting was originally 18 units which has steadily been reduced now at 7 units.

To take it once a day. Body is apparently still producing some insulin 'honeymoon phase'. So comment I'd agree perhaps I don't need 24 hours coverage. Can see logic of dose changes will be quicker to take effect. I'll look at the 2 links you've kindly posted when I'm awake for the day. Nearly 2am here woken up with alarm going off low.

Having to treat hypos for hours after any exercise +30 mins.

 

[grantg]

Well I've been given some answers to why the dsn wanted to change the insulin type that's thanks to the drs surgery pharmacist she called me earlier today to let know change in my prescription I let her know my concerns so she spoke with DSN on my behalf. They wish to see if pancreas is able to produce enough insulin by itself and would be able to tell fairly quickly by overnight levels.

They agreed it would most likely lower sugars even more throughout the day, however as awake during daytime would've been more able to tend to lows from doing so.

Bottom line is no change unless I'm comfortable with it with exception very slowly every 3 days to try a unit less until such time either 1) I take zero insulin at all or 2) sugars start to continue to rise through the night

c-peptide a1c etc tests 9th Jul if they can manage to get bloods done. They are concerned libre showing 33 for a1c

Honeymoon period I've to expect maybe back on insulin at some point in the future