Lantus vs Toujeo

chuckie8059 said:

I have been taking metformin and glimepiride for quite some time now but my sugar has been 180+ so my M.D, sent me to a Diabetes Dr. who placed me on a Lantus SoloStar insulin Pen and started me out at 20 units but am now up to 24 units and is finally looking like I got it under control, I have no prescription plan until May 1st and can not afford to pay $400.00 for a box of 5 so I went back to the Dr. office to explain so the receptionist gave me 2 TOUJEO insulin pens that will help me until my medicare Part D starts . Is there any reason why I should not use Toujeo after starting Lantus ? Feedback would be appreciated thanks !

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GrantGam said:

Hello and welcome to the forum

As far as I'm aware, Lantus and Toujeo are both insulin glargine but differ substantially in terms of their concentration. Lantus is 100u/ml where Toujeo is 300u/ml. The rationale behind Toujeo is to allow insulin resistant type 2's to inject smaller quantities of insulin than they would with Lantus. Given the differences in concentration, I would NOT be starting to use the Toujeo without seeking the advice of your Doctor. I'm sure the receptionist was just trying to help, but what she has done is actually pretty dangerous.

If you were to take the same dose of Toujeo as you would Lantus then you will be injecting a greater concentration of insulin and run the risk of severe hypoglycemia which can lead to death...

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robert72 said:

I'm pretty sure that Toujeo comes in pens that are calibrated to give the same dose, to avoid risk of overdosing. Same with Tresiba 200u strength, for example, you can't get that in a vial that would fit a novopen - only in flexpens.

Nevertheless, changing basal insulins always needs careful attention and advice from one's HCP.

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GrantGam said:

Thanks for setting me right @robert72. I always thought that the concentrated form of glargine was to reduce the number of units injected. In my mind, it would great taking 1/3rd of your prior dose if you were insulin resistant and injecting large doses of 80-100u at a time for example.

Thanks again

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robert72 said:

NP. Just found this that shows the pen is calibrated to deliver the same dose of insulin units of Lantus, but obviously in one third of the volume (look on the graphic).

https://www.toujeo.com/toujeo-solostar-pen

We used to have to do a lot of maths in the old days with U20, U40, U80 insulin when we only had glass/metal syringes and that was risky

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