Switching from Levemir to Toujeo - having a nightmare!

[Michele01]

I've been T1 for 3 years now and have been on Levemir (22 units x twice daily) and Novorapid 3 times a day after meals (around 14-18 units depending on what's eaten). My HBA1c is between 55 and 65 (so typically an average of around 8).

My consultant changed me to Toujeo 3 weeks ago and advised taking 32 units at night. For the first few days I had massive hypos during the night and I learned I had to run high to avoid them. From everything I've read, Toujeo isn't supposed to spike but that's not my experience. HOWEVER during the day I am having to almost double my Novorapid to get any type of control (from 14-18 to 24 plus).

I've just spoken to my DN and she suggested switching Toujeo to first thing in the morning and increasing the dose from 32 to 36 but honestly, I'm so unhappy with this insulin. I don't know whether to give it a go or just give up and go back to my trusty Levemir. I understand it can take a while to adjust your dose to get control but I'm worried that this does seem to spike with me even though it's not supposed to.

Also (and this could be totally unconnected), the last 3 nights I've been coughing in my sleep. It could be totally unconnected but when I'm mildly allergic to something, this can happen.

What would you do/advise please? I'm beyond upset at the moment and can't decide what to do for the best. I don't want to give up but I also don't want to carry on especially as I'm going on holiday in 2.5 weeks.

 

[Cumberland]

I’m sorry that you’re switch to Toujeo appears not to be agreeing with you

I would consider talking to your diabetic team about your concerns

If you were ok on Levemir then why switch you

In my case I have been on
Insulatard, Levemir, Lantus and Humulin I

None of them brought my stupidly high levels down

Consultant put me on Toujeo 2 and a half years ago and in the early days and weeks I started getting hypos which rarely happened before

I stuck with it and although I sometimes get shocking highs from time to time I think Toujeo has controlled me better than any other basal

Were all different and as you know what works for one doesn’t mean it will work for another

Good luck and best wishes to you

 

[Michele01]

Thank you @Cumberland. I think if I wasn't going on holiday so soon, I'd bear with it but it's really stressing me out and I don't want to keep fighting such high levels.

 

[Cumberland]

Thank you @Cumberland. I think if I wasn't going on holiday so soon, I'd bear with it but it's really stressing me out and I don't want to keep fighting such high levels.

Can I ask how high your reaching?

Isn’t having diabetes an absolute nightmare?

 

[Michele01]

Can I ask how high your reaching?

Isn’t having diabetes an absolute nightmare?

@Cumberland with Levemir I never had to take more than 18 units of novorapid at any meal (and that would have been a carb heavy meal). For the same meal now with Toujeo I have to take 26-28 units and even then after the two hours it steadily rises so my blood levels are in double figures 14-20. It’s horrible.

 

[mentat]

I keep hearing the same story. Lantus and Toujeo (the "better Lantus") suck. Levemir and Tresiba (the "better Levemir") are decent.

That said—yes, a new basal can completely change what sorts of short-acting doses you need and that in itself isn't cause for alarm. But even once you work out your short-acting, some basals do legitimately make control harder than others.

In any case, why fix it if it ain't broke? Were you trying to get better results or was it just pushed on you as a "more modern" insulin? (Which Pharma are pushing onto medical professionals.)

 

[Cobia]

Funny thing with me is both my DE and endo suggested i try Toujeo. Couple years ago i didnt react too well to lantus when we came out of winter. Levimir was more stable.

I declined it on the grounds its basicly lantus revved up.

 

[Michele01]

I keep hearing the same story. Lantus and Toujeo (the "better Lantus") suck. Levemir and Tresiba (the "better Levemir") are decent.

That said—yes, a new basal can completely change what sorts of short-acting doses you need and that in itself isn't cause for alarm. But even once you work out your short-acting, some basals do legitimately make control harder than others.

In any case, why fix it if it ain't broke? Were you trying to get better results or was it just pushed on you as a "more modern" insulin? (Which Pharma are pushing onto medical professionals.)

@mentat it wasn't pushed on me but I had mentioned that I was fed up of injecting 5 times a day and so it was suggested that using Toujeo would cut that back to 4. Actually it was a very smooth injection and much easier than Levemir BUT just not for me. I've now reverted back to Levemir and my levels now are almost back to normal! I'm sure I could have persevered by taking more Toujeo and perhaps using it in the morning instead of evenings but I'd got to the stage where it was upsetting me so much that I just wanted to go back to "normal". I'm seeing my consultant on Thursday so it'll be interesting to see what he has to say.