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Tresiba or Toujeo?

Discussion in 'Ask A Question' started by alisonhe, Apr 11, 2017.

  1. alisonhe

    alisonhe Type 1 · Active Member

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    Hi all,
    I have always been using NPH (Humulin I) overnight and shots of regular Humulin for each meal. I recently broke my radius by falling downstairs in the middle of the night - my blood was a little low, so I have been off work which has given me time to look into things. So, I am now for the first time ever in 31 years, questioning whether I should change my insulin. My NPH is unpredictable and I have never questioned that before, just accepted it. I think I would benefit from having a basal dose during the day as this mimics the way the body works naturally and I have been advised that Tresiba is a new long lasting and dependable insulin. Others it didn't work with have said that Toujeo is very good. I experience the dawn phenomenon so I think having a daytime basal dose would help as currently I have to test multiple times and make changes around my workouts.
    Has anyone tried these 2 insulins and can you share your experiences?
    I am seeing a diabetic nurse this evening.

    Many thanks, Ali
     
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  2. tim2000s

    tim2000s Type 1 · Expert
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    Hi @alisonhe - it sounds as though you are contemplating MDI with modern insulins as opposed to the original MDI (which I too was on in the nineties). I suspect that you'll find both Toujeo and Tresiba vastly different. I've tagged @robert72 as a long term Tresiba user. I'm afraid I don't know any Toujeo ones.

    Your fast acting insulin which is needed alongside this will be any of Novorapid, Humalog, Apidra or (and I'd recommend this over all of the others) Fiasp (which is considerably faster acting and can truly be taken just before meals).

    It will take a bit of time to become acclimatised to the change in action of the various insulins, however, the regime is remarkably similar to what you're used to in that you take one or two basal doses daily and then shots with each meal.
     
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  3. TorqPenderloin

    TorqPenderloin Type 1 · Well-Known Member

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    Until someone can prove otherwise, I'm convinced that Toujeo is just a more concentrated form of Lantus.
    The USA patent for Lantus expired a couple years back which opened the drug up to competitors. Lantus is/was one of Sanofi's most profitable drugs so they had to do something in order to maintain the revenue they had been generating. The result was Toujeo which is on TV commercials all the time here in the states. It's for similar reasons why you're probably not hearing much about Toujeo in the UK as the NHS operates completely different from the health insurance market in the USA.

    Tresiba from Novo Nordisk is vastly superior to other basal insulins on the market, or at least that's the general consensus. I personally switched from Levemir at the end of last year and the absorption rate is phenomenal. If you search around on this site and others you'll find that there is a huge following of Tresiba advocates with only a handful of people who were not satisfied.

    In general, I hear more people praise the effectiveness of Tresiba more than any other insulin type.
     
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  4. robert72

    robert72 Type 1 · Well-Known Member

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    Hi @alisonhe

    I have been using Tresiba for almost 3 years now and find it very predictable - especially compared to NPH and even Lantus. Would thoroughly recommend it. I haven't tried Toujeo so can't comment about that.
     
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  5. EllsKBells

    EllsKBells Type 1 · Well-Known Member

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    Hi @alisonhe , I would also agree with @robert72 about tresiba, I have been using it for about four months now and the difference is phenomenal. It really is so much more predictable. It seems to have a very slight peak about 11 hours after injecting, and other than that it is a beautifully smooth profile.

    I think @DaftThoughts uses Toujeo?
     
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  6. DaftThoughts

    DaftThoughts LADA · Well-Known Member

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    I do. :) Been on it since July 2016 and once I found my right dose, I am experiencing extremely stable background levels. I also experience dawn phenomenon but the Toujeo works so well for me at night that I am at an alright value in the morning to get a good headstart on it with Novorapid. I can fast for 6+ hours during the day and remain extremely stable around the same value before I slowly start dipping. Without active rapid acting insulin on board, exercise only barely dents my levels too. All in all I have no reason to consider switching, it works how I need it to.

    I disagree, Toujeo lasts 36 hours, whereas Lantus only maxes out somewhere between 18 to 26. The way Toujeo crystalizes in the fat cells is different from Lantus leading to a different rate of insulin release in the body. It's why most on Lantus need to be on split dosages, but on Toujeo that is absolutely not necessary. Most people who go on to use Toujeo also experience less night time hypos and better overall control due to the release rate. It's not for everyone, but no one insulin is the miracle medicine for all diabetics, so it's bound not to work for some folks. The general consensus among Toujeo users is that is it an actual improvement over Lantus for them. My DSN has switched many struggling patients over from Lantus to Toujeo and noticed a dramatic approval in their values when they changed little else, it's the only reason she put me on it right away rather than starting with Lantus.

    I hear the same about Toujeo. We have to be careful when it comes to anecdotal evidence because we are more likely to find biased sources to confirm our own experiences than we are to truly find objective evidence for these claims. I have only heard good things about Toujeo and it works perfectly for me, the only complaint I find from basically anyone who complains is "Lantus' patent expired so Toujeo must be a money making repackaging scam". I don't consider that a valid concern to judge the effectiveness of a drug on, especially when so many people who struggle on Lantus stop having issues once they switch. If it was really just Lantus repackaged they would still have the same issues, wouldn't they?

    I'd also like to be careful about claiming one insulin type superior over another, by the way. Just because many people experience improvement with Toujeo and Tresiba doesn't mean Lantus and Levemir don't suit anyone or are less capable of working out perfectly. Like I said, there is no one miracle insulin for all. Let's focus on what works for individuals and offer advice based on their needs rather than hailing one type of insulin as 'the best'.
     
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  7. ickihun

    ickihun Type 2 · Master

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    Can I piggyback on your post Ali? I'm very interested in Toujeo300 especially. I won't hog your thread thou. (Silient, well nearly silent)
     
  8. ickihun

    ickihun Type 2 · Master

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    Ive been told nhs Sunderland want toujeo as uniform for type2s on insulin. Less injections so keeping cost down for type2s.
    Is it triple the strength of lantus or just double? Im taking a mixed insulin so a 70% intermediate and 30% short acting.I think even nurse is hesitant over the dilemma of how to start me off.. Its making me nervous!
     
  9. lukkymik

    lukkymik Type 2 · Well-Known Member

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    Hi... I'm currently on Lantus solostar as a bolus @ 9am/9pm and Apidra with meals we split the Lantus into 2 doses as I was running nasty lows early mornings and it's been fine for a while but I'm starting to see my BG readings creeping up again yet I've not changed my eating regime??? Having read about the numbers of people struggling with Lantus has anyone out there got experience of another Bolus that can be split am/pm as I work weird shift patterns on the railway!!!
     
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  10. ickihun

    ickihun Type 2 · Master

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    I haven't but these 2 insulins are longer lasting. Could they not be better for you too?
     
  11. DaftThoughts

    DaftThoughts LADA · Well-Known Member

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    Do you meal basal? Bolus is rapid-acting insulin for meals, basal is long-acting background insulin (that's what Lantus is :) )

    You might need to change your basal rate, it happens sometimes that your dosage changes over time. I highly recommend trying this: https://mysugr.com/basal-rate-testing/

    See what results you get with this, then talk to your healthcare team about bumping up your dosage if needed.

    Not sure I'd say it's triple the strength or anything, if you were taking 12 units of Lantus you'd take 12 units of Toujeo. The Toujeo pen has 450 units instead of 300 units like Lantus, so the Toujeo arguably lasts longer. It's just that the volume of the insulin is different, hence the increased units, and instead of 18-24 hours it lasts 36, so you don't have to split the dosage.

    Mixed insulin is useful if you you eat a specific amount of carbs at fixed times, but it's not very handy when you're on weird schedules or can't eat at the same time every day. Having separate injections for basal and bolus allows more flexibility, so it's something you'll have to figure out for yourself. It doesn't hurt to get started on the mixed insulin and see if that works for you.

    As far as I know, the type of diabetes you have doesn't define the type of insulin you need when you become insulin dependent. Lots of T1s and T2s for example share the same kind of insulin. It's just a matter of figuring out what works for your body and situation.
     
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  12. TorqPenderloin

    TorqPenderloin Type 1 · Well-Known Member

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    It is literally the same molecule (insulin glargine) just at a higher concentration. I'm not making that up. I pulled it straight from their website.

    https://www.lantus.com/hcp/insulin-treatment-options

    The test study results were nearly identical, the molecule is the same, positive anecdotal evidence is weak at best, and their patent conveniently expired around the same time Toujeo was introduced.

    If you read any of my posts, you'll see that I make a habit of not making empty statements and do my best to support every claim I make.

    It's not a fact, I never said it was....it's a well-supported opinion.

    As far as Tresiba being the "best" insulin. If I said that then that was a mistake. What I believe I said was that it is a "superior" insulin which is different. Either way, that's strictly an opinion as it's not quantifiable.

    I had a 5.4% a1c on Levemir and I have a 5.4% a1c on Tresiba so I'm the first one to admit that other insulins work just fine.

    It's generally understood that none of us are healthcare professionals, myself included. Consequently, my opinions are only intended as a fellow diabetic.

    Note: I'm in the USA which allows me to have a certain level of choice when it comes to my insulin therapy. A lot of this comes from doing my own research before deciding what is best for me (which isn't necessarily best for everyone else).
     
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  13. ickihun

    ickihun Type 2 · Master

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    I was quite happy to use tresiba200 but nhs sunderland decided no. Toujeo300 it is to be. Its been a farce and I'm still not changed over! I'm not impressed with the timing. Just before a coronary angiogram to be done. I hope to god it isn't a sign that I have to say in hospital. Hence a basal to work from if I have to go nil by mouth. Gulp!
     
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