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oblivious

Just started on Toujeo, experience?

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oblivious

Just got my diax from beeing type 2 for five years to now beeing type 1.5 (LADA).

So my endo got me straight on insulin right away.

This is the slow kind, wich is effective for 36 - 48 hours.

 

This is the first time I am trying insulin, has anyone else tried this kind before?
It was the new kid on the block according to my nurse.

 

I saw on our medicine catalog online that you have to keep the pen at room temperature for 1 hour before using it.

Is that very important for the insulin to be effective?
I just took it out of the fridge this morning and set 6 units (my starting dose) without letting it warm up.

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NoraWI

Toujeo is nothing more than Lantus in a 3x concentration. Lantus has come out of patent and its manufacturer has created a condensed form with a new name (and new patent) to target the large T2 population that far exceeds T1s. They are actively marketing this "new" product to this larger market. Anyone who uses Lantus can tell you how to deal with it... whether to refrigerate or not. Before pumping Novolog, I used Lantus from a vial which I stored in the fridge between uses. Don't know whether that was necessary or not. What do the instructions on the accompanying paperwork say?

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oblivious

 What do the instructions on the accompanying paperwork say?

 

It says store unopened pens in the fridge and opened pen in room temperature.

Leave the pen in room temperature for one hour before use.

 

Seems like it is working, but it is very slow, so I suspect I will have to up my dosage from 6 units to 10 units.

Just have to see how it progresses during the day.

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oblivious

Toujeo is 3 times more concentrated and used with insulin resistant type .2's. I would think you would have to use less, not more.

 

Well, the starting dose is suposed to be 0.2 units per 2.2 lbs bodyweight.

For me that equals to 14+ units.

My nurse usually starts people off at 12, but she wanted me to ease in to it and start at 6.

 

Since insulin resistance is not my primary problem, but the lack of insulin is, I would have to increase, not reduce.

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jwags

Most Type 1's actually use less insulin than insulin resistant type 2's. Toujeo was designed for Type 2's who use a ton of insulin, not Type 1's. I don't understand the rationale for using more.. It super concentrated so 1 unit of Toujeo is equal to 3 units of Lantus.

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oblivious

The nurses recomendations and the starting dose that is defined in the manual is not based on how much Lantus (or other insulins) one uses.

It is based on how Toujeo works.

 

My instructions are to start with 6 units every morning and increase with two units every third day until FBG is under 7mmol/l.

 

I am not sure if insulin resistance will build up for type 2`s, but when you don`t have enough insulin production you have to find the maintenance level the dosage should be at. So I started at under half of what is recomended as a starting dose, and ramp up 2 units every third day until FBG is satisfactory.

 

Had I been type 2 maybe it would be diferent, but since I am type 1.5 this is the procedure.

 

And even though it is marketed for type 2`s, it is just like you said just a more potent version of lantus.

So it works fine for type 1 and 1.5 aswell as type 2`s. The dosing will probably differ based on individual needs.

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ronmesnard

As I read it oblivious is on half the normal starting dose for type 2s because he is probably not insulin resistant.  Congratulations oblivious that you are now properly DXed so you can get proper treatment. Insulin resistance is mostly genetic with some environmental factors thrown in that are needed to trigger it or 'get the ball rolling'.  One factor that we are sure of is higher BG.  You are long past the triggering stage.  If you don't have any now you probably will not see any later.  Yes, I believe insulin resistance may get worse for those that have it but I don't have enough information to feel confident either way.

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NoraWI

Seems like it is working, but it is very slow, so I suspect I will have to up my dosage from 6 units to 10 units.

Just have to see how it progresses during the day.

Toujeo is a basal insulin. It is meant to work very slowly and in the background. If you want faster working insulin then you should ask your doctor for a bolus insulin such as Novolog, Humalog or Apidra in addition to the Toujeo.

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oblivious

Toujeo is a basal insulin. It is meant to work very slowly and in the background. If you want faster working insulin then you should ask your doctor for a bolus insulin such as Novolog, Humalog or Apidra in addition to the Toujeo.

 

I don`t want that, at least not yet.

My endo gave me a prescription for the fast acting aswell, but we all agreed on me trying out the slow acting first to see how that pans out.

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jwags

What was your c-peptide? If it is still in the normal range you may be able to get away without fast acting for awhile. but eventually you will need both tyoes of insulin.

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oblivious

What was your c-peptide? If it is still in the normal range you may be able to get away without fast acting for awhile. but eventually you will need both tyoes of insulin.

 

Yeah I suspect that aswell. C-pep was at 260 and 310 at my last two bloodworks, with 300 beeing the bottom at the normal range.

Now I had high FBG at the time of the test, so it should have been a lot higher.

But at least I still have a little bit of production left, so a small amount of added insulin might do the trick for now.

 

The second day today with toujeo and I am still above 8 FBG, but now I have upped my carbs a bit as well and it does take three days for it to become steady state.

So I am thinking a small increase might just do the trick.

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Kenton

I just switched over Thursday night after I gave the 5 remaining Lantus pens to someone with a diabetic dog.

I was using 25 units of Lantus but I was splitting the dose with 15 units at night and 10 in the morning with my final pens of it.

Since I was told I may need less as I was splitting the dose or more according to the leaflet that came with it decided to be conservative and start with 20 units at night.

I'm waking up to 145+ mg/dl readings in the am and a 8 hour testing fast today resulted in  readings climbing to 196 so I'm going to add 3 units back tonight.

Usually I wake up to readings around 100 and a fast with little physical activity would result in readings that changed at most 20 mg/dl.

I'm on both Toujeo and Novolog so I added 2 units to my calculation for the supper bolus.

Which has me now at 129 mg/dl 3 hours later, not perfect but with time I should adapt to it.

If I do not hopefully I can switch back to Lantus as I had good control with the split dosage method.

Toujeo is a basal insulin and should have minimal effect on meals.

Since you are producing some insulin you may get by with it keeping your basal under control and using whatever your body can produce to control meals times.

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Kenton

The warming up by the way is for 2 reasons or so I was told.

One you may draw air into the pen when you screw on the needle if the pen is cold and Two cold insulin can sting when injected.

In the beginning I put mine back in the refrigerator because I was concerned I would not use it all in 28 days.

I never noticed the air bubbles getting bigger but I did notice it stung at times.

After I figured out that I was getting  less than 2 weeks out of a pen I started leaving them out.

The only time I keep them cool now is when traveling or during the summer here as it gets hot.

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