I love you, I hate you Toujeo

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Toujeo is the new basal insulin from Sanofi. It’s not quite a replacement for Lantus as Sanofi will continue to sell Lantus. But, since a generic of Lantus will be coming on market later this year, it’s a new product for Sanofi that Lantus users might prefer.

My personal interest in switching from Lantus to Toujeo is it’s reported to last up to 36 hours. Lantus doesn’t make it the 24 for me. And it shows less nighttime hypoglycemia. Lantus typically drops me to 55 mg/dl around 5 AM most nights and then my blood sugar starts coming back up. Likely either my liver starts shooting sugar into my bloodstream to save me or the Dawn Effect begins, or both. But then by 6:30 or 7 AM my blood sugar is rising like a runaway train.

I’ve been using Toujeo since June 1, three weeks. From personal use I can also report the button is extremely easy to press. So if you’re a type 2 and take a lot of basal insulin, this will be much more comfortable injecting.

But I am absolutely crazed trying to figure out how much Toujeo I need along with my mealtime Humalog. When I take the same amount of Toujeo as I do Lantus, I seem to run high during the day. When I up the Toujeo by a unit, I drop overnight. And, every HCP will tell you not to change your dose for 3 days as your body has to get used to the change.

It is hair-pulling making this switch which I didn’t think would be difficult at all. I keep wondering how much longer to experiment. Granted, it’s not good to go hypo every night as I do with Lantus, but at least I knew my pattern, and I always came back up. Yes, I know, one day I might not. But now I’m having to figure out the impact of all the variables all over again: food, exercise, alcohol, weather, illness, stress, lag times.

I’m not giving up – yet. I more or less change one thing each day to see if it helps during my three day interval, and I’ve got two Toujeo pens left thanks to the largesse of my CDE friend who gave me samples.

So while improvements are always welcome, they’re not always easy.

29 thoughts on “I love you, I hate you Toujeo

  1. My 17 year old got some of these pens form the endo. I am scared for him to try them. Keep writing more on this subject. If it lasts 36 hours, do you still take it every 24 hours? We have been doing lantus in the early afternoon. Otherwise he goes low at night. Taking it in the afternoon makes the peak more at dinner, which is perfect. The endo always wants us to take it at night but that was a nightmare. Anyway, keep us posted, and thanks!

    • Ginger, so you know, Toujeo is three times more concentrated than Lantus. While you dial up the dose in the pen similarly, if you were to extract the insulin from the Toujeo pen you’d be in trouble because the measure is not the same as unit/unit.

      • Riva,
        You may have just helped me save my husband’s life. He did not understand the unit difference correctly and had been trying to use up the syringes we have before getting pen cap syringe. He just started toujeo a week ago and had been having extreme lows because he was taking the same amount that he did with Lantus (as instucted) but measuring with syringe. Wow!!! I am beyond thankful I read your post after an hour of research. Thank you! God bless

  2. Donna, while it lasts up to 36 hours you take it once a day. Any extra I was told gets peed away. You take it the same time of day each day. Don’t extract insulin from the pen with a syringe as Ginger suggests. It is a different measure of units than a syringe holds.

  3. I started toujeo 2 weeks ago on June 14th. I also switched over from the lantus. I was taking 32 units of lantus at night and now taking 32 units of toujeo. I’m still unsure how I feel about toujeo. First 10 days my sugar levels also were higher they have seemed to have gotten better though. No lows during the night like I would get every once in awhile with the lantus. But yes when was on lantus I also had it down perfect knowing exactly what my sugar levels would do when I did this or that or ate this or that. Now I also feel I’m learning all over again different patterns with the toujeo. One other thing I have been experiencing is dry lips dry mouth dry eyes. I am thinking some sort of dehydration. Started when started taking toujeo. The first week it was bad but the dryness has been better the second week but still experiencing it every day. I will also give it more time to see if my body is still getting used to toujeo. If not I guess will go back to lantus if my endo agrees.

  4. Type 1 20 years. I have been using Toujeo for almost 3 months now and I really like it. I was on lantus, and I had to take it twice a day because of coverage and using Toujeo once a day is a big help. I really couldn’t find any meaningful information when I started except for that it is just a more concentrated form of Lantus. So, i just experimented. Was taking a total of 12-13 U of lantus, now I’m taking 5 U of Toujeo. I draw up in my syringe. It took me a while to figure it out, you have to factor in the overlap (36 hr). BTW, extra insulin does not get peed away, you’ll get low just like any other insulin that you take too much of.

  5. Toujeo doesn’t work for me. Only 2nd day. 6am BS 352 took 30u Toujeo & 3u Humalog, 8:21am BS 116 ate granola bar & 3 bite canteloupe, 9:24am BS 128, 10:38am BS 135, 12:19pm BS 221, 1:19pm BS 230 took 2u Humalog ate 1/4th Sclotzsky Sand with 1c salad, 3:08pm BS 325. The cartridges are smaller by volume so u have to take more than you normally take with U100 . 3x’s stronger is questionable & it doesn’t even work 24 hrs ratherless 36. I was running sugar with only the Toujeo. For lunch, I didnt have much to eat & with Humalog I was still running sugar. Feel like Toujeo is a placebo. I also don’t like the way I feel. Its like my metabolism is being slowed down. I am tired, no energy, nausea. Feel like I am running sugar when I am 116. am going back to the Levimer. I split my dose 24u am 8u pm with 1u Humalog to 20gm of carbs with 1u to every 80 pts over 150. I do have issues with low BS. Humalog can kick my butt. But at least with the Levimer when I drop low, I can be 40 & still lucid. Toujeo is not worth it. Its all just a sales pitch. Only 3 pens in a box.

    • Just started on insulin a couple of months ago when the pills and Victoza stopped being effective. BS had gotten to the 300s and was not being controlled. Am currently up to 60 units of Toujeo and no change in my sugars. Have decided to get a gastric sleeve and that is scheduled for a month from now. In addition to dramatic weight loss and change of lifestyle eating habits, all of the people I know who have had this procedure and are diabetic are now off their insulin and pills. For me, it was the only remaining viable choice. Thanks for the info on your experience with Toujeo.

      • Just saw a few replies here and remembered my post earlier this year. Just a personal update. 64 years old. Sleeve gastrectomy on 3/22. As of this morning, have lost 96 pounds (high of 376 down to 280). Still have 80 more I want to lose and it is proceeding ahead of schedule (currently @ 12-15 pounds/month). Sugar down from 310 on 60 units of Toujeo to 100 on 10 units. Expect to be off completely in another 4-6 weeks. Off of statins completely as cholesterol now normal. Energy levels up. Eating all the foods I enjoy just no hunger pangs or binges anymore. I do realize that this surgery not for all and that diabetes is a different journey for everyone, but for me the surgery has been a Godsend and a successful vehicle to allow for a necessary lifestyle change. It scared me to death but the recovery was fine and was back at work in 2 weeks. I wish each of you the best on your journey.

  6. Hey Ive been trying really hard to figure it out im suppose to take the toujeo over night and the humalog when i sleep but im finding that my sugar goes up. Right now it almost 1am and im at 318 i took 40 unit of the toujeo when i was at 300 dropped to 280 then shot up to 318 can i take like 10 units of the humalog to bring me down since one is fast acting and one is long acting im not even sure if i can over dose on this and i have no one to ask. Thanks!

    • Max, you need to check with your doctor. Humalog is for meals, Toujeo can be taken at any time, once a day, taking it always at the same time. More than this, your doctor has to council you as we are all different in how food and medicines work in our body.

  7. Hello, I have my Toujeo sat in the fridge as I pluck up courage to get going. I’m having very similar symptoms as you describe, good at 1am catastrophic at 8am This has been happening for last year after a period of really good balance. There are plenty of bizarre variations which have finally led me to the knowledge I have to change, they’ve come up with Toujeo with Humalin (I use this already). I just wanted to know if you finally came to terms with the Toujeo because I’m struggling to find anyone who is wholeheartedly enthusiastic or even mildly pleased.

    • Yes, I’m wholeheartedly pleased. My blood sugar still drops a bit overnight but that’s nothing new, that’s my pattern. But Toujeo is in my system 24 plus hours which means whenever I wake up and take my morning dose of rapid-acting insulin, I’m still covered by the Toujeo so my blood sugar isn’t rising like a freight train. Try it, that’s the only way you’ll know.

      • Thanks Riva. I’ve been diabetic 50 years and this is the first time when there doesn’t appear to be a logical reason for blood sugars. I’m sure part of my psychological problem re this is my confidence has been shattered ( I had plenty!). I’m pleased you are having such a good reaction and for the vote of confidence. Jan

    • Jan, I just started with Toujeo (40) units & 10+ Humolog. So far my numbers are really good, well under 100. Before I was taking toujeo I was on Lantus 30 units a day. It seemed that the Lantus just stopped working for me. Hope this helped.

  8. Hmmm I find the opposite. Been type 1 25 years. Not sure how American units work but Canadian ideal is 4-6. Yet for all my life I can go from 2-30. In a day. Dr put me on toujeo It was great for three months. Now if i miss a snack which I always do. I drop soo low. I hv called 911 several times because it got too low. Once I actually thought I was dying. Worst low ever. Was having siezures and don’t remember anything. Now I am too scarred to take any long acting. I keep it hi all the time scarred it could drop. Can’t stop remembering what a scary feeling it was. I check 10 or 12 times a day.
    Don’t know what to do

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  10. I am on 80 units of toujeo at bedtime. Once a week I take Byduron shot. 1000 mg of Glucophage 2x a day. Doctor just added Apidra 3 units after dinner meal. I feel like I am on way too much medicine!! taking toujeo at bedtime, if I eat 4 to 5 carbs my sugars are around 100 in morning. I tried not eating a snack at bedtime and even 1 carb 2 carbs and my sugar will raise to around 200. I used byeta several years ago, it raised my sugar levels. I’m wondering if byeta and toujeo are closely related? I have gained about 30 pounds now in the past 6 months.

  11. I been taking toujeo for a year now and at first 60 units a day worked fine. The last batch I got does not do anything. I taken as much 80 units in the morning and 80 units at bed time and my sugar level still is at 120-130 in the morning, eating the same things I did while taking 60 units. I try to limit carbs to 60 a day but still find myself taking more novolog more often to keep sugar levels even. I did not have this problem with Lantus.

  12. I have started Toujeo 2 days ago, as a recommendation from a new endocrinologist who by talking to me said that it seemed I was not comfortable with Lantus. More recently than not, I have been waking up in the 20’s (Canada) and it is very discouraging to start your day with a high blood sugar. My first night on Toujeo I had a late dinner just before bed and I must not have given myself enough short term because I woke up 20.1. However, I can say that even though I did feel my blood sugar was high, it did not feel as though I was as annoyed, or like my blood was boiling. Has anyone else had different experiences with high blood sugars using Toujeo? Having read the above comments it seems that some are experiencing different kinds of low blood sugar, so I was just wondering if this insulin may interact differently on a cellular level when synthesising to allow your body to use the sugar you have in the blood? On the website it says that more often than not, patients using Toujeo have adjusted their dosing to be a bit more than they did with Lantus because it is so flat, has anyone else experienced this?

    Also, I am very self-conscious about my weight (5,4 – 135 lbs) and I am curious if anyone has experienced weight gain with this medicine?

    • Lillian, I can imagine it’s very discouraging waking up with a high blood sugar. I myself don’t know how it interacts on a cellular level, but all insulins can cause weight gain. Insulin is a fat storage hormone. Toujeo is known for its flatter profile overnight, causing less hypoglycemia, so perhaps you didn’t cover your late meal with enough mealtime insulin. Most people find they need 10% more Toujeo than Lantus. My personal recommendation, you can help lower your blood sugars by reducing the amount of carbohydrates you eat, particularly simple sugars and starches. These are what cause blood sugar to go up more than any other food. Take more carbs out of your diet, replace them with protein and healthy fats like nuts, olives, avocados, and your blood sugars will come down and you will need less insulin.

    • I gained 10 pounds! Before Toujeo I weighed 120 pounds. 3 months into it I weighed 130 pounds (I’m 5’3″). Diet and exercise do not get rid of the weight at all. I just started Lantus up again yesterday, and I am hoping to drop the extra weight I gained soon now that I am off of Toujeo!

      • That’s interesting Jennifer, I have never heard of that. It is true insulin can put weight on because you begin to absorb the calories you eat, but I’ve never heard of one insulin or another being more weight gaining. I wonder if your doctor has an answer for that or Sanofi, the manufacturer of Toujeo.

      • I ran as far away from that garbage as I could. More or less this Toujeo product is a SHAMEFUL attempt to reclaim profit from dropping revenues since a generic glargine lantus emerged on the market. It has terrible reviews online and from what I have seen, it is not molecularly sound.

  13. Lillian, there’s an expression, Your Diabetes May Vary. Different drugs work differently for different people. For me Toujeo is great, it gives me coverage for more than 24 hours which Lantus never did. All we can do is try different things and see what works best for our own body.

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