From the Research
When switching from 65 units daily of Tresiba (insulin degludec) to Toujeo (insulin glargine), the recommended approach is to initiate Toujeo at the same dose of 65 units once daily, as supported by the most recent and highest quality study 1. This unit-to-unit conversion is generally appropriate because both medications are long-acting basal insulins with similar pharmacological profiles, though they are not identical.
- Key considerations for this transition include:
- Monitoring blood glucose closely for 3-7 days after starting Toujeo, as dose adjustments may be necessary.
- Some patients might require a slightly higher dose of Toujeo to achieve the same glycemic control as with Tresiba due to differences in pharmacokinetics and potency, as noted in studies comparing insulin glargine 300 U/mL (Toujeo) with other basal insulins 2, 1.
- Titrating the Toujeo dose by 2-4 units every 3-4 days based on fasting blood glucose readings until target levels are achieved.
- Maintaining consistent timing of administration each day, though Toujeo offers some flexibility in timing.
- Informing patients that the full steady-state effect of Toujeo may take 3-4 days to develop, so initial glycemic control might fluctuate during the transition period.
- Carefully monitoring hypoglycemia risk during this adjustment phase, given the differences in hypoglycemia risk profiles between Toujeo and Tresiba, as highlighted in comparative studies 1, 3. The most recent study 1 provides a comprehensive comparison of the clinical efficacy and safety of insulin glargine 300 U/mL (Toujeo) versus insulin glargine 100 U/mL, supporting the use of Toujeo as a viable option for patients with type 1 or type 2 diabetes, with considerations for its pharmacokinetic profile and potential for reduced hypoglycemia risk.