Switching to Tresiba From Toujeo

I’m making the switch this week. I have 200u/ml degludec.

Has anyone made this switch or have any sage advice?

I switched from Lantus, just took Lantus one day and tresiba the next, same dose, no big deal… worked fine. A lot of people seem to want to overthink this one… give it a few days of the same dosage to stabilize before you make any adjustments

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@Sam That’s what I did going from Lantus to Toujeo, but they are basically the same insulin just different concentrations. Just wasn’t sure going to a different insulin. Thanks Sam!

I’d just go strait across then keep a closer eye on it for the first few days and be prepared to correct if necessary… I bet you’ll like it, be sure to fill us in on how the transition goes

So two weeks in Tresiba. Started at the same dose I used for Toujeo–50 units/day. So far it’s been a disaster, average Bg around 145 with no change in diet.

Titrated to 60u/day, starting today. We’ll see what happens. So far I’m totally underwhelmed with Tresiba.

You aren’t going from 50 straight to 60, are you? Like you have gradually been increasing it from 50 to 60 for two weeks?

Can you mention your adjustment details? Like how many units you increase at a time, and how many days you wait between an adjustment? That would be of interest.

@Eric Yes, going straight from 50 to 60. I have a feeling it will end up somewhere in between, but when I titrate I just don’t have the patience to sneak up on it.

For Tresiba I’m giving the change two weeks before another titration.

Don’t give up on it… it is not surprising that a few dose adjustments will be necessary to get it dialed in

@Sam No, I won’t give up. Not because I like Tresiba so much, more because of how much I disliked Toujeo.

Why not make smaller changes for less time (5 days)? Doesn’t seem like it would take 2 weeks for the dose to stabilize (I’d argue it’s really only 3 days, and I do 2-3 myself, but 5 seems safe I guess), and you’d get more precision in the same amount of time…

I’m significantly different on weekends, so I like to have at least two weekend periods in the mix just to minimize other variables.

I think 60u may be a tad bit too much because I had the first nighttime low in over a week last night. If it happens again this weekend and on one more weekday, then I’ll scale back 5u.

How will that work with Tresiba? Will you lower your dose on Friday and ramp back up on Monday?

Wouldn’t advise it… the whole point of tresiba is to get off the roller coaster

No, when I find the most advantageous dosage of Tresiba, I’ll adjust my C/I accordingly. I eat completely differently on the weekends, and one of my goals with Tresiba is to stop having to eat based on my basal.

Sorry Doc! I don’t understand this.

When you were on Toujeo, you could simply adjust your weekend dosage. You could have more or less as needed. It seems that not being able to adjust on certain days will make feeding your basal even more of a necessity.

On some days your basal will be too high, and you will have to eat for that. On some days your basal will be too low, and you will have spikes.

Sorry, I am missing something.

Was the problem with Toujeo some odd-ball duration length that made it hard to balance? For example, an 18 hour duration sucks because it’s too short for one shot per day, and too long for 2 shots per day, so you are stuck in the middle without a full day of coverage. Is that the reason for the move to Tresiba?

I might be missing something. I see you said you “eat” differently on weekends, but what was confusing to me is that I thought somewhere at some point you had mentioned that your basal needs were different on weekends also, because you did stuff outside in your yard and so-forth. Eating different on weekends wouldn’t matter for a basal as much as activity differences. Maybe I just misunderstood.

Hey @docslotnick,

Now that it has been a few months, what are your feelings about Tresiba vs. Toujeo?


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@EricH Tresiba seems very much different than Toujeo and Lantus, for the better.

First, it is the only one of the three that I have actually experienced a fairly level full 24 hour cycle. Unlike Lantus and Toujeo there seems to be no peaks and it doesn’t peter out after 14-18 hours. I’m currently taking one injection per day, something I was not able to achieve with the other two

Second, I don’t know if this is the insulin or my LCHF diet, but it seems I need less units of Tresiba than either Lantus or Toujeo.

I’m still titrating my optimal dose (I tend to do this very slowly), but I’m getting very close now. Started at 56u, down to 44u currently, and it seems to be working well.

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I’ve been on Tresiba since it came out. In fact, I ditched my pump because of it.

It is a TREMENDOUS basal. I take one shot in the morning and there are no peaks with it. My fasting BS is outstanding on it. Plus, there is a lot of flexibility in dose timing.

@docslotnick I’m at 44u as well.

Started tresiba in march, was using toujeo before that. Its worked wonders for me, Levels looking real good :blush:


My doc just switched me to Tresiba because the insurance co would no longer pay for Toujeo. My question is why would she start me at 20 units? I was on 70 units of Toujeo.

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