Horrible increases between hours

@"Tyler"

toujeo is an insulin that lasts 24 hours and its effect is basal, almost flat (not flat flat, that is pure theory).Therefore, the time you are injected by the same, you will have the same amount approximate of blood basal during the 24 hours after the injection, regardless of whether it is in the morning that at night.With lantus if the schedule of putting it is very important because it is nothing flat (it makes a kind of action plateau quite important a few hours after the injection) and hardly hard the 24h. Therefore, toujeo as threeiba they cover well 24h, regardless of injection time.

Not to put on the lantus one night and wait the next morning not!You can't be one night without slow insulin.If I were going to do it, I would put the Toujeo first in the afternoon, then I would advance at noon, then mid -morning and until arriving in the morning ...

The change will tell you the endocrine as.I changed from Lantus at night to Toujeo in the morning and my endocrine paid me the following:
The last night with Lantus put half of the dose
That day in the morning half of Toujeo and the next day the complete dose of Toujeo.
Still he told me that it would take 2 or 3 days to stabilize because Toujeo usually needs 2 days to appreciate the changes so I was high between hours 2 or 3 days correcting quickly.Toujeo doses are also often needed than used with Lantus.I was directly uploaded by something when making the change (I think 2 more units) and he told me that after 3 days of change he was adjusting according to fasting glucose.Now I think I remember that I get 4 more than with Lantus but I don't remember fixing.

If you're going to get Lantus, it's much better in the morning.
If you are putting toujeo, you can get half the dose at night and then the total dose in the morning.
If you change toujeo to Lantus, you may need less dose of Lantus.
But you can try a few days with Toujeo in the morning
And if you see that it is not going, you go to Lantus.

yagoba said:
hello alb 85
I have improved a lot, since the head of Cabezra takes me, today for example before eating 96, then at two hours 125, it seems good to me, that with the capillary, but with
Freestyle, I get 158 ​​or 33 points of difference with the capillary, is it normal?
I beg you to tell me something, thanks
Greetings

Hi Yagoba.
I'm glad you go better.
On what you ask me, the truth is that I am not yet using it, it has come to me this morning but I have not put it yet.
From what I have read to the classmates, I think that a little care between both measurements could be normal, but I would not know how to tell you for sure if that difference is within normality.Let's see if any partner who knows more about the subject can solve the doubt.

125 and 150 although it seems a lot of difference is practically within 20% margin that could exist between capillary glucose and interstitial glucose in moments of stability.
In any case, if it is true that it is a fairly striking difference in capillary and stability Normaglycemia values, with freestyle and its algorithm should not happen and the values ​​should be much more even.
I now use the Enlite sensor (although I will have the free sensor in my arm a few more days, which allows me to compare) and the measurements before eating have been:
Capillary 126
Enlite 117
Freestyle 134
All within rank, with differences much lower than 20%.

tyler said:
with Lantus was more or less the same (perhaps something worse before), I also put it at night.And yes, not exercising the climb has no brake (I exercise to compensate for it as I can).

I exercise daily, so I don't know how to tell you how much I would go down in case of not doing (I panic not to move).

The same is what you comment on the difference in the need for basal during the day, although it could also be that the toujeo made me peak during the first hours and then lost effect (like me and many other people has happened to Lantus).

The novorapid adjustment according to what I am going to eat, what I have moved and what I am going to move.I have not used the other insulins, but I understand the idea of ​​distributing better ... all this could aim and take it to my endocrine (I am not funny to have to put the basal twice, but everything is for good control. If it works...).

With all the sketches made, I think that before leaving the basal in two punctures of Levemir, Lantus trying in the morning.I think something should improve the situation.If you improve at all, we stay here.If it improves but not enough, I would try to change the rapid noon for Actrapid or a Novomix70.And if nothing changes, it doesn't matter if you get Lantus or Toujeo, tomorrow or night, and I would try to change the fast noon as I commented before.

To try to put the toujeo in the morning, as they have commented, you can try it (it is a way to try without the need for the insulin of the recipe to change), but it is expected that the change is minimal (as they have alsocommented).Of course, if it were three, I would not try (because the time strip lasts, and in fact the state of equilibrium is not reached until you have not been putting it for 3 days).

Above all, if you change the toujeo in the morning, it is always better to advance it little by little or overlapping minor doses, as Yesssica_a commented, that I do not skip a night without basal (although for your profile I do not think that would give you many problems).

The only problem of getting Lantus in the morning is the weekend, which forces you to get up early and put it on.If you go out and wake up at the 1st noon without having put it on, you can be high or even with incipient ketosis (if the last fast bolus was at the previous dinner).

I really appreciate everyone's advice and intention.I don't think Lantus returns because I was not better than now, and if it was still less flat ...

I can speak with the endocrine and comment on the change of schedule with Toujeo, and make it progressive as you all tell me.

I would hurry those options before having to return to Lantus, for giving Toujeo the opportunity, and as the last resort I have the option of changing rapids, which I understand something less.

Really thanks to everyone.

My daughter, with Lantus at night, was fatal.Downloads of no che and uploads, because dose had to be reduced.However, when passing it in the morning (or at noon) it could increase dose and cover it well 24 hours, without any nocturnal hypo.
It has not changed to Toujeo yet because he is thinking about it.
If you don't just see yourself with Toujeo, you can go very well with Lantus, which gives you freedom of schedules in meals.

I will take it into account, if the schedule change would not work, I would tell him the possibility of returning to Lantus to the endo.

I do not say anything from my experience, but the impression it gives me is that most have been happy with the change from Lantus to Toujeo.Even so, if your daughter is stable with Lantus, it's like thinking well.

I think the concept of "Toujeo is better to move away is better than Lantus."Toujeo is not better than Lantus.Toujeo is flatter than Lantus.Tresiba is flatter than Lantus.

For the patient who needs a very flat basal insulin, it is true that Toujeo and Tresiba will be better basal than Lantus (which are many).But not all patients have those needs, as an example, that of @tyler or that of @regina's daughter, as he explained very well (if the lantus was put at night, he had to lower the dose not to make declines,And then the rest of the day had a tendency to climb;

In fact that is one of the advantages of insulin pumps, they put the basal that you programs for time slots.By this I do not mean that everyone will go better with an insulin bomb, I simply say it to illustrate the fact that many DM1 patients have different basal needs throughout the day, and therefore, in thesecases, what in principle is "the disadvantage" of some insulins (such as Levemir or Lantus), for them it can be precisely "the trick" that fixes the profile.

As an extreme case, there are patients with DM1 (anecdotal cases, it is true) that as a basal insulin they receive a daily dose of NPH, which may seem nonsense because it only lasts between 8 and 12 hours.But they are people who with Lantus or Levemir rise very high (starting from a correct postcena), and then they do hypoglycemia before the food and before dinner (starting from postdesayuno and correct post -composition) [This profile would be the opposite that the one of @Tyler or the daughter of @regina]

What happens is that the pressures of the industry are the pressures of the industry, and they always have to increase the sales of the newly launched products, and with the patent without expiring, which are responsible for promoting, sometimes withLittle ethical strategies (from my point of view, how to suggest doctors, practically, pass all their patients with "old and bad" to "new and good").But what I said before, not always an insulin because it is more flat and durable will be better for All patients.And the flatter one is an insulin, the less the moment of the day it is placed (so with Lantus it is a difference, and with the new ones, not).

You have made it very clear to us @"endocrinaantinewage", ::)>--

I'm glad: \ ">

I understand the idea, although being the flattest toujeo, it seems to me that it makes me peak during the early hours of the night (similar to Lantus).

I have at least noticed little difference between the two basal precisely because of that (hence Toujeo raised in the morning, acting in me in a similar way).

tyler said:
I understand the idea, although being the flattest toujeo, it seems that it makes me peak during the first hours of the night (similar to Lantus).

It is not for pretending to be Cabezona hahahaha, but look what he says on the FDA product sheet regarding the peak of the early hours of the night:

Link
The onsest of action of toujeo develoops over 6 Hours following an injection .IN TYPE 1 DIABETES PATients Treated with IV Insulin, Consider The Longer Onset of Action of Toujeo Before Stopping IV Insulin.The Full Glucose Lowering Effect May Not Be Apparent for At Least 5 Days [See Dosage and Administration (2.2) and Clinical Pharmacology (12.2)].

With which, if this is true, we could almost say that in the early hours of the night, it is practically making more "queue" action of the dose of the previous night, than the one you just put on.

Look at the graph that appears on page 11 of this document:
Link

There it is seen that the Lantus, indeed, does make a small climb within a few hours of administering it, before reaching the "plateau".

But in the end, each body is a world ... if you want, you will tell us how the passage of Toujeo works in the morning, which solves the problem of a stroke (never better) and more easily than changing frominsulin ;-)

Oysters, because I would never have said it, really.:-EITHER

Thanks again, we will continue testing ... (very good about the plumazo :)))