KATHY: Hi, I’m Kathy and I’m a diabetes educator. Welcome to today’s webinar.
Your blood sugar levels may rise and fall for different reasons such as changes in diet and weight, variations in exercise routine, lifestyle changes and increases in stress and general changes in the body. Even when people living with diabetes follow the diabetes management plan set by their physician, their diabetes and body can change over time. They may need to work with their doctors to change their treatment plan over time as well.
So it’s important for you to talk with your doctor about changes in your diabetes. Exploring different treatment options along with adjustments in diet and physical activity levels can help to find a treatment plan that works best for you.
One treatment option for patients with diabetes is long-acting insulin, Toujeo®. So what is Toujeo® (insulin glargine injection) 300 units per milliliter?
Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus. Toujeo® contains three times as much insulin in one milliliter as standard insulin 100 units per milliliter.
Toujeo® is not for use to treat diabetic ketoacidosis.
Toujeo® should not be used in children.Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.
Long-acting insulin Toujeo® can play a role in managing blood sugar levels in adults with diabetes. This type of insulin is designed to help replace your body’s natural basal insulin production which, in patients with diabetes, can be lost over time. When choosing a long-acting insulin with your doctor, it’s important to consider your options.
Some of my patients asked what it means that Toujeo® has three times as much insulin in one milliliter. I will give you more details about this very soon.
But before we go there, I want to emphasize some important safety information you should know for Toujeo®. Do not reuse needles or share insulin pens even if the needle has been changed. Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®. Before starting Toujeo®, tell your doctor about all your medical conditions, if you are pregnant or planning to become pregnant.
As we are discussing Toujeo® today, we will also talk about doses. If your doctor prescribed a long-acting insulin like Toujeo® for you, finding the appropriate dose is a critical step that can help manage your A1C levels and help work toward your day to day blood sugar goals. That’s why it is important for you and your doctor to find the appropriate dose that will help you move toward your treatment goals.
Later we will talk about this more.
Be sure to test your blood sugar levels daily while using insulin, including Toujeo®. And please read the full Important Safety Information for Toujeo® to learn more about taking insulin with certain medicines called TZDs.
Let’s learn a little more about Toujeo®. We already said that Toujeo® (insulin glargine injection) 300 units per milliliter is a long-acting insulin. Toujeo® is from the makers of Lantus® (insulin glargine injection) 100 units per milliliter. Toujeo® has been proven to control blood sugar for the full 24 hours.
Toujeo® has been approved by the FDA for blood sugar control in adults with type 1 and type 2 diabetes, and Toujeo® was compared to Lantus® in clinical studies including over 3000 patients with diabetes.
Once-daily Toujeo® should be taken at the same time each day, and I want to repeat that it’s very important to test your blood sugar levels daily while using insulin, including Toujeo®.
What does it mean that Toujeo® contains three times as much insulin in one milliliter as standard insulin 100 units per milliliter? Well, one unit of Toujeo® has the same amount of insulin as one unit of Lantus®, so no conversion is needed when comparing a unit of Toujeo® to a unit of Lantus®. However, Toujeo® has more insulin in every milliliter versus Lantus®.
Each unit of Toujeo® contains one-third the fluid volume of Lantus®. The smaller injection volume of Toujeo® slowly delivers small amounts of insulin for the full 24 hours. But remember, Toujeo® should be taken once a day and at the same time every day.
As Toujeo® delivers small amounts of insulin, it provides blood sugar lowering activity that lasts beyond 24 hours with no pronounced peaks or wear off.
Now let’s talk more about safety information for Toujeo®. If a doctor prescribes Toujeo® for you, it’s important to know that the most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia) which may be serious and can be life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat and blurred vision. You should talk about this with your doctor and develop a plan together.
Also, Toujeo® may cause serious side effects that can lead to death, such as severe allergic reactions. Be sure to read the full Important Safety Information for Toujeo® so you’re aware of the signs and symptoms of severe allergic reaction.
We already discussed that Toujeo® provides proven, full 24-hour blood sugar control. Toujeo® also was proven to significantly reduce A1C levels in EDITION clinical trials. The average A1C reduction was similar to that of Lantus®.
Do not take Toujeo® during episodes of low blood sugar or if you’re allergic to insulin or any of the ingredients in Toujeo®. Also, it’s important for you to know that you should discuss with your doctor all medications that you take, especially if you’re taking TZDs. They may cause heart problems when taken with insulin. Please be aware of the symptoms of heart failure.
We said before that taking the appropriate dose of insulin is important. Dosing to individualized goal and getting to goal is something that you and your doctor will need to discuss. Whether you’re new to insulin or changing from another brand, it’s important to work with your doctor to adjust your insulin dose to find the one that’s right for you.
Remember: it’s important to monitor your blood sugar levels as your doctor recommends. Keep in mind, the dose will most likely be adjusted based on your FPG (fasting plasma glucose) goal. You probably know that fasting plasma glucose is your blood sugar levels in the morning before you eat anything. And when you start Toujeo®, it should be titrated, which means the dose may be increased. That should happen no more frequently than every three to four days to minimize the risk of hypoglycemia.
You should test your blood sugar levels daily while using insulin, including Toujeo®. Verify that you have the correct insulin before each injection. Your dose for Toujeo® may be different than other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.
After beginning Toujeo®, your doctor may adjust your dose as needed. If you’re starting insulin for the first time, expect to start at a low dose and your doctor may adjust it to the appropriate dose. Or, if you’re changing from another once-daily long-acting insulin, expect to start at the same dose as your current long-acting insulin, and your doctor may adjust as necessary.
In clinical trials, after titration, patients treated with Toujeo® used more insulin than patients treated with Lantus®.
While using Toujeo® do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use other medications that contain alcohol.
In summary, Toujeo® provides proven, full 24-hour blood sugar control, proven safety and efficacy and is proven to lower A1C levels.
Remember that the most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and can be life-threatening. It’s important for you to recognize the symptoms of low blood sugar.
And Toujeo® is available in a redesigned SoloStar® pen which features a small, thin needle; 450 units of insulin in every pen versus 300 units for Lantus®; one unit to one unit conversion from Lantus®; a large dosing window with clear visibility; five-second hold time versus ten seconds for Lantus®; and less injection force. Do not reuse needles or share insulin pens, even if the needle has been changed.
And now here’s the full Important Safety Information for Toujeo® (insulin glargine injection) 300 units per milliliter.
Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.
Do not reuse needles or share insulin pens, even if the needle has been changed.
Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.
Heart failure can occur if you are taking insulin together with certain medicines called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms of heart failure, including:
Tell your doctor about all medications you take, including over the counter medicines, vitamins and supplements, including herbal supplements.
Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not make changes to your dose or type of insulin without talking to your doctor. Verify you have the correct insulin before each injection. Your dose for Toujeo® may be different from other insulins you’ve taken. Any change of insulin should be made cautiously and only under medical supervision.
Do not dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.
While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use other medicines that contain alcohol.
The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and can be life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.
Toujeo® may cause serious side effects that can lead to death such as severe allergic reactions. Get medical help right away if you have
Toujeo® may have additional side effects, including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling and itching.
Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.
And now here are some frequently asked questions that I get asked a lot. Can you ever come off insulin once you start? Can you ever stop taking insulin?
Well, if your pancreas no longer makes insulin, then you will always need to take insulin injections. Your doctor will monitor your treatment plan and decide when adjustments need to be made with your medications.
Another question I get asked often is do blood sugar levels need to be checked more often when you start insulin, and is there any need to change when or how often blood sugar levels are tested?
The American Diabetes Association recommends that individuals on insulin injections test their blood sugar levels at least prior to meals and snacks. Your doctor may direct you on how often and when to test. Your doctor may also recommend that you test at other times including after meals, at bedtime, before exercise, and when you suspect that your blood sugar is low.
Here’s another question that I get asked frequently: can Toujeo® be taken with diabetes pills? Yes, Toujeo® can be taken with oral diabetes medications. Only your doctor can determine what diabetes medications you should continue while taking Toujeo®. Be sure to tell your doctor about all medications and supplements you take, as they can change the way insulin works and how it may affect the other organs.
Here’s another question: can Toujeo® be taken while on mealtime insulin? If I’m on mealtime insulin will the dose or how often mealtime insulin is taken need to change?
If your doctor prescribes it, you can take Toujeo® with your mealtime insulin. If you’re on mealtime insulin you should ask your doctor how much and when you should take your mealtime insulin while taking Toujeo®. It’s important to monitor your blood sugar levels and discuss the results with your doctor. This information will help your doctor decide whether changes are needed to your mealtime insulin, as well as Toujeo®.
Another question I hear often is will it take long to get to the right dose of Toujeo®? Your doctor will recommend a starting dose of Toujeo® and then adjust it to work towards your blood sugar targets. This process is individualized for each person. This adjustment is also known as titration. Your doctor may still adjust your dose from time to time if you’re above or below the goals that he or she has set for you.
How often do I take Toujeo®? Does it matter when I take Toujeo®? You should take Toujeo® once a day. Just remember to take it at the same time every day. It can be taken any time of the day but remember to take it at the same time each day. You should discuss with your doctor what time of the day is best for you to take Toujeo®.
Here’s another question: what is the difference between Toujeo® and Lantus®? Toujeo® is three times more concentrated than other long acting 100 unit per milliliter insulins like Lantus®. Each unit of Toujeo® contains one-third the injection volume of Lantus®. The smaller injection volume of Toujeo® slowly releases insulin into your body. Both Lantus® and Toujeo®were proven to reduce A1C. Since it releases slowly, Toujeo® has blood sugar lowering activity that lasts beyond 24 hours. Toujeo® should be taken once a day at the same time each day.
Now here are some questions about concentration. Since Toujeo® has more insulin in one milliliter than Lantus®, does it mean I need to take less Toujeo® than Lantus®?
For patients who take Toujeo®, their doctors will recommend the starting dose. In clinical trials, patients converting from Lantus® started on the same dose of Toujeo® as Lantus®. In clinical trials, patients required higher dose of Toujeo® over time than Lantus®.
Now here’s some questions about the higher dose. Why do patients need a higher dose of Toujeo® than Lantus®? Toujeo® is a different product than Lantus®. In clinical trials, patients treated with Toujeo® used more insulin than patients treated with Lantus®. Each insulin requires its own dosing to help patients reach their blood sugar goals. Toujeo® has a slow, gradual release.
Questions about conversion. If Toujeo® was more concentrated, why is it recommended to start with a 1:1 conversion from Lantus®? The Toujeo® SoloStar® pen is already calibrated to ensure that one unit of Toujeo® has the same amount of insulin as one unit of Lantus®. The same number of units of Toujeo® was delivered in a smaller volume than Lantus®. For patients who are switching from Lantus®, their doctor will recommend an initial dose of Toujeo® and how it should be adjusted over time.
We want to thank you for viewing today’s webinar. Educating yourself about your diabetes and your insulin is an important part of your treatment plan. If you think Toujeo® is right for you, speak with your doctor. Thank you.
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