Can Toujeo be given twice a day?
Medically reviewed by Carmen Fookes, BPharm. Last updated on June 25, 2020.
- Even though Toujeo is usually given once a day, some people may experience better blood sugar control if the dose is split and given twice a day (every 12 hours).
- Those that tend to benefit from twice-daily Toujeo include those experiencing early morning hypoglycemia or persistent hyperglycemia at dinner time.
- Twice daily Toujeo also improved HbA1c levels.
Toujeo is a long-acting form of man-made insulin (insulin glargine) that may be used for the treatment of high blood sugar levels in adults and children 6 years and older with diabetes mellitus.
Toujeo lasts for up to 36 hours and is usually given once a day, usually in the morning.
Despite its long duration of action, there are some instances when it may be better to dose Toujeo twice a day. These circumstances include:
- People experiencing low blood sugar levels (hypoglycemia) early in the morning or before breakfast
- People with persistently high blood sugar levels (hyperglycemia) before dinner despite modifying their insulin dosage at lunchtime.
Research has shown that twice-daily dosing with insulin glargine significantly improved blood glucose control in 50 patients with uncontrolled type 2 diabetes. The average daily dose of insulin glargine increased from 53 units/day to 78 units/day, and a higher dose of short-acting insulin was needed at mealtimes. HbA1C levels also significantly improved, from an average of 10.3% in people on once-daily glargine down to an average of 8.4% in people on twice-daily glargine.
How does Toujeo work?
Toujeo contains insulin glargine which is a long-acting, manmade form of human insulin.
To make insulin glargine, scientists have genetically modified a bacterium called Escherichia coli to produce insulin that is very similar to human insulin. To make it longer acting, the amino at position 21 of the A-chain (asparagine) has been replaced with glycine and two arginines have been added to the C-terminus of the B-chain. Insulin glargine may also be called an insulin analog because it is a modified version of human insulin.
Toujeo works by replacing the insulin that is normally produced by the body. The main role of insulin is to allow cells throughout the body to uptake glucose (sugar) and convert it into a form that can be used by these cells for energy. Without insulin, we cannot survive, and death from diabetes was a common occurrence until insulin was discovered in the early 1900s by Frederick Banting and Charles Best.
- Toujeo (Insulin glargine) Sanofi https://www.drugs.com/pro/toujeo.html
- Eledrisi M, Suleiman NN, Salameh O, et al. Twice-daily insulin glargine for patients with uncontrolled type 2 diabetes mellitus. J Clin Transl Endocrinol. 2018;15:35-36. Published 2018 Dec 11. doi:10.1016/j.jcte.2018.12.002
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