Hi Melody,

A picture is worth a thousand words is true. Basically, the pen itself has been designed to make all conversions necessary and YES, you DO use the same dialed up number with TOUJEO as with your Levemir.

The DROP of one unit of Levemir is different than a drop of Toujeo in volume. See the picture in the link provided by mrs D.

You may try to think of it as you would a pill. For example, a pill containing 150 mg of a drug is about the same SIZE as the pill containing 300 mg of the same drug.

It boils down to (from the picture) that the amount of insulin can be delivered in smaller drops.

I noticed that when I prime my needle with two units of my FAST-acting insulin, there is MORE liquid coming out than when I prime my needle for my LONG-acting once a day insulin. NOW, I understand why.

It has more to do with how much "liquid" is used to deliver X amount of insulin.

Sort of like it takes some people only an ounce of water to swallow a pill and others may need 4 ounces of water to get it down.

THAT's what they mean by concentrated. They pack more insulin in the same amount of fluid that is in the pen to deliver the insulin.

All the conversions are already done and calculated so that you can just dial your usual number and get the right amount of insulin. You are just going to be using less fluid to get the same amount of insulin into your system.

OK, that is MY way of understanding it.

If you dial up the same number on your Levemir and put it in a measuring glass, then dial up the same number on the Toujeo and put IT in a measuring glass, the volume of liquid in the two glasses will be different but the amount of insulin packed into that volume of liquid would be the same. Does that make any sense to you?

I could be all wrong but that is the way I understand it after having done some research.

I don't know how often you test each day but if you use less than the same amount of Toujeo than you use with your Levemir, your blood sugar numbers will show it. They will go up because you would not be getting the full dose.

The amount of "liquid" is NOT the same as the amount of insulin.

That is obvious with my fast-acting vs long-acting insulins.

The only advantage to using this new insulin (besides keeping big bucks rolling in to the drug manufacturer) is that for people using a large # of units of the older types, this concentrated one would inject less liquid into the skin. This may help with skin reactions etc, and in general be more cost effective since the pen machine itself is very expensive-- costs probably more than the insulin inside of it.

What really bothers my brain, is the statement that people may need higher units than before. This tells me that lower doses may not be very accurately delivered by the pen.

Think of this: 10 units per injection of the old types would be
.1ml injected. 10 units of Toujeo would be .033 ml. That may not be really an accurate amount for the pen. Hence that person may need MORE Toujeo to get any insulin at all. And that explains that qualifying statement we have all read.

1ml of water is about 20 drops. So one drop is .05ml. So 10 units from the Toujeo pen is less than one drop in volume!

I don't see this pen lasting long for sale. It is going to mess up alot of therapies and confuse too many people, and result in using higher doses of units, for those who only use low dosing like 10 or 20 units at a time. (because the pen can't be really accurate in those low ranges.)

The new oral insulins are doing very well in the later trials. Could be available in only a couple of years!
http://www.neurotalk.org/health-news...ial-yahoo.html

Hi mrsD,

Was I on the right track about volume of the delivery fluid?

I agree that the new TOUJEO would not be of much benefit to someone using lower amounts of once a day insulin. I think it would benefit a select group of people that use a higher volume, like 60 units and more as there would be less fluid being injected using TOUJEO than Lantus.

Again, I appreciate your continued efforts to help us with this discussion.

Yes, you are right.
Alot depends on if the pen is good enough to deliver small
doses.

Some medications never catch on or don't last for various reasons. Remember the nasal delivery system for insulin that Pfizer had?
It didn't last 2 years and was discontinued.

My doctor says he has two NEW (different than Toujeo and the others) to give me if I stop by. I haven't been brave enough to try the Toujeo yet.

I did however ask the pharmacist the following question.

"Since the patent on Lantus is soon to expire, does this mean that other companies might be coming out with generic insulin that is equal to Levemir and Lantus?"

She nodded and said "Yes".

Really??? Anyone!!!!

I would imagine some company would make an insulin calling it 'Insulin Glargine (or however it's spelled).

So confusing.

Melody