Lantus To Tresiba? | Diabetes Forum The Global Diabetes Community
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community New2T1D Don't have diabetes Well-Known Member Diabetes nurse advised me to consider changing from Lantus to Tresiba yesterday, to take account of fact that Lantus doesn't last the full 24 hours. She said that it takes 7 days for Tresiba to be fully in its groove/ pattern, whereas with Lantus is it 3. It's also less flexible when one has active vs non-active days (relevant for a teenager: my son)! That said, he can be more flexible about when in the day he gives injections (no dead set time), which would be a positive. It's only recently been licensed for under 18 age and seems harder to get hold of for pharmacists than Lantus is (consultant's prescription needed) as a downside and I also hear it can cause crashing headaches. So I'm slightly worried about the newness of the drug - what do people think? I don't want to cause any risk to my son. That said, I read that Lantus is potentially carcinogenic, so what do you do? I have to be honest, I'm also nervous of changing the drugs. We've been living with T1 since November 2016 and so are relatively new to it. I'm a bit anxious about disturbing the status quo....any advice or thoughts from people. Thank you Also, how do you give it, when it's a 42 hour lasting drug???? A set number of units every 24 hours for example? And how do you change over/ transition from Lantus to Tresiba? Thanks again. Tagging @robert72 for you as I think he uses Tresiba. Have you tried splitting the Lantus to get better coverage @New2T1D ? Hi the DSN's should give you advice on how to make the transition, I've been on it since I was diagnosed nearly 9 months ago and I haven't suffered any side effects from it, I take a certain am Continue reading >>
How Tresiba® Works
Read the Instructions for Use and take Tresiba® exactly as your health care provider tells you to Do not do any conversion of your dose. The dose counter always shows the selected dose in units Know the type and strength of insulin you take. Do not change the type of insulin you take unless your health care provider tells you to Adults - If you miss or are delayed in taking your dose of Tresiba®: Take your dose as soon as you remember, then continue with your regular dosing schedule Make sure there are at least 8 hours between doses If children miss a dose of Tresiba®: Call the healthcare provider for information and instructions about checking blood sugar levels more often until the next scheduled dose of Tresiba® Check your blood sugar levels. Ask your health care provider what your blood sugar levels should be and when you should check them Do not reuse or share your needles with other people. You may give them a serious infection, or get a serious infection from them Never inject Tresiba® into a vein or muscle Never use a syringe to remove Tresiba® from the FlexTouch® pen Tresiba® may cause serious side effects that can be life-threatening, including: Low blood sugar (hypoglycemia). Signs and symptoms that may indicate low blood sugar include anxiety, irritability, mood changes, dizziness, sweating, confusion, and headache Low potassium in your blood (hypokalemia) Heart failure in some people if taken with thiazolidinediones (TZDs). This can happen even if you have never had heart failure or heart problems. If you already have heart failure, it may get worse while you take TZDs with Tresiba®. Tell your health care provider if you have any new or worse symptoms of heart failure including shortness of breath, tiredness, swelling of your ankles or feet, and su Continue reading >>
TRESIBA® (insulin degludec) for Injection DESCRIPTION TRESIBA (insulin degludec injection) is a long-acting basal human insulin analog for subcutaneous injection. Insulin degludec is produced by a process that includes expression of recombinant DNA in Saccharomyces cerevisiae followed by chemical modification. Insulin degludec differs from human insulin in that the amino acid threonine in position B30 has been omitted and a side-chain consisting of glutamic acid and a C16 fatty acid has been attached (chemical name: LysB29(Nε-hexadecandioyl-γ-Glu) des(B30) human insulin). Insulin degludec has a molecular formula of C274H411N65O81S6 and a molecular weight of 6103.97. It has the following structure: Figure 1: Structural Formula of TRESIBA TRESIBAis a sterile, aqueous, clear, and colorless solution that contains insulin degludec 100 units/mL(U-100)or 200 units/mL(U-200). Inactive ingredients for the 100 units/m Lare: glycerol 19.6 mg/mL, phenol 1.50 mg/mL, metacresol 1.72 mg/mL, zinc 32.7 mcg/m Land water for injection. Inactive ingredients for the 200 units/m Lare glycerol 19.6 mg/mL, phenol1.50 mg/mL, metacresol 1.72 mg/mL, zinc 71.9 mcg/m Land water for injection. TRESIBA has a pH of approximately 7.6. Hydrochloric acid or sodium hydroxide may beadded to adjust pH. font size A A A 1 2 3 4 5 Next What is Type 2 Diabetes? The most common form of diabetes is type 2 diabetes, formerly called non-insulin dependent diabetes mellitus or "adult onset" diabetes, so-called because it typically develops in adults over age 35, though it can develop at any age. Type 2 diabetes is diagnosed more often in people who are overweight or obese, and who are not physically active. Type 2 diabetes is an illness in which the body does not process ingested sugars (glucose) properly. In type Continue reading >>
Onset of action - time period after injection that insulin will begin to work Duration of action - length of time after injection that insulin will have a measurable effect Peak effect - time after injection when insulin will have its greatest activity (effect) NOTE: Pharmacokinetic parameters are affected by age, kidney function, liver function, concomitant medications, medical conditions, and other variables. Because of this, parameters may vary widely among patients. In the U.S., most insulins cost > $150 a vial/pens with one exception; Walmart sells Novolin R, Novolin N, and Novolin 70/30 for $25 a vial * For use in HumaPen Luxura HD and HumaPen Memoir See Inhaled insulin for a complete review of Afrezza Afrezza comes in a sealed foil package with 2 blister cards inside Each blister card has 5 rows of 3 cartridges Before use, cartridge and inhaler should be at room temperature for 10 minutes Inhaler should be thrown away after 15 days Sealed foil package is good until expiration date Sealed blister cards + strips - use within 10 days SoloStar is compatible with all BD pen needles Apidra is a premeal (also called prandial) insulin Inject Apidra within 15 minutes before a meal or within 20 minutes after starting a meal Apidra is compatible with some insulin pumps UNPUNCTURED, REFRIGERATED (Vials and Pens) Inject Fiasp at the start of a meal or within 20 minutes after starting a meal KwikPen is compatible with all BD pen needles Inject Humalog within 15 minutes before a meal or immediately after a meal Humalog is compatible with some insulin pumps HumaPen Luxura HD is a reusable pen that allows dosing in 0.5 unit increments HumaPen Memoir records the time, date, and dose of the last 16 injections UNPUNCTURED, REFRIGERATED (Vials, Pens, Cartridges) UNPUNCTURED, ROOM TE Continue reading >>
Lantus Vs Tresiba: The Better Long Acting Insulin For Diabetes
Lantus vs Tresiba: The Better Long Acting Insulin for Diabetes So you are asking yourselfwhich is the better long acting insulin? The judges have declared the winner, and it wasnt even close! First, some back story in order to understand the importance of this epic fight. Why would Tresiba want to take on Lantus? Lantus has been the champion of long-acting insulin for over fifteen years. Thats right! Lantus was an amazing discovery for diabetes management : the first long-acting basal insulin . Before the year 2000, doctors did not have many types of insulin to choose from. Lantus is actually an analogue of natural human insulin. The insulin molecule was changed slightly in the lab, creating differences in the way it is absorbed. In the case of U-100 glargine (the generic name of Lantus), there is an amino acid substitution and a slight lengthening of one of the two chains that make up the insulin molecule. When Lantus is injected, this alteration increases the time over which the insulin is absorbed, giving it a longer half-life than all the insulins available previously. Fast-forward sixteen years, and Tresiba is now an excellent alternative for what doctors call basal insulin. Basal insulin is a type of insulin that lasts long periods of time and helps control blood sugars between meals and overnight. Several changes were made to slow the absorption of Tresiba, making its effect on lower blood sugar more predictable. As compared to regular insulin, Tresiba contains an amino acid deletion and a special bond with a fatty acid. When combined with zinc and phenol, degludec (the generic name of Tresiba) forms multihexamers under the skin. Once absorbed, it reversibly binds to the main protein in the blood, called albumin. The end result of these modifications is a new cl Continue reading >>
Fda Approves Ultra-long-acting Basal Insulin Tresiba – Take It At Any Time Of Day!
Twitter Summary: @US_FDA approves next-gen once-daily basal #insulin Tresiba, plus Xultophy (Victoza + Tresiba) now submitted Novo Nordisk recently announced the FDA approval of the next-generation once-daily basal insulin Tresiba (insulin degludec) and the premixed insulin Ryzodeg (70/30 mixture of insulin degludec and insulin aspart). Tresiba will be launched in early 2016 and will come in prefilled FlexTouch pens. The insulin will launch in two concentrations (U100 or U200), enabling maximum doses of 80 units or 160 units per injection. Exact pricing information is unavailable at this time and we're really hoping that it's priced similarly to Levemir. What makes Tresiba exciting? Several things: Flatter profile: Tresiba lowers blood sugar in a flatter, more predictable way than Levemir or Lantus. Less nighttime hypoglycemia: In certain trials, Tresiba seemed to cause less nighttime hypoglycemia vs. Lantus. This is not exactly “on the label,” but it seems to be true in the "real world” according to doctors with experience with Tresiba. Dosing Flexibility: Tresiba can be taken at any time throughout the day – for example, 8 am on Monday, 12 pm on Tuesday, and 7 am on Wednesday. The insulin lasts for an impressive 42 hours (at least), and doses must be taken at least eight hours apart. This flexibility is a major plus, as all other basal insulins (Levemir, Lantus, Toujeo) must be taken at the same time every day according to the label (though Toujeo gets reports in the real world of also having some further flexibility). Fewer Injections for those using high doses of insulin: Patients can take up to 160 units of Tresiba in a single injection with the U200 pen, which means most patients should be able to take a day’s worth of insulin in a single dose. Toujeo is Continue reading >>
Is Newly Approved Tresiba The Best Long-acting Insulin?
Comparing long-acting insulins? Newly approved Tresiba may come out ahead. With the exception of NPH insulin (the original long-acting insulin—examples include Humulin N and Novolin N), they are all going to cost you. So, if you are already paying big bucks for your long-acting insulin, here are some things to think about: What does a long-acting or basal insulin do for me? This is your baseline insulin, the insulin that is secreted to control your sugars when you are not eating (in the fasting state). Put another way, basal Insulin is used to suppress liver glucose production and help you maintain normal sugars even when you aren’t eating. What are my options? The old-school and well respected NPH insulin has been around forever and is considered intermediate acting. Levemir and Lantus were then joined this year by Toujeo and now Tresiba as the main players. Toujeo is basically Lantus (which was losing its patent) and may not gain any traction in the market. These insulins are typically administered once daily to provide basal insulin levels. Basaglar was just approved by the FDA and think of Basaglar as the Lantus “generic” or copycat–that will be available soon and let’s hope it’s cheaper than Lantus. What is Tresiba? Tresiba (insulin degludec) is the longest acting insulin available and there don’t appear to be any coming down the pipeline that give this duration of coverage. What makes Tresiba a hero is the long duration of action (>40 hours) with less fluctuation in blood levels of the drug. It’s given once a day. Is Tresiba the best long-acting insulin? This can only be answered on an individual basis and along with your provider. Lantus, Levemir and Tresiba may have some modest advantages over NPH (less symptomatic and nighttime hypoglycemia) i Continue reading >>
Novo Nordisk’s New Insulin Tresiba To Take On Lantus
Novo Nordisk’s insulin degludec injection, known by the brand name Tresiba, met with FDA approval in late September. It is expected to be available to patients with a doctor’s prescription in the first few months of 2016, according to Novo Nordisk’s chief medical officer for North America, Dr. Todd Hobbs. “This insulin is very predictable and stable,” Hobbs says about Tresiba, which is a long-acting basal insulin. “It has a half life of 25 hours, and can last at least 42 hours.” Hobbs points out while it’s advisable, and desirable, for diabetics to take their daily dose, or doses, of insulin at the same time each day, sometimes that simply isn’t possible. Sometimes, he says, life intrudes and a person is delayed in taking their medication. But, with Tresiba, such an occurrence wouldn’t necessarily impact blood sugar in a significant way. “A patient might miss their dose by a few hours, but we designed Tresiba to accommodate those sorts of events,” he says. Approval for Tresiba comes almost a decade after the molecule that forms the basis for the treatment was first isolated. Hobbs says that even before Novo filed its first attempt for approval through the FDA in 2012, Tresiba had already been in pre-clinical development for five or six years. Tresiba is poised to be a direct competitor to the long-acting insulin, Lantus, which is sold by the pharmaceutical company Sanofi SA. Lantus is the market leader in long acting insulin with more than 80 percent of market share and annual sales of almost $8 billion. These figures, however, were before the patent on Lantus expired in Europe and the U.S. earlier this year. Tresiba already boasts a commanding presence in the world insulin market. According to Science Times, Tresiba is sold in 30 countries aroun Continue reading >>
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Effects Of Switching From Insulin Glargine Or Detemir To Insulin Degludec In Patients With Type 1 Diabetes Mellitus
Go to: Abstract Insulin degludec is a new, ultra-long-acting basal insulin. The aim of this study was to analyze the changes of basal insulin dose and blood glucose profile in basal–bolus therapy of type 1 diabetes mellitus (T1DM) at the switching of basal insulin from insulin glargine or detemir to insulin degludec. Sixteen patients with T1DM were enrolled. The patients underwent continuous glucose monitoring before and after the switching of insulin glargine or detemir to degludec. Ten patients treated with insulin glargine or detemir twice daily, were switched to insulin degludec with 80–90% of the prior insulin dose. The remaining six patients treated with insulin glargine once daily, were switched to insulin degludec without down titration. The changes of daily insulin dose and glycated hemoglobin (HbA1c) were also examined for 12 weeks after switching to insulin degludec. In the patients switched from twice-daily basal insulin, no significant difference was found between before and after switching in the blood glucose profile. In the once-daily group, blood glucose levels showed a tendency to decrease after switching to the degludec treatment. During the study period, total daily insulin dose (TDD) and total daily basal insulin dose (TBD) decreased significantly in the twice-daily group, and TDD and TBD showed a tendency to decrease after switching to degludec in the once-daily group. In both groups, the changes of HbA1c were not significantly different. It is possible to achieve similar glycemic control with once-daily injection and lower doses of insulin degludec in patients with T1DM who have been treated with insulin glargine or detemir. Keywords: Basal–bolus insulin therapy, Continuous glucose monitoring, Hypoglycemia, Type 1 diabetes mellitus, Insulin Continue reading >>
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Switching From Lantus To Tresiba
As indicated in a few other threads, Im switching from Lantus to Tresiba today. Ive had some trouble determining what my starting dose should be, so I thought Id create a thread documenting how a 1:1 conversion worked for me (really, this was @Michel s suggestion). I generally take a total of 23 units of Lantus everyday, so Ill be starting with 23 units of Tresiba per day. I did my last Lantus dose of 10 units at 5 PM yesterday (a little late for me). I did my first dose of Tresiba at 7:30 AM this morning. Ill have some leftover Lantus on board from yesterday evenings dose for a portion of today, but that may be helpful since it takes a few days for Tresiba to take full effect. Im planning to wait to make any dosage changes until after the 3rd day of Tresiba because I want to make sure Im making dosage changes based off of Tresiba at its full effect. Ill post an update either later tonight or tomorrow morning. Depends on whether things get interesting Good luck with your switchover! I really hope Triseba works as well for you as it does for some users here at FUD! For what its worth, EHs (now former) endo prescribed a 1:1 Triseba to replace Tuojeo amount and it was way too much. He was drifting really low all night and it was somewhat concerning. Worked out fine in the end, he dialed it back 20% and that didnt make him crash as badly. I think others have had the exact opposite experience - 1:1 worked fine. So, we will look forward to having another persons experience to learn from! Im planning to wait to make any dosage changes until after the 3rd day of Tresiba because I want to make sure Im making dosage changes based off of Tresiba at its full effect. This is a good plan unless youre running low once your Lantus has worn offif you are, Id adjust ASAP, since its only Continue reading >>
Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Drug UPDATES: TRESIBA ®- insulin degludec injection [Drug information / PDF] Click link for the latest monograph Dosing: Click (+) next to Dosage and Administration section (drug info link) Initial U.S. Approval: 2015 Mechanism of Action: The primary activity of insulin, including TRESIBA, is regulation of glucose metabolism. Insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis. TRESIBA forms multi-hexamers when injected into the subcutaneous tissue resulting in a subcutaneous insulin degludec depot. The protracted time action profile of TRESIBA is predominantly due to delayed absorption of insulin degludec from the subcutaneous tissue to the systemic circulation and to a lesser extent due to binding of insulin-degludec to circulating albumin. INDICATIONS AND USAGE: TRESIBA is indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use TRESIBA is not recommended for the treatment of diabetic ketoacidosis. Dosing: Individualize dose based on type of diabetes, metabolic needs, blood glucose monitoring results and glycemic control goal. Rotate injection sites to reduce the risk of lipodystrophy. Do not dilute or mix with any other insulin or solution. Administer subcutaneously once daily at any time of day. Do NOT perform dose conversion when using the TRESIBA U-100 or U-200 FlexTouch pens. The TRESIBA U-100 and U-200 FlexTouch pens dose window shows the number of insulin units to be delivered and NO conversion is needed. HOW SUPPLIE Continue reading >>
Compare Tresiba Vs. Lantus
Lowers blood sugar. Tresiba (insulin degludec) is a long-acting insulin you use once a day for all-day sugar control. It can cause low blood sugar, so make sure you can recognize the signs & symptoms and always have a source of sugar handy. Injectable insulins are the most effective medicines for controlling your blood sugar. Tresiba (insulin degludec) is a long-acting insulin that can be taken once daily and at any time during the day. The dose can be adjusted according to your needs. Each pen can deliver up to 160 units per injection. The pens are good for up to 8 weeks at room temperature. Insulin is one of the most effective blood sugar-lowering medication and can lower your A1c (average blood sugar over time) by up to 2-3%. Lantus (insulin glargine) is a long-lasting insulin that provides consistent, all-day sugar control with just once or twice daily dosing. Dose can be easily adjusted to make a customized regimen that's tailored to your body's needs. Lantus (insulin glargine) can be used with liver or kidney problems. Not enough review data. 584 reviews so far Have you used Lantus (insulin glargine)? Leave a review Continue reading >>
Long-acting Insulin: How It Works
When you eat, your pancreas releases a hormone called insulin. Insulin moves sugar (glucose) from your blood to your cells for energy or storage. If you take insulin, you may need some at mealtime to help lower your blood sugar after you eat. But even between meals, you need insulin in small amounts to help keep blood sugar stable. This is where long-acting insulin comes in. If you have diabetes, either your pancreas can’t produce enough (or any) insulin, or your cells can’t use it efficiently. To control your blood sugar, you need to replace or supplement the normal function of your pancreas with regular insulin injections. Insulin comes in many types. Each type differs in three ways: onset: how quickly it starts working to lower your blood sugar peak: when its effects on your blood sugar are strongest duration: how long it lowers your blood sugar According to the U.S. Food and Drug Administration (FDA), the five types of insulin are: Rapid-acting insulin: This type starts to work just 15 minutes after you take it. It peaks within 30 to 90 minutes, and its effects last for three to five hours. Short-acting insulin: This type takes about 30 to 60 minutes to become active in your bloodstream. It peaks in two to four hours, and its effects can last for five to eight hours. It is sometimes called regular-acting insulin. Intermediate-acting insulin: The intermediate type takes one to three hours to start working. It peaks in eight hours and works for 12 to 16 hours. Long-acting insulin: This type takes the longest amount of time to start working. The insulin can take up to 4 hours to get into your bloodstream. Pre-mixed: This is a combination of two different types of insulin: one that controls blood sugar at meals and another that controls blood sugar between meals. Lo Continue reading >>
Tresiba (insulin Degludec) Vs. Lantus (insulin Glargine)
www.adverahealth.com Â© 2016 Advera Health Analytics 1 For more information contact us Drug Evidence Review: Â© Copyright. 2016 Advera Health Analytics, Inc. All rights reserved. This material MAY NOT BE REPRODUCED, DISPLAYED, MODIFIED, DISTRIBUTED or LINKED TO without the express prior written permission of the copyright holder. Advera Health Analytics Inc.â€™s research may be cited but not excerpted in its entirety. For permission, contact Sharon Miller Actionable Intelligence: Tresiba (insulin degludec), the FDA- approved long-acting injectable insulin analog, seems to have a similar safety profile to its comparator Lantus (insulin glargine), based on their matching labeled serious adverse events (AEs). In head-to-head clinical trials comparing these two insulin analogs, Tresiba (insulin degludec) was statistically non-inferior to Lantus (insulin glargine) in reducing glycosylated hemoglobin levels, fasting glucose levels & confirmed hypoglycemic episodes, but the rate of nocturnal hypoglycemic events were significantly reduced especially in type 2 diabetes patients treated with Tresiba (insulin degludec). Both the drugs had similar rates of serious AEs through the clinical trials. Based on real-world adverse events reported for Lantus (insulin glargine), our analytics have identified: non-labeled Active RxSignals for serious events such as liver transplant, cerebral thrombosis, and myelitis transverse; an RxScore of 43.88; and an RxCost per prescription of $1.62. Drugs Covered: Tresiba (insulin degludec), Lantus (insulin glargine [rDNA origin] injection) Indications Covered: Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 1 Drug Classes Covered: Insulins and analogues for injection, long- acting MoA Covered: Insulin Receptor Agonists Overview Novo Nordis Continue reading >>
Important Administration Instructions • • Inspect visually for particulate matter and discoloration. Only use TRESIBA if the solution appears clear and colorless. • Train patients on proper use and injection technique before initiating TRESIBA. Training reduces the risk of administration errors such as needle sticks and incomplete dosing. • Inject TRESIBA subcutaneously into the thigh, upper arm, or abdomen. • Rotate injection sites within the same region from one injection to the next to reduce the risk of lipodystrophy [see Adverse Reactions (6.1)]. • DO NOT administer TRESIBA intravenously, intramuscularly or in an insulin infusion pump. • DO NOT dilute or mix TRESIBA with any other insulin products or solutions. • DO NOT transfer TRESIBA from the TRESIBA pen into a syringe for administration [see Warnings and Precautions (5.4)]. General Dosing Instructions • In adults, inject TRESIBA subcutaneously once-daily at any time of day. • In pediatric patients inject TRESIBA subcutaneously once-daily at the same time every day. • Individualize and titrate the dose of TRESIBA based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal. • The recommended days between dose increases is 3 to 4 days. • Dose adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), changes in renal or hepatic function or during acute illness to minimize the risk of hypoglycemia or hyperglycemia [see Warnings and Precautions (5.3)]. • For adult patients, instruct patients who miss a dose of TRESIBA to inject their daily dose during waking hours upon discovering the missed dose. Instruct patients to ensure that at least 8 hours have elapsed betwee Continue reading >>