Dr. Ahmed Toujeo and Lantus are two well-known formulations of insulin glargine. They are both formulated to provide a stable basal insulin supply for 24 hours to help patients control their blood sugar levels.
Though they are similar, formulation, efficacy, and safety here will compare Toujeo and Lantus, including their characteristics, effectiveness, and practical considerations.
What are Toujeo and Lantus Insulin?
Lantus Insulin (Glargine U-100):
Lantus (insulin glargine U-100) is a first-generation long-acting insulin launched in 2000. Many patients have since used it to maintain basal insulin levels during the day for diabetes type 1 or 2.
Lantus acts by forming micro-precipitates at the injection site, slowly releasing insulin over 24 hours, which ensures constant blood sugar control through one injection daily in most cases. Key characteristics of Lantus include:
- Formulation: Insulin glargine 100 units/mL
- Onset: It starts acting after 1–2 hours of injection
- Duration: Acts for up to 24 hours with minimal peak and steady glucose control
Toujeo Insulin (Glargine U-300):
Toujeo is one of the recent formulations of insulin glargine, which hit the market in 2015. It contains 300 units/mL instead of 100 units/mL in a concentrated form similar to Lantus.
Since it has more concentration, injection volumes are smaller, and the release is prolonged in the body system.
Toujeo is branded as providing a steadier supply of blood glucose control, which is significantly better for those with higher insulin doses. Key characteristics include:
- Formulation: Insulin glargine 300 units/mL.
- Onset: Starts working within about 6 hours.
- Duration: Provides more than 24 hours of coverage, with some patients extending into 36 hours.
Toujeo vs. Lantus – Blood Glucose Control
Although both insulins are effective in achieving long-term glucose control, each has its unique benefit based on a specific profile of the patient.
Both have similar efficacy in hbA1c reduction. However, doses might vary to achieve the desired glycemic control. According to one meta-analysis, Toujeo and Lantus showed similar glucose control, but patients with Toujeo required higher doses to reach glycemic targets as compared to Lantus. [Ref]
A similar study demonstrated that the formulation of Toujeo allows for less fluctuation in blood sugars, notably at night, when the risk for hypoglycemia occurs. Lantus is a stable drug at other times, but in some patients, it sometimes causes minor peak effects that elevate variability. [Ref]
The efficiency of Toujeo may be greater for those who require higher insulin doses due to its highly concentrated formulation, which allows for lower injection volumes and thus may better absorb and minimize discomfort. However, for a patient with smaller insulin requirements, Lantus may be more than enough.
Moreover, each patient responds differently due to factors including age, weight, insulin sensitivity, and concurrent health conditions. While some do well on Lantus, others do best on Toujeo’s more prolonged action.
Safety and Side Effects of Insulin Toujeo Vs Lantus Insulin:
Toujeo and Lantus share a common safety profile. However, it has some relevant differences in the incidence of adverse effects and complications:
Hypoglycemia Risk:
Toujeo is a bit less likely to cause hypoglycemia, especially at night. This is because it slowly releases insulin and has a lower peak activity than Lantus. So, for people who suffer from nocturnal hypoglycemia, Toujeo might be a better choice.
Injection Site Reactions:
Both insulins can cause mild irritation, redness, or swelling at the injection site. These reactions are usually temporary and resolve without medical intervention.
Weight Gain:
The most common side effect of insulin therapy is weight gain. Both Lantus and Toujeo cause weight gain, though it varies from person to person, depending on diet and level of activity.
Serious Side Effects:
Hypersensitivity reactions or severe hypoglycemia can occur in very rare cases. The risk of these side effects can be reduced with proper monitoring and follow-up by a healthcare provider.
Ease of Use and Practical Considerations
Convenience is an essential factor in adherence to treatment, and both Toujeo and Lantus have been designed with user-friendly features.
Injection Devices:
Both can be given with a pre-filled SoloStar pen, which makes dosing easy and very accurate. The pen is for high-dose users, who require bigger doses to be dispensed at one time, resulting in fewer injections.
Frequency of Injections:
Both insulins are administered once daily. Some patients may, however, split their Lantus dose into two injections, when necessary, although this is less common with Toujeo, as it lasts longer.
Storage and Handling:
Both insulins must be refrigerated before use but can be kept at room temperature for up to 28 days after opening. The Toujeo pens are smaller because of their concentrated formulation, which some users find more convenient.
Read: Lantus Vs Levemir: Insulin Glargine Vs Insulin Detemir
Cost Comparison
Toujeo is also more costly than Lantus when compared per unit, but its strength makes the net cost null for patients requiring large doses.
| Feature | Toujeo | Lantus |
| Composition | Insulin glargine U-300 | Insulin glargine U-100 |
| Concentration | 300 units/mL | 100 units/mL |
| Onset of Action | ~6 hours | 1–2 hours |
| Duration | >24 hours (up to 36 hours) | Up to 24 hours |
| Risk of Hypoglycemia | Lower, especially at night | Slightly higher, particularly at night |
| Dosing Frequency | Typically, once daily | Typically, once daily (may require splitting for some) |
| Injection Volume | Smaller due to higher concentration | Larger due to lower concentration |
| Storage Requirements | Room temperature after opening (28 days) | Room temperature after opening (28 days) |
| Price | Typically, more expensive per unit | Generally, less expensive per unit |
| Patient Suitability | Ideal for those needing higher doses or with variable schedules | Suitable for those needing predictable, stable insulin levels |
Conclusion
Toujeo and Lantus are two very effective diabetes drugs, but each has different features that may make one more appropriate than the other for specific individuals.
Although Lantus is a tried-and-true choice, Toujeo’s advanced formulation offers some unique benefits to patients who need more flexibility or higher doses.
