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I'm currently taking a long-acting insulin called Triceba. But I recently changed my health insurance, and the new insurance doesn't cover Triceba, it only covers another long-acting insulin called Toujeo.

My question is, what are the differences between Triceba and Toujeo? Do they have significant differences in effectiveness, side-effects, and ease of use?

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Triceba is actually Tresiba. It is a very long-acting basal insulin, that you take once a day. It is probably the best basal insulin today for people who do not have fast-changing basal needs like athletes: very insensitive to when you are taking it.

Toujeo is a 3x concentrated version of insulin glargine -- i.e. 3x Lantus. It acts roughly like Lantus, but its increased concentration gives it slightly different properties in terms of timing. The most interesting aspect of Toujeo is that it does not appear to wane "too early" as Lantus often does with many users (Lantus can wane sometimes in as little as 18 or 20 hours for some individuals). This research paper shows more sustaining power for Toujeo vs Lantus.

Both Tresiba and Toujeo are modern insulins that are superior in some ways to the old ones. One can be better than the other depending upon your need:

  • if you need A LOT of insulin, then Toujeo is superior to Tresiba, because of its concentration.
  • if you have a significant waning problem with basal insulins, Toujeo would probably be better than any except Tresiba. Tresiba is the ultimate duration-optimized insulin.

If you have a waning problem with Toujeo (rare but not impossible), approach your doctor and ask him for a letter of medical necessity, to explain to your insurance that the only insulin you can use really is Tresiba. But there is a good chance that Toujeo may actually work well for you, and even be the superior insulin if you are somewhat insulin-resistant. Good luck!

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