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Insulin is as vital as water for many individuals with diabetes. Out of the more than 30 million Americans with diabetes, around 7.4 million depend on insulin to manage their condition. Finding the right insulin can be difficult, especially with many options available. Two popular choices are Toujeo and Basaglar. Both are long-acting insulins, but which one is better for you?

In this article, you will learn about the differences between Toujeo and Basaglar, their benefits, potential side effects, and how they compare in terms of effectiveness.

Key Takeaways

  • Toujeo and Basaglar have effectively managed blood sugar levels in patients with type 1 and type 2 diabetes. Clinical studies have shown significant reductions in HbA1c levels, indicating improved blood sugar control over time. Toujeo has been reported to reduce average HbA1c levels from 8.2% to 7.6% over 12 months, while Basaglar has shown comparable reductions in HbA1c levels in clinical trials.
  • Toujeo exhibits a lower incidence of symptomatic hypoglycemia, with a rate of 0.23 events per patient year, indicating a reduced risk of low blood sugar episodes. This makes Toujeo a compelling option for patients seeking stable and effective insulin therapy with a lower risk of hypoglycemia. On the other hand, Basaglar has also demonstrated steady blood sugar control, reducing the risk of blood sugar spikes, albeit with a potential need for supplemental short-acting insulin for meals.
  • Toujeo and Basaglar offer distinct advantages in terms of dosing and administration. Toujeo’s once-daily dosing and longer duration provide flexibility in insulin management, while Basaglar’s steady insulin release and ease of use make it convenient for patients, especially for those who require consistent blood sugar control throughout the day and night.
  • Both medications have a similar safety profile, with common side effects such as injection site reactions and the potential for allergic reactions. However, Toujeo may cause localized cutaneous amyloidosis and lipodystrophy at injection sites, requiring careful management to avoid complications. Conversely, Basaglar cannot be used to treat diabetic ketoacidosis, which limits its use in emergency hyperglycemic conditions.
  • Toujeo and Basaglar are approved for use in adults and children aged 6 years and older with type 1 and 2 diabetes. This broad approval allows for using these medications across a wide age range, making them suitable options for pediatric and adult populations needing long-acting insulin therapy.

Comparing Toujeo vs Basaglar

Toujeo Basaglar
Drug Class Long-acting human insulin analog Long-acting human insulin analog
Prescription Yes, a prescription is required Yes, a prescription is required
Indications Type 1 and Type 2 diabetes Type 1 and Type 2 diabetes
Age approval Approved for adults and children aged 6 years and older Approved for adults and children aged 6 years and older
Common Side Effects Hypoglycemia, weight gain, injection site reactions (such as erythema, edema, pruritus), lipodystrophy Hypoglycemia, allergic reactions, injection site reactions (including lipodystrophy), severe hypoglycemia which can be life-threatening or cause death, and hypersensitivity reactions including anaphylaxis.
Dosage Forms and Strengths Available Available in two prefilled pen forms: Toujeo SoloStar (1.5 mL of 300 units/mL, 450 units total) and Toujeo Max SoloStar (3 mL of 300 units/mL, 900 units total) Injection: 100 units per mL (U-100) in 3 mL prefilled Basaglar KwikPen delivery device.
Onset and Duration Onset: 6 hours, Duration: up to 36 hours Onset: 1-2 hours, Duration: 24 hours
Average US Price Approximately $480 (Toujeo SoloStar), $320 (Toujeo Max SoloStar) Approximately $280 for a 1-month supply (Basaglar KwikPen)
Our Price $150 (Toujeo SoloStar) for 3 pens $115 for 5 pens

What is Toujeo?

Toujeo Insulin Pen

Toujeo is a long-acting insulin used to improve blood sugar control in adults with diabetes mellitus. Toujeo works by mimicking natural insulin. It has a slow, prolonged release that helps maintain stable blood sugar levels over 24 hours. Due to its higher concentration, Toujeo provides a steady insulin release with a smaller injection volume.

Pros Cons
  • Provides steady glucose control, reducing blood sugar spikes.
  • Once daily dosing can be taken at any time, at the same time each day.
  • Compared to other insulins, it has a reduced risk of causing low blood sugar at night.
  • Longer duration provides more flexibility
  • Concentrated dose requires a smaller injection volume
  • It may cause localized cutaneous amyloidosis and lipodystrophy at injection sites.
  • Needs careful management of injection sites to avoid complications.
  • It cannot be diluted or mixed with other insulin or solutions, which may limit flexibility in managing diabetes.
  • Longer onset time may delay initial blood sugar control
  • Higher cost compared to Basaglar

What is Basaglar?

Basaglar Pen

Basaglar is a long-acting insulin used to control blood sugar levels in people with type 1 and type 2 diabetes. It is biosimilar to Lantus (insulin glargine) and helps maintain consistent blood glucose levels over 24 hours. Basaglar is similar to Toujeo by mimicking the body’s natural insulin. It helps glucose enter cells from the bloodstream, thus lowering blood sugar levels. Basaglar provides a steady, prolonged release of insulin to manage blood sugar levels throughout the day and night.

Pros Cons
  • Provides consistent blood sugar control
  • Easy to use, convenient for travel
  • Steady insulin release reduces the risk of blood sugar spikes
  • A more affordable option for long-term management
  • It cannot be used to treat diabetic ketoacidosis, limiting its use in emergency hyperglycemic conditions.
  • Pen devices can be less precise than vials for some users
  • May require supplemental short-acting insulin for meals
  • May not be covered by all insurance plans

Both Basaglar and Toujeo are FDA-approved. Basaglar was approved by the FDA in 2015, while Toujeo was approved in 2015.

Toujeo vs Basaglar: Which Works Better For Diabetes?

Toujeo

Toujeo has proven highly effective in managing type 2 diabetes. A study involving 62 patients reported that after switching from other insulins to Toujeo, average HbA1c levels significantly reduced from 8.2% to 7.6% over 12 months, indicating improved blood sugar control. Additionally, fasting plasma glucose levels were significantly reduced from 9.1 mmol/L to 7.4 mmol/L.

Importantly, the incidence of symptomatic hypoglycemia was low at 9.7%, with a rate of 0.23 events per patient-year, showcasing a lower risk of low blood sugar episodes. For pediatric patients (ages 6-17) with type 1 diabetes, Toujeo was studied for 26 weeks and showed effectiveness similar to what was observed in adults.

These results highlight that Toujeo can effectively manage blood sugar with a reduced risk of hypoglycemia, making it a viable option for patients with type 2 diabetes seeking stable and effective insulin therapy.

Basaglar

Basaglar has been studied extensively and shown to effectively manage diabetes by improving glycemic control in type 1 and type 2 diabetes. Its effectiveness was comparable to other insulin glargine products and NPH insulin in clinical trials. For instance, in a study involving patients with type 1 diabetes, Basaglar showed similar reductions in HbA1c (a measure of blood sugar control over time) as seen with a comparator insulin glargine product. Both groups started with an average HbA1c of around 7.7% to 7.9% and decreased by about 0.35% to 0.46% after 24 weeks of treatment.

In another study involving patients with type 2 diabetes, Basaglar was compared with another insulin glargine product when used alongside oral antidiabetic medications. Both treatments significantly reduced HbA1c from a baseline of about 8%. After 24 weeks, the average HbA1c in both groups decreased by roughly 1.3%, showing non-inferiority to the comparator product.

Moreover, in a large-scale study that included over 12,000 participants, insulin glargine products like Basaglar were used to evaluate their impact on cardiovascular outcomes and diabetes control. In this study, the insulin glargine group maintained stable fasting blood sugar levels and slightly reduced incidents of severe hypoglycemia compared to standard care.

These findings also illustrate that Basaglar is a reliable option for achieving steady and effective blood sugar management in diabetic patients, making it a viable long-acting insulin choice for daily use.

Dosage and Administration of Toujeo vs Basaglar

Toujeo

Toujeo is injected under the skin once daily at the same time each day. You can inject it into your belly, thigh, or upper arm. Changing the injection site within the chosen area each time is important to prevent skin problems such as lumps or thickened skin. Toujeo should not be mixed with other insulins or solutions, and you should not use it in an insulin pump. Initial doses for those new to insulin typically range from one-third to one-half of their total daily insulin needs, with the rest supplemented by short-acting insulin spread throughout the day.

The effect of Toujeo starts to work over several hours, taking up to 6 hours for onset, and may not reach its full glucose-lowering effect for up to 5 days. Before injecting, ensure the insulin is clear and colorless without particles. Each dose should be checked on the pen’s dose counter, and adjustments may be necessary based on your blood sugar monitoring, diabetes type, meal timing, and physical activity.

Basaglar

Basaglar is administered through a subcutaneous injection, which is injected under the skin. Patients are advised to inject Basaglar once daily, at the same time each day, to maintain consistent blood sugar control. The specific starting dose for type 1 diabetes is typically around one-third of the patient’s total daily insulin requirement, with the remainder provided by mealtime insulin.

For adults with type 1 diabetes, the recommended starting dosage is about one-third of their total daily insulin needs, with additional mealtime insulin to cover the rest of the day’s requirements. For those with type 2 diabetes, the starting dose is generally 0.2 units per kilogram of body weight or up to 10 units once daily, which may need to be adjusted depending on the individual’s response and other medications they might be taking.

After injection, Basaglar works slowly over 24 hours without a pronounced peak, steadily releasing insulin throughout the day and night to help manage blood glucose levels continuously.

Switching to Basaglar from another long-acting insulin may require adjusting the dosage. For example, if switching from NPH insulin (usually taken twice daily), the starting dose of Basaglar should be 80% of the total NPH dosage to reduce the risk of low blood sugar. It’s crucial not to mix Basaglar with other insulins or dilute it, and the injection site should be rotated with each dose to prevent skin problems like thickening or pits. Always inspect the insulin in the KwikPen to ensure it is clear and colorless before injecting.

Side Effects of Toujeo vs Basaglar

Toujeo

The side effects associated with Toujeo include:

  • Hypoglycemia (low blood sugar): Symptoms may include dizziness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood changes, and hunger.
  • Allergic reactions: This can range from mild skin rashes to severe reactions like anaphylaxis. Signs include swelling of the face, tongue, or throat, trouble breathing, and a fast heartbeat.
  • Injection site reactions: This may include pain, redness, itching, swelling, and irritation at the injection site.
  • Lipodystrophy: Changes in the skin at the injection site, like thickening or pitting of the skin.
  • Weight gain: This is a common effect when controlling blood sugar with insulin.
  • Localized cutaneous amyloidosis: Lumps in the skin occur at the injection sites due to continuous use of the same injection site.
  • Hypokalemia (low potassium levels): This can lead to respiratory problems, irregular heartbeat, and potentially fatal cardiac issues.

Basaglar

The side effects associated with Basaglar, include:

  • Hypoglycemia: Low blood sugar is the most common adverse reaction. Symptoms can include dizziness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood changes, and hunger.
  • Allergic Reactions: These can range from mild skin reactions at the injection site (such as redness, swelling, and itching) to severe, life-threatening reactions like anaphylaxis, which may include difficulty breathing, rapid swelling of the face, tongue, or throat, and a fast heartbeat.
  • Lipodystrophy: Repeated insulin injections at the same site can cause fatty tissue under the skin to thicken or shrink, affecting insulin absorption.
  • Weight Gain: Weight gain is a possible side effect and can occur due to the anabolic effects of insulin and the decrease in glucosuria (glucose in the urine).
  • Peripheral Edema: Fluid retention and swelling, particularly if poor metabolic control is improved rapidly with intensified insulin therapy.
  • Hypokalemia: A potentially serious decrease in potassium in the blood that could lead to muscle cramps, weakness, or cardiac irregularities.
  • Injection Site Reactions: Patients may experience reactions like pain, redness, itching, hives, swelling, or inflammation.
  • Immunogenicity: As with all therapeutic proteins, there is a potential for an immune response. Some patients may develop antibodies to insulin glargine.
  • Heart Failure: When used with thiazolidinediones (TZDs), insulin can cause dose-related fluid retention, which may exacerbate or lead to heart failure.

Can you Switch Toujeo to Basaglar?

Yes, you can switch from Toujeo to Basaglar. When making this change, the initial dose of Basaglar should be 80% of your current Toujeo dose. For example, if you take 50 units of Toujeo daily, you would start Basaglar at 40 units once daily. This adjustment is based on the different concentrations of the insulin formulations in Toujeo and Basaglar. When switching your doctor will need to write a new prescription. Pharmacists cannot automatically substitute one for the other without their approval.

Toujeo vs Basaglar Cost

Strength Quantity US Price BCI Price SAVINGS
Toujeo(Solo Star Pen) 300U/ml 3 pens $481 $150 $331
5 pens $721 $200 $521
Basaglar (kwikpen) 100U/ml 5 pens $339 $115 $224
10 pens $741 $220 $521
15 pens $1,235 $315 $920
20 pens $2,170 $400 $1,770

Customers can enjoy additional savings with our 10% discount on first orders of Toujeo or Basaglar using the coupon code FIRST10.

Final Thoughts

Choosing between Toujeo and Basaglar depends on your specific needs and preferences. Toujeo offers a longer duration and lower risk of hypoglycemia, making it suitable for those seeking stable blood sugar control with once-daily dosing. Basaglar, on the other hand, provides consistent glucose management and is often more affordable. Both insulins are effective for managing diabetes, but your choice should consider factors like dosing flexibility, side effects, and cost. Always monitor your blood sugar levels and adjust your insulin as needed to find the best fit for your diabetes management.

Frequently Asked Questions

No, Toujeo and Basaglar are not the same. Toujeo is a long-acting insulin glargine with a concentration of 300 units/mL, while Basaglar is also an insulin glargine but with a concentration of 100 units/mL. They are used for different dosing strategies and may affect blood sugar control differently.

Lantus (insulin glargine) is equivalent to Basaglar. Both are long-acting insulins with the same active ingredient (insulin glargine) and similar pharmacokinetic profiles.

Lantus (insulin glargine) is also considered equivalent to Toujeo in terms of the active ingredient. However, Toujeo is more concentrated (300 units/mL) than Lantus (100 units/mL), affecting dosing and absorption.

Toujeo and Basaglar are different forms of insulin glargine, and whether one is better depends on individual needs. Toujeo, being more concentrated, may provide more stable blood sugar levels and longer-lasting effects for some patients. Basaglar, with its standard concentration, is often preferred for its predictability and ease of dosing.

Lantus (insulin glargine) is a good alternative to Toujeo. Both contain insulin glargine but differ in concentration. A long-acting insulin alternative could be Levemir (insulin detemir).

Lantus (insulin glargine) is a direct alternative to Basaglar as they share the same active ingredient. Levemir (insulin detemir) and Tresiba (insulin degludec) are also alternatives to long-acting insulins.

The initial dose of Toujeo is usually individualized based on the patient’s previous insulin regimen, blood sugar levels, and other factors. A typical starting dose for patients without previously used insulin might be around 0.2-0.4 units per kilogram of body weight per day, but this can vary widely.

Toujeo is typically taken once daily, at the same time. However, it can be taken at any time convenient for the patient as long as it is consistent daily. Some patients may take it in the morning, while others prefer the evening.

Taking too much Toujeo can lead to hypoglycemia (low blood sugar). Symptoms of hypoglycemia include shakiness, sweating, confusion, dizziness, and, in severe cases, loss of consciousness. If you suspect an overdose, seek medical attention immediately.

The dosage of Basaglar is individualized based on the patient’s blood sugar levels, previous insulin use, and other factors. An initial dose might be around 0.2-0.4 units per kilogram of body weight per day and up to a maximum starting dosage of 10 units per day, but this can vary. It’s essential to follow the dosing instructions provided specifically for you.

Basaglar and Toujeo both contain insulin glargine but differ in concentration. Basaglar has a concentration of 100 units/mL and is usually administered once daily. Toujeo has a concentration of 300 units/mL and is also administered once daily, but provides a longer duration of action and may require fewer adjustments.

Yes, Basaglar can be taken twice a day in some cases. Although it is typically administered once daily, some people may require a split dose to maintain better blood sugar control. This adjustment is based on individual needs and should be determined based on your unique circumstances and blood sugar monitoring results.

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Sources

Wiesli, P., & Schories, M. (2018). Improved Glycemic Control with Insulin Glargine 300 U/mL (Toujeo®) in Patients with Type 2 Diabetes: Real-World Effectiveness in Switzerland. Diabetes Ther, 9(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250621/

Sanofi-aventis U.S. LLC. (2019). TOUJEO (insulin glargine injection) U-300: Highlights of prescribing information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/206538s012lbl.pdf

Center for Drug Evaluation and Research. (2015). Highlights of Prescribing Information: BASAGLAR (insulin glargine injection) U.S. Food and Drug Administration. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/205692lbl.pdf

Eli Lilly and Company. (2021). Basaglar® (insulin glargine) injection: How are patients transitioned from another basal insulin to Basaglar® (insulin glargine)? Retrieved from https://medical.lilly.com/us/products/answers/how-are-patients-transitioned-from-another-basal-insulin-to-basaglar-insulin-glargine-56265