About

This information provides clinical context for the Toujeo Dose Calculator. The tool is designed for healthcare professionals to determine the recommended starting dose of Toujeo® (insulin glargine U-300 injection) based on specific patient scenarios, consistent with prescribing guidelines. It is intended for educational purposes and should not replace clinical judgment.

Outputs

The calculator provides a recommended starting dose of Toujeo administered once daily. The output is based on the selected patient profile:

• Insulin-Naïve (Type 2 Diabetes): Calculates a weight-based dose of 0.2 units/kg.
• Switching from Once-Daily Basal Insulin: Recommends a 1:1 unit conversion from the patient’s previous total daily basal dose.
• Switching from Twice-Daily NPH Insulin: Recommends an 80% dose conversion (a 20% reduction) from the patient’s total daily NPH dose to minimize hypoglycemia risk.
• Patients with Type 1 Diabetes: Provides guideline information instead of a specific dose, as this calculation requires individualized clinical assessment of the total daily insulin dose (TDD).

How to Use

To use the calculator, follow these steps:

1. Select Patient Scenario: Choose between “Insulin-Naïve (Type 2),” “Switching Basal Insulin,” or “Patient with Type 1 Diabetes.”
2. Enter Patient Data:
   • For the Naïve scenario, input the patient’s weight and select the unit (kg or lbs).
   • For the Switching scenario, select the type of previous insulin (once-daily long-acting or twice-daily NPH) and enter the total daily dose in units.
   • The Type 1 Diabetes scenario requires no data input.
3. Calculate Dose: Click the “Calculate” button to view the recommended starting dose and accompanying clinical notes. The “Reset” button clears all inputs.

Dosing Overview

Toujeo is a long-acting human insulin analog indicated to improve glycemic control in adults and pediatric patients (6 years and older) with diabetes mellitus. It should be administered subcutaneously once a day at any time of day, but at the same time every day.

The dose provided by this tool is a starting dose only. Individual dosage must be personalized and titrated based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goals. Never share Toujeo pens between patients, even if the needle is changed.

Switching

When switching a patient to Toujeo, the following recommendations apply:

• From other once-daily long-acting insulins (e.g., insulin glargine 100 units/mL, insulin detemir): The recommended starting dose of Toujeo is the same as the previous once-daily basal dose (1:1 conversion).
• From twice-daily NPH insulin: The recommended starting dose of Toujeo is 80% of the previous total daily NPH dose. This reduction helps to lower the risk of hypoglycemia during the transition period.

Close glucose monitoring is recommended during the transition and in the initial weeks thereafter.

Missed Dose

If a dose of Toujeo is missed, patients should be instructed to take it as soon as they remember. If it is almost time for the next scheduled dose, they should skip the missed dose and resume their regular dosing schedule. Patients should be advised not to take two doses at once to make up for a missed dose. Blood glucose should be monitored more frequently until the next scheduled dose.

Safety Alerts

Hypoglycemia: The most common adverse reaction associated with all insulins, including Toujeo, is hypoglycemia. It can be caused by excessive insulin administration, increased glucose utilization, or insufficient caloric intake. Severe hypoglycemia can be life-threatening.

Medication Errors: Toujeo contains 300 units/mL of insulin glargine. Accidental mix-ups between insulin products can occur. Instruct patients to always check the insulin label before each injection to avoid errors between Toujeo and other insulins.

This tool is not a substitute for the Full Prescribing Information. Healthcare professionals should exercise independent medical judgment and consult the official product labeling for complete safety information.

FAQ

1. Why does the calculator use 0.2 units/kg for insulin-naïve patients?
   This is a standard, conservative starting dose recommended in clinical guidelines for initiating basal insulin in patients with type 2 diabetes to balance efficacy with the risk of hypoglycemia.
2. How does the tool handle weight in pounds (lbs) vs. kilograms (kg)?
   The tool automatically converts pounds to kilograms using the conversion factor of 1 kg ≈ 2.20462 lbs before applying the dosing formula.
3. Why is the dose reduced by 20% when switching from NPH insulin?
   This precautionary reduction is recommended because NPH has a different pharmacokinetic profile. The 80% conversion helps mitigate the risk of hypoglycemia when transitioning to the more consistent and prolonged action of Toujeo.
4. Why doesn’t the calculator provide a specific dose for Type 1 Diabetes?
   Dosing for patients with type 1 diabetes is highly individualized. The starting basal dose depends on the patient’s total daily insulin dose (TDD), which includes both basal and mealtime (prandial) insulin. This complex calculation requires clinical judgment beyond the scope of this automated tool.
5. Is the calculated result the final dose my patient should take?
   No. The result is a recommended starting dose. The final maintenance dose must be determined through careful titration based on regular blood glucose monitoring and the patient’s individual glycemic targets.
6. Can I use this calculator for Lantus or other basal insulins?
   No. This tool is specifically designed for Toujeo (insulin glargine U-300) and its unique dosing recommendations. Do not use it for other insulin products.
7. What is the difference between Toujeo and Lantus?
   Both are insulin glargine, but Toujeo is a more concentrated formulation (U-300, 300 units/mL) compared to Lantus (U-100, 100 units/mL), resulting in a different pharmacokinetic and pharmacodynamic profile.
8. Does the tool round the final dose?
   Yes, the code uses standard rounding to provide a whole number for the final dose in units, as insulin pens deliver full-unit increments.

References

• Toujeo (insulin glargine) injection Prescribing Information. U.S. Food and Drug Administration.
• Toujeo HCP Official Website – Dosing & Administration. Sanofi.
• American Diabetes Association. Standards of Care in Diabetes. Diabetes Care.
• Riddle MC, et al. New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using basal insulin and oral antihyperglycaemic drugs: the EDITION 2 randomized 12-month trial, including 6-month extension. Diabetes Obes Metab. 2015.