Toujeo vs Metformin

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Introduction

For patients with Type 1 or Type 2 diabetes, certain drugs that regulate the levels of glucose in the blood can assist in maintaining balanced blood sugar and managing symptoms. Toujeo and Metformin are two such drugs typically prescribed for diabetes management. They each have different methods of action but both help to control high blood sugar levels in diabetic individuals. Toujeo is a long-acting insulin, which helps to lower the level of glucose in the blood by signaling cells to absorb more glucose. On the other hand, Metformin belongs to a class of medications called biguanides; it works by decreasing liver-produced glucose and increasing cell sensitivity towards insulin, thereby promoting better absorption of glucose.

What is Toujeo?

Insulin Glargine (the generic name for Toujeo) is a long-acting insulin analog that was approved by the FDA in 2015. It helps control high blood sugar levels in adults and children who are 6 years of age and older with diabetes mellitus. Toujeo works by replacing the insulin that is normally produced by the body and stopping the liver from producing more sugar than it needs to, effectively stabilizing glucose levels within the bloodstream for up to 24 hours after administration.

On the other hand, Metformin, first approved by the FDA in 1994, belongs to a class of drugs called biguanides. It's used primarily as an oral antidiabetic drug for people suffering from type 2 diabetes — especially overweight individuals. Metformin lowers blood sugar levels by improving your body’s sensitivity towards insulin, which improves its ability to transport glucose into cells where it can be used as energy. Unlike many other antidiabetic medications, metformin doesn't lead to weight gain or hypoglycemia if taken alone.

The choice between these two medications depends on individual health conditions and advice from healthcare providers.

What conditions is Toujeo approved to treat?

Toujeo is approved for the treatment of both type 1 and type 2 diabetes:

Type 1 diabetes, where it's used in combination with short-acting insulin
Type 2 diabetes, where it can be used alone or together with other glucose-lowering medications including metformin.

Metformin on the other hand, is only indicated for use in:

Type 2 Diabetes: It is utilized as a first-line medication to improve blood sugar control in adults and children over ten years.
Prediabetes: To prevent progression to type II diabetes in high-risk individuals.

How does Toujeo help with these illnesses?

Toujeo helps to manage type 1 and type 2 diabetes by mimicking the role of insulin, a hormone that regulates blood sugar levels. It does this by prompting cells to absorb glucose from the bloodstream, thus lowering high blood sugar levels over time. As a long-acting insulin analog, Toujeo has been modified slightly from human insulin in order to prolong its duration of action up to 24 hours or more. Glucose is a simple sugar that your body likes for energy, but too much in your blood can cause serious health problems.

On the other hand, Metformin works differently: it reduces glucose production by the liver and enhances sensitivity towards insulin. Therefore, it can limit negative effects of uncontrolled diabetes such as hyperglycemia (high blood sugar) and help patients manage their condition better with fewer side effects than some other medications used for diabetes.

What is Metformin?

Metformin, sold under the brand name Glucophage among others, is a first-line medication in the treatment of type 2 diabetes. Metformin works by reducing glucose production in your liver and improving your body’s sensitivity to insulin so that your body uses insulin more effectively. It was initially approved by the FDA in 1994. As metformin is not an insulin product, it does not have hyperglycemia as a side effect. Its lack of action on blood sugar levels means its side-effect profile is also different from that of drugs such as Toujeo which can cause low blood sugar (hypoglycemia). Common side effects include diarrhea, nausea and abdominal pain. However, these are most common during initiation and may lessen over time. The benefits on blood sugar control can be long-lasting making Metformin beneficial for those with type 2 diabetes especially those who do not respond well to other medications such as Toujeo.

What conditions is Metformin approved to treat?

Metformin is approved for the management of:

Type 2 diabetes mellitus
Prediabetes In addition to its primary use, Metformin also has evidence supporting its effectiveness in managing conditions like polycystic ovary syndrome (PCOS). It's often used as a first-line treatment due to its proven track record and safety profile.

How does Metformin help with these illnesses?

Metformin is a commonly prescribed medication that functions as an effective treatment for type 2 diabetes. This oral drug works by reducing the amount of glucose your liver produces and improving your body's sensitivity to insulin, thus helping control blood sugar levels more effectively. Its role in the management of blood glucose levels is significant, unlike its counterpart Toujeo, which is a long-acting insulin used primarily when other methods of controlling blood sugar have proven ineffective or insufficient. As with norepinephrine's function in depression management, metformin plays a central role in managing high blood sugar conditions. Since it does not lead to weight gain and may even cause modest weight loss, Metformin is often chosen over other anti-diabetic medications when patients are overweight or obese. Furthermore, it can be combined with other anti-diabetic drugs including insulin if needed.

How effective are both Toujeo and Metformin?

Both insulin glargine (Toujeo) and metformin have established histories of success in treating patients with diabetes, and they act on different aspects of the disease, hence may be prescribed under different circumstances. Insulin glargine primarily acts by providing a steady level of basal insulin to control blood glucose levels throughout the day whereas metformin reduces glucose production by the liver and improves insulin sensitivity.

The effectiveness of Toujeo and metformin in controlling glycemia has been studied extensively both individually as well as combined therapy. Both drugs exhibit robust efficacy in managing symptoms of hyperglycemia with good safety profiles. However, none of the various parameters used to measure efficacy differed significantly between patients receiving either drug alone or those receiving a combination.

A 2017 review demonstrated that starting on metformin treatment early can help manage blood sugar levels effectively from an early stage and its side effect profile is generally favorable over other oral hypoglycemic agents. Metformin is also considered safe for use even among elderly populations.

Research conducted until 2020 indicates that Toujeo seems to be more effective than traditional once-daily basal insulins at reducing HbA1C levels without increasing risk for hypoglycemia; it provides better glycemic control compared to first-generation basal insulins such as Lantus (another form of insulin glargine). Despite this, Toujeo is typically added only if oral antidiabetic drugs fail to provide adequate control or when there's a specific need such as pregnancy where tight glycemic control becomes paramount.

abstract image of a researcher studying a bottle of drug.

At what dose is Toujeo typically prescribed?

Dosages of Toujeo, a long-acting insulin used in treating type 1 and type 2 diabetes, are individualized based on the patient's needs. It is typically started at one-third to one-half of the total daily insulin dose. The remaining two-thirds or half of the patient's daily insulin requirements should be administered in divided doses as a short-acting premeal insulin. For Metformin, which helps control high blood sugar and is used for people with type 2 diabetes, the usual starting dose is 500 mg twice a day or 850 mg once a day. Dosage can gradually increase every week if needed until blood sugar levels are controlled. The maximum dosage should not exceed 2000 mg per day for adults.

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At what dose is Metformin typically prescribed?

Metformin therapy usually begins with a dosage of 500 mg taken once or twice daily, with meals. Depending on glycemic control and tolerance, the dose can be gradually increased to 1000-2000 mg/day divided into two doses, spaced approximately 12 hours apart. A maximum dose is typically up to 2550 mg/day for adults, divided into three doses and taken with meals throughout the day. If there is no sufficient response after several weeks of treatment at this level, additional strategies may need to be considered in consultation with your healthcare provider.

What are the most common side effects for Toujeo?

Some of the most common side effects of Toujeo and Metformin include:

Hypoglycemia (low blood sugar)
Weight gain
Allergic reactions, such as rash or itching
Injection site reactions (redness, swelling, and itching at the spot where you injected Toujeo)
Upper respiratory tract infection
Diarrhea
Nausea or vomiting
Gas
Weakness
Indigestion For Metformin specifically:
Decreased vitamin B12 levels in the body might occur.

It's important to remember that not everyone will experience these side effects and they may vary from person to person based on a variety of factors including dosage, overall health status, and other medications being taken concurrently.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Toujeo?

While both Toujeo and Metformin are effective in managing blood sugar levels, they can cause potential side effects. For Toujeo, these may include:

Allergic reactions such as itching or rash, swelling of the face, lips or tongue
Breathing difficulties
Rapid heartbeat and sweating which might indicate low blood sugar (hypoglycemia)
Sudden weight gain with no clear reason
Swelling in your hands or feet

For Metformin:

Lactic acidosis symptoms: unusual muscle pain; feeling cold; trouble breathing; feeling dizzy, light-headed, tired or very weak.
Hypoglycemic episodes if combined with other diabetic medications
Digestive problems like nausea, vomiting, upset stomach leading to loss of appetite
A metallic taste on your mouth

It's important to note that many people take these medications without major issues. However if you do experience any concerning symptoms while taking either medication seek medical attention promptly.

What are the most common side effects for Metformin?

Metformin, a common medication used for managing type 2 diabetes, can have several side effects. These may include:

Digestive problems such as nausea, vomiting, stomach pain and loss of appetite. It is also known to cause diarrhea more often than constipation.
A metallic taste in the mouth leading to a decrease in appetite.
Weakness or fatigue due to the regulation of blood sugar levels.
Headaches and dizziness are quite common too.
In rare cases, metformin could lead to lactic acidosis which presents with symptoms like muscle pain and difficulty breathing.
Some people report sleep issues when on this drug but it's not very common.

It should be noted that these side effects usually subside over time as your body gets accustomed to the medication. However, if any of them persist or worsen you should contact your healthcare provider immediately.

Are there any potential serious side effects for Metformin?

While Metformin is generally well-tolerated, there are some severe side effects that should prompt immediate medical attention. These may include:

An allergic reaction: Symptoms can range from skin rash, itching or hives to difficulty breathing, swelling of the face or throat
Lactic acidosis: This is a serious metabolic complication that can cause symptoms such as feeling very weak or tired; unusual muscle pain; trouble breathing; stomach pain with nausea and vomiting; slow irregular heartbeat
Hypoglycemia (low blood sugar): Signs of hypoglycemia include confusion, dizziness, feeling shaky, hungry or irritable.
Changes in vision
Unusual changes in mood or behavior

If you experience any of these symptoms while taking Metformin, seek medical help right away. It's important to remember that most people using this medication do not have serious side effects.

Contraindications for Toujeo and Metformin?

Both Toujeo and Metformin, along with most other diabetes medications, may cause hypo- or hyperglycaemia in some people. If you notice your blood sugar levels fluctuating significantly or experience symptoms of these conditions (like excessive thirst/hunger, frequent urination, fatigue), please seek immediate medical attention.

Neither Toujeo nor Metformin should be taken if you are experiencing diabetic ketoacidosis. Always inform your healthcare provider about all the medications you're taking; certain drugs like corticosteroids, diuretics and thyroid products can affect how well insulin works and it's important to adjust doses accordingly.

Toujeo is a long-acting insulin that shouldn't be mixed with any other insulins before injection while Metformin isn't suitable for patients with kidney disease without proper dose adjustment and monitoring by a doctor due to the risk of lactic acidosis. This highlights the need for tailored medical advice when choosing between different treatments for diabetes.

How much do Toujeo and Metformin cost?

In terms of brand name versions:

The price for a 3ml pen (300 units) of Toujeo insulin averages around $140 - $170, which works out to about $4.67-$5.67/day based on the average daily dose of 30 units.
The price for a one-month supply (30 tablets) of Glucophage XR, Metformin's brand-name version, varies between $60 and $120 or approximately $2-$4 per day.

Therefore if you're using an average dosage range for Toujeo (i.e., around 30 units/day), then the brand-name Glucophage XR is less expensive on a per-day treatment basis. However, cost should not be your primary consideration when determining which drug is right for you.

Considering generic versions:

Generic metformin costs significantly less than its branded counterpart — typically in the range of $10 to $20 for a month’s supply depending on the pharmacy.

Toujeo does not currently have a generic alternative available in the market as it's relatively new compared to Metformin. This further contributes to its higher cost compared to metformin.

Popularity of Toujeo and Metformin

Insulin glargine, in generic form as well as brand names such as Toujeo, was estimated to have been prescribed to about 1.2 million people in the US in 2020. Insulin glargine accounted for just over 15% of long-acting insulin prescriptions in the US. It appears to be a popular choice among other "long-acting" insulins due its once-daily dosing schedule and fewer hypoglycemic events compared to traditional insulins.

Metformin, on the other hand, is one of the most commonly prescribed medications worldwide with approximately 80 million prescriptions filled annually across all dosage forms and strengths in America alone. In fact, metformin accounts for nearly half of all diabetes medication prescriptions within the United States due to its effectiveness and low cost. The prevalence of metformin use has remained steady over recent years given its established role as first-line therapy for type 2 diabetes.

Conclusion

Both Toujeo (insulin glargine) and Metformin have a long-standing record of usage in patients with type 2 diabetes, and are backed by numerous clinical studies indicating that they are more effective than placebo treatments. In many cases, the drugs may be combined to provide better glucose control for patients. Due to their different mechanisms of action, with Metformin reducing hepatic glucose production and improving insulin sensitivity while Toujeo provides continuous steady-state levels of basal insulin over 24 hours, they tend to be prescribed under different circumstances. Metformin is considered a first-line treatment option due its effectiveness and safety profile whereas Toujeo is generally used as an addition or alternative when oral medications such as metformin fail to adequately control blood sugar levels.

Metformin is available in generic form offering cost savings especially for patients who must pay out of pocket whereas there's no generic version available yet for Toujeo which can make it considerably more expensive.

The side effect profiles differ between the two drugs: common side effects for metformin include gastrointestinal symptoms like diarrhea and nausea while Toujeo's most common side effect is hypoglycemia (low blood sugar). For both drugs, patients should closely monitor their blood sugar levels especially when starting treatment or changing doses.