Basal Switching: Insulatard to Toujeo

I switched from Insulatard (an intermediate insulin) to Toujeo recently.

This was after having been on Lantus and being taken off (site reaction) and then Levamir (was like injecting water). I've been on Insulatard for the last two years. I have had a tolerable relationship with it. It was just barely doing its one job. It was time for a change.

Night 1:

Toujeo suggests an 80% reduction of the total daily for your intermediate/NPH insulin. So I went from 14u to 11u.

Unfortunately, Toujeo takes about five days to get fully entrenched and Insulatard is all 'fuck all y'all, I'm out' after about 10-12h. So my night was fun.

Once the Toujeo kicked in, it wasn't too bad, and I'm hoping it has a positive effect on my dawn phenomenon/foot on floor issues. I still woke up north of 350 mg/dl (19.5 mmol/l).

Day 1:

The weirdest sensation to wake up to so far as a person with Type 1 is having dry mouth, eyes that feel like they were rolled around in the desert and reinserted, a powerful need to wee... and being sticky because it's humid out. I'm not sure how there can be so much difference between internal and external but there we are.

Day 2:

I am forever in the Sahara. The wind never abates. I have always been thirsty, I will always be thirsty.

Day 3:

There's two days left of titration. I suspect the dosage is low. While the smart thing would be to wait until the full titration period is over, I am renowned for my impatience. Upping by 1u tonight.

Day 4:

Better, but not perfect. We've downgraded from the Sahara to southern Portugal in the dry season. It's an improvement.

Day 5:

WHY IS THIS NOT PERFECT YET?
I am blaming my frustration and desire to cry on high BGLs over the last five days. I just want to feel normal, thanks.

Day 6:

One more unit increase. Debated on jumping 2 units, but using the rule of 'no more than 10% of basal increase at a time', I'm trying to be good. Especially in light of Day 3's impatience.

Day 7:

Fuck this. Another unit up. Waking over 300 (16.6) is not what I signed up for with this new basal, thanks.

Day 8:

Did I... Did I just wake up in the low 300s? Okay, it was 311 mg/dl (17.2 mmol/l), but I'm going to take it as a good sign. Another unit up tonight. Yes, I know, I should be more patient, but waiting three days between increases means that I'd be at this for weeks to get sorted. I just can't.

Day 9:

Woke up at 249 mg/dl (13.8 mmol/l). Not perfect, but pretty close to my normal thanks to Dawn Phenomenon. One more unit, for luck.

Day 10:

Inadvertent basal testing in the afternoon (got distracted, forgot to get lunch) shows a nice flat line in the 150 mg/dl (8.3 mmol/l) range. This is an improvement from the flat lines that exist only because I maxed out my Dexcom.

Day 11:

Woke up in the morning at 216 (12), which is more in line with my usual. I'm hesitant to increase more without basal testing since yesterday lunchtime showed a pretty flat line. Would have been lower if I'd compensated for the Dawn Phenomenon (I can't abbreviate it to DP, my brain goes elsewhere) and the Foot on Floor rise - but without knowing if it was going to send me low during the day, I figured probably best to err on the side of not hypo.

Final dosage: 15 u.

So what's next?

Basal testing (again) and reworking my carb ratios, since the evening ones were compensating for the drop off with Insulatard.

The 'good' news is that it doesn't seem that any of the current basals will address my Dawn Phenomenon/Foot on the Floor issues sufficiently and the main solution for that is an insulin pump with programmable basal rates.

Manually being your own organ is a huge pain in the ass.