Tresiba vs Toujeo

In the red corner, meet Toujeo, a long-acting insulin medication produced by Sanofi, a global biopharmaceutical company from France. And its opponent today from the blue corner, a real samurai in the insulin world known as Tresiba by Novo Nordisk. 

Toujeo and Tresiba are the products of arch-rivals that have been going toe-to-toe for years, trying to take a bigger slice of the insulin market share. If you know a thing or two about diabetes, you must have heard about these next-gen medications, otherwise you must be living under a rock. 

However, pitting Toujeo against Tresiba is quite a challenge as there are more similarities between them than differences, which has been proven in a number of clinical studies over the recent years. A definite answer to the question which one is better at controlling blood glucose levels in patients with diabetes type 1 & type 2 while keeping the risk of nocturnal hypoglycemia low simply doesn’t exist. Both of these insulin medications can be called an uber-potent weapon against diabetes.

What is Toujeo?

Just like its elder “cousin” Lantus, Toujeo contains insulin glargine. Approved as a diabetes treatment for adults since early 2015, Toujeo is known for a more consistent insulin activity. It effectively provides a stable blood sugar control which means fewer ups and downs in energy or hunger levels. This injectable insulin medication is administered using disposable prefilled SoloStar pens. 

Tresiba vs Toujeo

What is Tresiba?

An ultra long-acting prescription-only insulin whose active ingredient is insulin degludec, Tresiba can be used to treat adults and children with type 1 & 2 diabetes. Its effects last longer in the body than those of Toujeo, around 42 hours, but it still needs to be administered once daily. Tresiba kicks in faster, with onset time being about 30-90 minutes, whereas Toujeo starts working approx. 6 hours after injection. 

Effectiveness of Tresiba and Toujeo

A number of clinical studies have been carried out with the aim to compare the effectiveness of Tresiba and Toujeo. The winner hasn’t been announced since both insulin medications were found to work equally well. For example, a 2018 study (BRIGHT) has demonstrated that Toujeo and Tresiba effectively decreased hemoglobin A1c (HbA1c) in patients with type 2 diabetes over the duration of 24 weeks. Another similar study in people suffering with the same medical condition has shown that these insulin medications were quite effective in lowering blood glucose levels. 


It might be difficult to estimate at first glance which medication is more expensive given the differences in concentration. However, when you do the calculations, you will see that Toujeo turns out to be slightly cheaper, with its real cost value of $29.41/ml versus $32.55/ml for Tresiba.

Please note that Toujeo remains fully potent only for 28 days once in use provided it is stored at room temperature. Tresiba lasts almost twice as long.

Side effects

Since both Tresiba and Toujeo contain long-acting insulin ingredients, they share similar side effects, the most common of which are the following:

  • weight gain
  • hypoglycemia
  • excessive buildup of fluid in the body
  • low potassium levels (hypokalemia)
  • respiratory infections
  • irritation, itching, pain, and swelling as an injection site reaction
  • allergic reaction and hypersensitivity

Apart from these unwanted side effects, Tresiba can also cause diarrhea, stomach ache, and headache. 

The issue of hypoglycemia

The major issue of concern for physicians and patients alike is hypoglycemia that might occur during insulin therapy. Hypoglycemia might be a life-threatening condition that should be avoided at all costs. Several studies that have been conducted to determine which medication – Toujeo or Tresiba – has less risk of nighttime hypoglycemia haven’t been conclusive enough. The latest of these comparison trials, the CONCLUDE, has suggested that Tresiba might be safer when it comes to the number of hypoglycemia incidence, but its results were criticized due to a lot of uncertainty with respect to the data. 

Fortunately, it’s absolutely obvious that both of these medications are much better in cutting severe nighttime hypoglycemia risk than insulin medications of older generations. If further research proves that one is better than the other, the difference won’t be that significant anyway, considering all the data we have collected up to date. Toujeo and Tresiba are safe options for patients with type 1 and type 2 diabetes when compared to other insulin medications available on the market today.

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