Short answer: Toujeo (insulin glargine 300 units/mL) and Tresiba (insulin degludec, 100 or 200 units/mL) are long-acting insulins taken once a day.12 Tresiba is approved from age 1 and adults may take it at any time of day; Toujeo is approved from age 6 and taken at the same time each day. Neither label reports a trial against the other.
| Toujeo (insulin glargine) | Tresiba (insulin degludec) | |
|---|---|---|
| Strengths | 300 units/mL pens1 | 100 units/mL pen or vial; 200 units/mL pen2 |
| Ages | Adults and children 6 and older1 | 1 year and older2 |
| Timing | Once a day at the same time1 | Adults: once a day at any time; children: same time each day2 |
| Type 2 start, not on insulin | 0.2 units/kg once a day1 | 10 units once a day2 |
| Dose changes | No more often than every 3 to 4 days1 | 3 to 4 days apart2 |
| Missed dose | No rule in the label1 | Adults: take when noticed, at least 8 hours before the next2 |
| Common side effects (besides low sugar) | Nasopharyngitis 12.8% (type 1), 7.1% (type 2)1 | Nasopharyngitis 23.9% (type 1), 12.9% (type 2)2 |
| Boxed warning | None1 | None2 |
Mostly timing. The Tresiba label lets adults inject at any time of day and gives a missed-dose rule: take it when noticed, keeping at least 8 hours before the next dose.2 The Toujeo label asks for the same time each day and has no missed-dose rule.1 Tresiba also comes in a 200 units/mL pen, and Toujeo in a Max SoloStar pen for larger doses.21
Low blood sugar is the most common side effect of both. The other side-effect rates come from different trials. These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Any insulin change is made with your prescriber. More detail: Toujeo side effects, Tresiba side effects, the Toujeo and Tresiba dosing schedules, and the Tresiba missed-dose page.