What Kind of Insulin is Degludec?

For people managing diabetes, understanding the type and properties of insulin prescribed is essential for optimal control over blood glucose levels. Insulin degludec, also known as Tresiba, is a basal insulin with ultra-long-acting qualities that set it apart from other options. Its unique mechanism of action and prolonged duration provide distinct benefits in maintaining stable blood sugar levels, reducing fluctuations, and potentially minimizing risks of hypoglycemia. Knowing these characteristics helps patients and healthcare providers make well-informed choices tailored to individual needs, ensuring effective and consistent diabetes management.

Key Takeaways

• Insulin degludec, also marketed as Tresiba, is a basal insulin with an ultra-long duration, offering steady blood glucose control for up to 42 hours.

• Its unique formulation helps maintain consistent glucose levels, reducing daily fluctuations and minimizing the risk of nighttime hypoglycemia.

• Degludec allows for flexibility in dosing times, which can benefit those with irregular schedules or travel routines.

• It is commonly prescribed for both type 1 and type 2 diabetes, either alone or in combination with other antidiabetic medications.

• Degludec’s prolonged release and gradual action reduce the risk of blood sugar peaks and lows, enhancing patient safety and comfort.

• While generally well-tolerated, insulin degludec may cause side effects such as hypoglycemia, weight gain, and potential injection site reactions.

• Compared to insulins like glargine, degludec offers a longer duration and potentially more flexibility, making it a versatile choice for sustained blood sugar management.

What Type of Insulin is Tresiba?

Tresiba is a long-acting insulin that contains the active ingredient insulin degludec. It is designed to help manage blood sugar levels in individuals with type 1 and type 2 diabetes. Tresiba provides a steady release of insulin throughout the day, allowing for once-daily administration via subcutaneous injection. This long-acting insulin works by mimicking the body’s natural insulin response, effectively lowering blood sugar levels between meals and overnight.

Tresiba is available in two concentrations: 100 units/mL and 200 units/mL, and it can be administered using either a vial with syringes or prefilled pens. The unique molecular structure of insulin degludec allows it to form multi-hexamers, which release insulin slowly and steadily, providing flexibility in dosing times while maintaining effective glycemic control. 

According to the CDC, diabetes is one of the most costly chronic medical conditions in the United States. The American Diabetes Association estimates that the total cost—both direct and indirect—of diabetes reached $245 billion as of 2012.

What is the Generic Name for Degludec?

The generic name for Degludec is insulin degludec. This medication is a long-acting insulin used primarily for the management of blood sugar levels in individuals with type 1 and type 2 diabetes. Marketed under the brand name Tresiba, insulin degludec provides a steady release of insulin, allowing for once-daily dosing. Its formulation enables it to maintain effective glycemic control over an extended period, typically up to 42 hours, making it a popular choice for those requiring basal insulin therapy. Insulin degludec is available in various concentrations, including 100 units/mL and 200 units/mL, and is administered via subcutaneous injection using a pen or vial

Is Insulin Degludec Long or Short Acting?

Itis classified as an ultra-long-acting insulin, which is longer than traditional long-acting insulins like insulin glargine (found in products like Lantus or Toujeo). Designed to provide a consistent level of insulin for up to 42 hours, insulin degludec is typically taken once daily. This characteristic minimizes the need for frequent adjustments and reduces the risk of both high and low blood sugar events.

Because of its prolonged action, insulin degludec is suitable for individuals with unpredictable schedules or those who struggle with adherence to a strict dosing regimen. Its ultra-long duration also enables flexibility in the timing of daily doses, which can be especially beneficial for people managing complex lifestyles or inconsistent daily routines.

Insulin Degludec Side Effects

As with any medication, insulin degludec may have potential side effects. Although not everyone will experience side effects, it’s essential for patients to be aware of them and consult their healthcare provider if they encounter any unusual symptoms.

Common Side Effects

Some common side effects associated with insulin degludec include:

•  As with other insulins, one of the primary side effects of insulin degludec is the risk of hypoglycemia, especially if a meal is missed or physical activity levels increase.
• Patients may experience redness, swelling, or itching at the injection site. This can often be reduced by rotating injection sites regularly.
• Insulin therapy, including insulin degludec, can lead to weight gain due to increased glucose uptake by cells.

Rare and Severe Side Effects

Although less common, some people may experience more severe reactions to insulin degludec, including:

• Symptoms can include rash, itching, swelling, or difficulty breathing.
•  Repeated injections in the same area can cause changes in fat tissue under the skin.
• Insulin degludec may impact potassium levels, leading to hypokalemia in some cases, which requires medical attention.

If any of these side effects occur or worsen, it’s essential to speak with a healthcare provider. Monitoring blood sugar levels, following a structured diet, and adhering to the recommended insulin regimen can help mitigate many of these potential side effects.

Insulin Degludec Mechanism of Action

Insulin degludec, marketed as Tresiba, is an ultra-long-acting insulin analog designed for the management of type 1 and type 2 diabetes. Its mechanism of action is unique and involves several key processes:

Formation of Multihexamers

Upon subcutaneous injection, insulin degludec forms large multihexamer assemblies. This occurs due to its molecular structure, which includes a 16-carbon fatty diacid chain attached to the B29 position of the insulin molecule. This modification allows insulin degludec to exist in a stable dihexameric form in solution, which then aggregates into multihexamers after injection. This formation creates a depot at the injection site from which insulin is released slowly and continuously into the bloodstream.

Slow and Steady Absorption

The multihexameric structure leads to a prolonged duration of action, allowing insulin degludec to be absorbed steadily over an extended period—typically exceeding 42 hours. This results in a flat pharmacokinetic profile with minimal peaks and troughs in insulin concentration, reducing the risk of hypoglycemia compared to other insulin formulations.

Interaction with Insulin Receptors

Once in circulation, insulin degludec binds to insulin receptors (IR) on target tissues, similar to human insulin. This binding activates signaling pathways that promote glucose uptake in peripheral tissues (such as muscle and fat) and inhibit hepatic glucose production. The stable release of insulin degludec from its depot ensures that basal insulin levels are maintained throughout the day, mimicking the natural secretion patterns of endogenous insulin.

Clinical Implications

The unique mechanism of action of insulin degludec allows for greater flexibility in dosing times and improved adherence for patients. It has been shown to provide effective glycemic control with a lower incidence of hypoglycemia, particularly nocturnal hypoglycemia, making it a favorable option for many individuals managing diabetes.

Insulin Degludec Uses

Insulin degludec is primarily used to manage blood glucose levels in patients with:

Treatment of Diabetes

• Insulin degludec is used as a basal insulin to help control blood glucose levels. In patients with type 1 diabetes, it is typically administered in conjunction with a rapid-acting insulin to manage blood sugar spikes from meals.
• For individuals with type 2 diabetes, insulin degludec can be used alone or in combination with other antidiabetic medications, including oral agents or other forms of insulin. It is particularly beneficial for those who require additional insulin to achieve glycemic control.

Advantages

• Insulin degludec has a prolonged duration of action, lasting over 42 hours, which allows for flexible dosing times. This means patients can administer it at varying times each day without compromising efficacy.
• Clinical studies have shown that insulin degludec is associated with a significantly lower incidence of hypoglycemia, particularly nocturnal hypoglycemia, compared to other basal insulins like insulin glargine. This makes it a safer option for many patients.
• The unique pharmacokinetic profile of insulin degludec allows for a flat and stable release of insulin, minimizing peaks and troughs in blood sugar levels. This results in more consistent glycemic control

Because of its unique duration and consistent action, insulin degludec is highly effective for both types of diabetes, reducing the need for frequent dosing adjustments and minimizing blood glucose variability.

Degludec vs. Glargine: A Comparison

Insulin degludec and insulin glargine are both long-acting insulin analogs used to manage blood sugar levels in individuals with type 1 and type 2 diabetes. However, they differ in several key aspects, including their pharmacokinetics, efficacy, safety profiles, and patient experiences.

Pharmacokinetics

• Insulin Degludec: It has an ultra-long duration of action, lasting over 42 hours. Upon subcutaneous injection, it forms multihexamers that dissociate slowly into monomers, providing a steady release of insulin without significant peaks. This results in a flat pharmacokinetic profile, which minimizes day-to-day variability in glucose-lowering effects.
• Insulin Glargine: Typically lasts around 24 hours. Glargine is known for its predictable absorption and action but may exhibit slight peaks in its pharmacokinetic profile, which can lead to variability in blood sugar control.

Efficacy

• Both insulins have been shown to achieve similar reductions in HbA1c levels. In clinical studies, insulin degludec demonstrated non-inferiority to insulin glargine regarding glycemic control. For example, reductions in HbA1c after 52 weeks were comparable between the two insulins, with degludec showing a marginally better fasting plasma glucose reduction in some studies.

Hypoglycemia Risk

• Insulin Degludec- One of the significant advantages of degludec is its lower risk of nocturnal hypoglycemia. Studies indicate that patients using degludec experience fewer episodes of nighttime low blood sugar compared to those using glargine. This is particularly beneficial for patients who are prone to hypoglycemic events.
• Insulin Glargine- While effective, glargine has a higher incidence of nocturnal hypoglycemia compared to degludec. The risk of severe hypoglycemic events is also noted to be higher with glargine in some studies.

Dosing Flexibility

• Tresiba offers greater flexibility in dosing times due to its long duration of action. Patients can administer it at varying times each day without losing efficacy, which may improve adherence to treatment plans.
• Insulin glargine typically requires more consistent timing for administration to maintain stable blood glucose levels.

Based on WebMD, one user shared, “I’ve been Type 1 for 52 years, and this is by far the best insulin I’ve ever used. I’ve been on it for about three weeks with no lows—just excellent BG readings.”

Benefits of Insulin Degludec

Insulin degludec, marketed as Tresiba, offers several benefits for individuals managing type 1 and type 2 diabetes. Here are the key advantages:

Ultra-Long Duration of Action

It has an ultra-long duration of action, lasting over 42 hours. This allows for flexible dosing schedules, enabling patients to administer it at varying times without compromising glycemic control. This flexibility can enhance adherence to treatment regimens.

Stable Glycemic Control

The unique formulation of tresiba allows it to form multihexamers that dissociate slowly into monomers after subcutaneous injection. This results in a steady release of insulin into the bloodstream, providing a flat pharmacokinetic profile with minimal peaks and troughs in insulin levels. Consequently, patients experience more stable blood glucose levels throughout the day and night.

Lower Risk of Hypoglycemia

One of the most significant benefits of Tresiba is its lower risk of hypoglycemia, particularly nocturnal hypoglycemia. Studies have shown that switching to insulin degludec from other basal insulins, such as insulin glargine or detemir, significantly reduces the rates of hypoglycemic events across all categories, including severe and nocturnal hypoglycemia. This is particularly beneficial for patients who may have impaired awareness of hypoglycemia.

Improved Glycemic Control

Clinical trials indicate that Tresiba is effective in improving glycemic control, with reductions in HbA1c levels comparable to those achieved with insulin glargine. Patients switching to degludec often experience better overall glycemic management with fewer fluctuations in blood sugar levels.

Convenient Administration

Insulin degludec can be administered once daily at any time of day, which can simplify diabetes management for patients and reduce the burden of frequent injections associated with other insulin regimens.

Patient Preference

Due to its long duration of action and reduced risk of hypoglycemia, many patients prefer insulin degludec over other basal insulins. The ability to adjust dosing times and the stability it provides contribute to higher satisfaction levels among users.

How to Use Insulin Degludec

Administering insulin degludec is similar to other basal insulins, but patients should follow the guidance provided by their healthcare provider. The typical usage involves:

Administration

1. Injection Sites- Insulin degludec should be injected subcutaneously (under the skin) into the thigh, upper arm, or abdomen. It is crucial to rotate injection sites within the chosen area to minimize the risk of lipodystrophy (changes in fat tissue) and localized reactions.
2. Dosing Frequency- It is typically administered once daily at any time of day. However, for optimal results, it is recommended to take it at the same time each day, especially for pediatric patients.
3. Dosage Forms- Insulin degludec is available in two concentrations:
   • U-100 (100 units/mL): Available in both pen and vial forms.
   • U-200 (200 units/mL): Available only in prefilled pens.

Starting Dosage

• Type 1 Diabetes- For insulin-naive patients, the starting dose is approximately 0.2 to 0.4 units/kg of body weight or about one-third to one-half of the total daily insulin requirement, with the remainder provided by short-acting insulin.
• Type 2 Diabetes- The recommended starting dose is typically 10 units once daily.

Adjusting Dosage

• After initiating therapy, dosage adjustments should be made based on blood glucose monitoring results and individual metabolic needs. Increases in dosage are generally recommended every 3 to 4 days, allowing time for the insulin to reach a steady state.

It’s important to follow all instructions for the storage and handling of Tresiba to maintain its effectiveness.

Tresiba is an option for people with diabetes seeking consistent, ultra-long-acting insulin support. Its unique structure and extended duration make it a suitable choice for those with both type 1 and type 2 diabetes, providing stable blood glucose control with flexible dosing options. Whether chosen for its reduced risk of hypoglycemia, enhanced blood sugar stability, or dosing flexibility, Tresiba has proven to be a reliable and effective basal insulin.

For those interested in this medication, consider buying Tresiba FlexTouch from Canada, where options for affordable access to essential insulin products are available.

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