Products
Insulin degludec is commercially available as a solution for injection (Tresiba). It is also combined fixed with insulin aspart (Ryzodeg, see under IDegAsp). It was newly approved in many countries in March 2013. In 2014, a fixed combination with liraglutide was registered (Xultophy); see under IDegLira.
Structure and properties
Insulin degludec has essentially the same structure as human insulin, with the following exceptions:
- The last amino acid of the B chain (threonine B30) has been removed.
- A glutamic acid and a 16-C fatty acid were added to lysine B29.
Effects
Insulin degludec (ATC A10AE06) has blood glucose-lowering properties. The effects are due to binding to the human insulin receptor. It is an insulin analog with a very long duration of action of over 24 hours, a flat action profile, and stable pharmacokinetics (ultra-long-acting basal insulin). After injection, it forms hexamers that act as a subcutaneous depot from which insulin is continuously released.
Indications
For the treatment of diabetes mellitus.
Dosage
According to the SmPC. The injection solution is administered subcutaneously with an insulin pen once daily and preferably always at the same time of day. Possible sites of administration include the thigh, upper arm, or abdominal wall.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Numerous drugs affect glucose metabolism and may cause drug-drug interactions.
Adverse effects
The most common potential adverse effects include hypoglycemia and injection site reactions such as redness, swelling, itching, and discoloration.
