Insulin Degludec
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Insulin degludec
Tresiba
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Summary
Common uses
Type 1 diabetes mellitus0, Type 2 diabetes basal coverage0
Pharmacy
Starting dose
~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting glucose
Preparations
100 U/mL (FlexTouch pen) and 200 U/mL (FlexTouch pen, higher-dose convenience)
US FDA Max
Titrated to glucose; no fixed ceiling
Pharmacology
Routes
Subcutaneous (never IV; not for use in insulin pumps)
Onset
~1 hour
Duration
>42 hours per dose (effectively flat once at steady state)
Half-life
~25 hours apparent (functional duration well over 42 hours from multi-hexamer depot)[1]
Bioavailability
~100% from subcutaneous depot
Pregnancy
Insulin is the preferred glucose-lowering therapy in pregnancy; degludec has reassuring observational data.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Insulin degludec self-assembles after subcutaneous injection into long multi-hexamer chains that slowly dissociate into monomers, providing a flat ultra-long-duration insulin profile (>42 hours) that supports forgiving dose-timing windows and lower nocturnal hypoglycemia rates than glargine in DEVOTE and SWITCH trials.0 Binds the same insulin receptor as endogenous insulin with comparable mitogenic-to-metabolic ratio[1].
References
- ↑ 1.0 1.1 FDA Prescribing Information, Tresiba (insulin degludec), Novo Nordisk, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/203314s022lbl.pdf