Generic
Insulin Degludec
1 brands available in the market
At a glance
Insulin Degludec is a long-acting human insulin analog used to improve glycemic control in patients 1 year of age and older with diabetes mellitus.
Description
Insulin Degludec is an ultra long-acting basal insulin for once-daily administration at any time of the day, preferably at the same time every day. It forms multihexamers when injected into subcutaneous tissue creating a subcutaneous depot. Its protracted action profile is predominantly due to delayed absorption from subcutaneous tissue to systemic circulation and to a lesser extent due to binding to circulating albumin.
Indications
- Improvement of glycemic control in patients 1 year of age and older with diabetes mellitus
Therapeutic class
Long Acting Insulin
Pharmacological class
Ultra Long-acting Basal Insulin Analog
Pharmacology
The primary activity of insulin, including Insulin Degludec, is regulation of glucose metabolism. Insulin and its analogues lower blood glucose by stimulating peripheral glucose uptake (especially by skeletal muscle and fat) and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis and enhances protein synthesis. Insulin Degludec forms multihexamers when injected into subcutaneous tissue, providing slow absorption and albumin binding for prolonged action.
Mechanism of action
Lowers blood glucose by binding to insulin receptors, facilitating glucose uptake in muscle and fat cells, and inhibiting glucose output from the liver.
Dosage
Adult Dose (Subcutaneous):
- Type 2 Diabetes: Recommended daily starting dose: 10 units, followed by individual dosage adjustments
- Type 1 Diabetes: One third to one half of the total daily insulin dose; general rule: 0.2-0.4 units/kg for insulin-naïve patients
- Once-daily at any time (preferably same time every day); minimum 8 hours between injections
- Conversion from other insulins: Start at same unit dose
- Dose adjustments: 3-4 days between increases; based on metabolic needs, blood glucose monitoring, glycemic control goal
Child Dose: Not indicated for use in pediatric population under 18 years
Administration
Administer once daily as subcutaneous injection in upper arm, thigh or abdominal wall; abdominal wall injection results in faster absorption; rotate injection sites; do not use IV, IM or in insulin pumps.
Missed dose
If you miss a dose, take it upon discovery and resume usual once-daily dosing schedule; ensure minimum 8 hours between injections.
Side effects
Side Effects:
- Nasopharyngitis
- Severe hypoglycemic episode
- Upper respiratory tract infection
- Headache
- Diarrhea
- Sinusitis
- Gastroenteritis
- Injection site reactions
- Peripheral edema
Precautions & warnings
Precautions:
- Hypoglycemia: Omission of meal or unplanned strenuous exercise may lead to hypoglycemia
- Hyperglycemia: Administration of rapid-acting insulin recommended in situations with severe hyperglycemia
- Eye disorder: Intensification of insulin therapy with abrupt improvement may be associated with temporary worsening of diabetic retinopathy
- Avoidance of accidental mix-ups: Always check insulin label before each injection
- Concomitant illness affecting kidney, liver, adrenal, pituitary or thyroid gland may require changes in insulin dose
Contraindications
Contraindications:
- Hypersensitivity to active substance or any excipients
- Hypoglycemia
- Hyperglycemia
- Eye disorder
Drug interactions
Drug Interactions:
- Corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents, thyroid hormones, estrogens, progestins, protease inhibitors, atypical antipsychotics decrease hypoglycemic effect
- Oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates, sulfonamide antibiotics increase hypoglycemic effect
- Octreotide and lanreotide decrease insulin resistance
- Pioglitazone, rosiglitazone increase risk of weight gain and peripheral edema
Food interactions
Food Interactions: It is unsafe to consume alcohol with Insulin Degludec.
Use in pregnancy
Use in Pregnancy: No clinical experience from well-controlled studies; animal studies show no differences in embryotoxicity and teratogenicity; use only if potential benefits justify potential risks to fetus.
Use in lactation
Use in Lactation: No clinical experience from well-controlled studies; unknown if excreted in human milk; in rats, secreted in milk (concentration lower than in plasma).
Pediatric use
Not indicated for use in children and adolescents under 18 years of age.
Geriatric use
No overall clinical differences in safety or effectiveness have been observed between elderly (≥65 years) and adult patients.
Renal / hepatic impairment
Renal Impairment: Can be used in renal impaired patients; glucose monitoring intensified and dose adjusted on individual basis; caution required.
Hepatic Impairment: Can be used in hepatic impaired patients; glucose monitoring intensified and dose adjusted on individual basis; caution required.
Overdose effects
Overdose: Excess insulin relative to food intake or energy expenditure may lead to severe and sometimes prolonged life-threatening hypoglycemia; mild episodes treated with oral glucose; severe episodes (coma, seizure, neurologic impairment) treated with IM/SC glucagon or IV glucose.
Storage conditions
Store in refrigerator at 2°C-8°C; do not freeze; protect from light.
Chemical structure
Insulin Degludec