Action and Spectrum

Actions and Spectrum: 

insulin degludec is a long-acting insulin analog that is used to help control blood sugar levels in people with diabetes. Here are some actions and spectrum of insulin degludec: 

• Action: insulin degludec lowers blood sugar levels by facilitating the uptake and use of glucose in the body’s cells. It also reduces the amount of glucose produced by the liver. 
• Spectrum: insulin degludec has a prolonged duration of action, which means that it can provide steady blood sugar control for up to 42 hours after injection. It is designed to provide a flat and consistent insulin release, without any peak in activity, which helps to minimize the risk of hypoglycemia (low blood sugar). 
• Dosage: The dosage of insulin degludec will depend on the individual’s needs and may be adjusted over time. It is typically injected once a day, preferably at the same time each day. It is available in pre-filled pens or cartridges for use with insulin pumps. 
• Administration: insulin degludec should be injected subcutaneously (under the skin) in the abdominal area, upper arm, or thigh. It should not be injected intravenously or into muscle tissue. 
• Side Effects: Common side effects of insulin degludec include hypoglycemia, weight gain, injection site reactions (such as redness, itching, or swelling), and allergic reactions. 

Drug Interaction

Adverse Reaction

Frequency Defined 

>10% 

Severe Hypoglycemia 

Headache 

Upper Respiratory Tract Infection 

Nasopharyngitis 

1-10% 

Diarrhea 

Gastroenteritis 

Sinusitis 

Peripheral Edema 

Reaction on Injection Site 

<1% 

Lipodystrophy 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

• Hypersensitivity: insulin degludec should not be used in individuals who have a known hypersensitivity to insulin degludec or any of its excipients. 
• Diabetic ketoacidosis: insulin degludec should not be used to treat diabetic ketoacidosis. In this condition, the body produces high levels of ketones, which can be life-threatening. 
• Liver or kidney disease: Patients with liver or kidney disease may require careful monitoring when using insulin degludec as their condition may affect the way the body responds to insulin. 
• Pregnancy and breastfeeding: insulin degludec should be used with caution during pregnancy and breastfeeding. Women who are pregnant or breastfeeding should consult their healthcare provider before using insulin degludec. 
• Hypoglycemia: insulin degludec can cause hypoglycemia (low blood sugar), particularly if the dose is too high or if it is taken with other medications that lower blood sugar levels. Patients should be advised to monitor their blood sugar regularly and adjust the dose as needed to avoid hypoglycemia. 
• Other medications: insulin degludec can interact with other medications, such as oral diabetes medications, certain blood pressure medications, and some antibiotics. Patients should inform their healthcare provider of all medications they are taking before starting insulin degludec. 

Pregnancy / Lactation

Pregnancy consideration:  

It is not secure to administer insulin degludec during pregnancy. 

Breastfeeding warnings:  

No data about the excretion of insulin degludec in human breast milk is available. Avoid using in lactating women. 

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: No evidence of risk to the fetus is found in animal reproduction studies, and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a human product; Pregnant women must take care of the potential risks. 
• Category D: There is adequate data with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergencies for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. The drug is not for pregnant women. 
• Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

insulin degludec is a long-acting insulin analog that lowers blood glucose levels by facilitating the uptake and use of glucose by the body’s cells. It has a slow and consistent absorption and a long duration of action, making it an effective option for controlling blood sugar levels in patients with diabetes. 

Pharmacodynamics: 

insulin degludec is a long-acting insulin analog that acts on insulin receptors to lower blood glucose levels. Here is a brief overview of the pharmacodynamics of insulin degludec: 

• Mechanism of action: insulin degludec is a synthetic analog of human insulin that binds to insulin receptors on the surface of cells, activating intracellular signaling pathways that promote glucose uptake and utilization. This results in a reduction in blood glucose levels. 
• Duration of action: insulin degludec has a long duration of action due to its slow and consistent absorption from the subcutaneous injection site. This allows for once-daily dosing in most patients, with a duration of action of up to 42 hours. 
• Onset of action: insulin degludec has a relatively slow onset of action, with peak effects occurring between 8 and 12 hours after administration. This allows for gradual and sustained reductions in blood glucose levels. 
• Dose-response relationship: The efficacy of insulin degludec is dose-dependent, with higher doses resulting in greater reductions in blood glucose levels. However, higher doses also increase the risk of hypoglycemia, which is a common side effect of insulin therapy. 
• Variability in response: The response to insulin degludec can vary between individuals, and may be influenced by factors such as age, body weight, insulin resistance, and concomitant medications. 
• Pharmacodynamic interactions: insulin degludec may interact with other medications, such as oral hypoglycemic agents, which can affect its pharmacodynamic properties. Patients should always inform their healthcare provider of all medications they are taking before starting insulin degludec. 

Pharmacokinetics: 

Absorption 

Peak plasma concentration is 4472 pmol/L and is achieved in 9 hours  

Steady state is achieved in 3-4 days 

Distribution 

Protein is 99% more bound to albumin 

Metabolism 

Inactive metabolites are formed  

Elimination and Excretion  

The half is about 25 hours 

The rate of clearance is 0.03 L/kg

Adminstartion

Administration: 

• Check the insulin: Before injecting insulin degludec, check the label to ensure that it is the correct medication, strength, and has not expired. 
• Prepare the injection site: Clean the injection site with an alcohol swab and allow it to dry completely. 
• Prepare the insulin pen or cartridge: Follow the instructions provided with the insulin pen or cartridge to prepare it for injection. This typically involves attaching a needle, priming the pen or cartridge, and setting the correct dose. 
• Inject the insulin: Insert the needle into the prepared injection site and inject the insulin according to the instructions provided with the pen or cartridge. Be sure to hold the needle in place for several seconds after injecting to ensure that all the insulin has been delivered. 
• Discard the needle: Safely dispose of the used needle according to local regulations. 
• Store the insulin: Store insulin degludec according to the instructions provided with the medication, typically in a refrigerator but not in the freezer. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: insulin degludec  

Pronounced: in-su-lin dee-glu-dek 

Why do we use insulin degludec? 

insulin degludec is used to control high blood sugar levels in patients with diabetes. Diabetes is a chronic condition where the body is unable to produce enough insulin or use insulin properly, leading to elevated blood sugar levels. Insulin is a hormone that regulates blood sugar levels by facilitating the uptake and use of glucose in the body’s cells. 

insulin degludec is a long-acting insulin analog that is designed to provide a steady and consistent release of insulin over a prolonged period, typically up to 42 hours after injection. This allows for effective blood sugar control, without the need for frequent injections. iInsulin degludec has a lower risk of hypoglycemia (low blood sugar) compared to other insulin types, due to its flat and consistent insulin release. 

insulin degludec is used to treat both type 1 and type 2 diabetes. It is typically prescribed in combination with other diabetes medications, such as oral hypoglycemic agents, to achieve optimal blood sugar control. insulin degludec is administered via subcutaneous injection once a day, preferably at the same time each day.