Insulin degludec is a medication used in diabetes management. It helps individuals maintain stable blood sugar levels. This article explores its characteristics, action, usage, and safety.
Insulin Degludec Defined
Insulin degludec is a long-acting, or basal, insulin analog, known as Tresiba. Its primary role is to provide a steady, continuous supply of insulin, mimicking the body’s natural background production. This helps control blood sugar levels throughout the day and night, including during fasting.
It is a modified human insulin, created through recombinant DNA technology. A slight alteration in its amino acid structure contributes to its prolonged action. Insulin degludec helps regulate glucose metabolism, maintaining blood sugar levels within a target range.
How Insulin Degludec Works
The mechanism of action of insulin degludec allows for its ultra-long duration and stable glucose-lowering effect. Upon subcutaneous injection, insulin molecules self-associate, forming soluble multi-hexamers. These large molecular complexes create a depot of insulin within the subcutaneous tissue. This formation is due to the addition of hexadecanedioic acid to a specific amino acid in its structure.
From this subcutaneous depot, insulin degludec slowly and continuously disassembles into individual insulin monomers. These monomers are then gradually absorbed into the bloodstream over an extended period. This slow and controlled release ensures a consistent and peakless action profile, meaning there are no sharp peaks in insulin activity that could lead to sudden drops in blood sugar. Its ultra-long duration of action, extending for more than 42 hours, contributes to stable and predictable glucose control with minimal day-to-day variability. Once in the bloodstream, it functions like natural insulin, binding to receptors on cells to facilitate glucose uptake and inhibiting glucose production by the liver.
Administering Insulin Degludec
Insulin degludec is indicated for improving glycemic control in individuals with Type 1 and Type 2 diabetes. It is approved for use in adults and children aged 1 year and older. The medication is typically administered once daily as a subcutaneous injection.
A notable feature of insulin degludec is its flexible injection time. While recommended at approximately the same time each day, adults can vary the dosing interval between 8 and 40 hours without compromising efficacy or increasing hypoglycemia risk. This flexibility benefits individuals with unpredictable schedules or those who travel. The injection is given under the skin, commonly in the abdomen, thigh, or upper arm. It is important to rotate injection sites within the chosen area to help prevent skin changes, such as lipodystrophy or localized cutaneous amyloidosis.
Key Safety Information
As with any medication, insulin degludec has important safety considerations. The most common side effect is hypoglycemia, or low blood sugar. Symptoms of hypoglycemia can include dizziness, blurred vision, anxiety, sweating, shakiness, confusion, and a fast heartbeat. It is important for individuals using insulin degludec to understand these symptoms and how to treat low blood sugar quickly, often by consuming a fast-acting source of sugar.
Other potential side effects include reactions at the injection site, such as pain, redness, swelling, or itching. Skin thickening or pits at the injection site, known as lipodystrophy, can also occur, which is why rotating injection sites is recommended. Allergic reactions, though less common, can also manifest as rash, itching, hives, or swelling of the face, tongue, or throat. Individuals should never share insulin pens, needles, or syringes with others, even if the needle is changed, as this poses a risk for transmitting blood-borne pathogens. Regular blood sugar monitoring is also important to ensure proper dosing and to manage blood sugar levels effectively.