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Insulin degludec: overview of a novel ultra long‐acting basal insulin
Author(s) -
Gough S. C. L.,
Harris S.,
Woo V.,
Davies M.
Publication year - 2013
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12052
Subject(s) - insulin degludec , insulin , dosing , basal (medicine) , pharmacodynamics , medicine , endocrinology , insulin glargine , bolus (digestion) , subcutaneous injection , pharmacokinetics , basal insulin , diabetes mellitus , type 2 diabetes , hypoglycemia
All the basal insulin products currently available have suboptimal pharmacokinetic ( PK ) properties, with none reliably providing a reproducible and peakless pharmacodynamic ( PD ) effect that endures over 24 h from once‐daily dosing. Insulin degludec is a novel acylated basal insulin with a unique mechanism of protracted absorption involving the formation of a depot of soluble multihexamer chains after subcutaneous injection. PK / PD studies show that insulin degludec has a very long duration of action, with a half‐life exceeding 25 h. Once‐daily dosing produces a steady‐state profile characterized by a near‐constant effect, which varies little from injection to injection in a given patient. Clinically, insulin degludec has been shown consistently to carry a lower risk of nocturnal hypoglycaemia than once‐daily insulin glargine, in both basal+bolus and basal‐only insulin regimens. The constancy of the steady‐state profile of insulin degludec also means that day‐to‐day irregularities at the time of injection have relatively little PD influence, thereby offering the possibility of greater treatment flexibility for patients.