Clinical use of insulin degludec.

Abstract

The limitations of current basal insulin preparations include concerns related to their pharmacokinetic and pharmacodynamic properties, hypoglycaemia, weight gain, and perception of management complexity, including rigid dosing schedules. Insulin degludec (IDeg) is a novel basal insulin with improved pharmacokinetic and pharmacodynamic properties compared to insulin glargine (IGlar) including a long half-life of ∼25 h and a duration of action >42 h at steady state, providing a flat and stable blood glucose-lowering effect when injected once daily. Evidence from phase 3a clinical trials with a treat-to-target design in patients with type 1 and type 2 diabetes has shown that IDeg has similar efficacy to IGlar, with a 9% and 26% reduction in risk of overall and nocturnal hypoglycaemia, respectively (in the pooled population) during the entire treatment period, and a 16% and 32% reduction during the maintenance period, respectively. Given its pharmacodynamic properties, IDeg offers a broad dosing window, allowing for flexible dose administration, if required. Two different formulations of IDeg are available (100 units/mL [U100] and 200 units/mL), the latter providing the same IDeg dose as the U100 formulation in half the injection volume. The unique pharmacokinetic profile of IDeg facilitates glycaemic control while minimising the risk of nocturnal hypoglycaemia.

• Authors: Jiten Vora, Bertrand Cariou, Marc Evans, Jorge Luiz Gross, Stewart Harris, Lena Landstedt-Hallin, Ambrish Mithal, Martín Rodríguez Rodriguez, Luigi Meneghini
• Journal: Diabetes research and clinical practice (Diabetes Res Clin Pract) Vol. 109 Issue 1 Pg. 19-31 (Jul 2015) ISSN: 1872-8227 [Electronic] Ireland
• PMID: 25963320 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Chemical References

• Blood Glucose
• Insulin
• Insulin, Long-Acting
• Insulin Glargine
• insulin degludec

Topics

• Blood Glucose (drug effects)
• Diabetes Mellitus, Type 1 (blood, drug therapy)
• Diabetes Mellitus, Type 2 (blood, drug therapy)
• Drug Administration Schedule
• Humans
• Hypoglycemia (blood, chemically induced)
• Insulin (pharmacokinetics, therapeutic use)
• Insulin Glargine (pharmacokinetics, therapeutic use)
• Insulin, Long-Acting (adverse effects, pharmacokinetics, therapeutic use)
• Weight Gain (drug effects)