insulin degludec (Tresiba)
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Introduction
FDA approves Sept 2015.
Indications
- treatment of type 2 diabetes mellitus
- may be used in association with metformin
- may be used for treatment of type 1 diabetes mellitus
Dosage
Pharmacokinetics
- 1/2 life > 25 hours
- duration of action (>40 hours)*
* roughly twice that of insulin glargine (Lantus)
Adverse effects
- hypoglycemia
- hypoglycemia occurs less often than with insulin glargine[6]
- nocturnal hypoglycemia occurs less often than with insulin glargine[1][2] Mechanism:
- long-acting insulin analog
- forms soluble multihexamer assemblies after subcutaneous injection, resulting in an ultra-long action profile.
Notes
- too expensive[5]
More general terms
Component of
References
- ↑ 1.0 1.1 Heller S et al. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 1 diabetes (BEGIN Basal-Bolus Type 1): A phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet 2012 Apr 21; 379:1489 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22521071
- ↑ 2.0 2.1 Garber AJ et al. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 2 diabetes (BEGIN Basal-Bolus Type 2): A phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet 2012 Apr 21; 379:1498 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22521072
- ↑ Zinman B et al. Insulin degludec versus insulin glargine in insulin-naive patients with type 2 diabetes: A 1-year, randomized, treat-to-target trial (BEGIN Once Long). Diabetes Care 2012 Dec; 35:2464 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23043166
- ↑ FDA News Release. September 25, 2015 FDA approves two new drug treatments for diabetes mellitus http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm464321.htm
- ↑ 5.0 5.1 California Institute for Clinical and Economic Review, 2015 Insulin Degludec (Tresiba<TM>, Novo Nordisk A/S) for the Treatment of Diabetes: Effectiveness, Value, and Value-Based Price Benchmarks. http://ctaf.org/sites/default/files/u148/Diabetes_Draft_Report_122115.pdf
- ↑ 6.0 6.1 Lane W, Bailey TS, Gerety G et al Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 1 Diabetes. The SWITCH 1 Randomized Clinical Trial. JAMA. 2017;318(1):33-44 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28672316 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2635629
Wysham C, Bhargava A, Chaykin L et al Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes. The SWITCH 2 Randomized Clinical Trial. JAMA. 2017;318(1):45-56. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28672317 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2635630
Seaquist ER, Chow LS Hypoglycemia in Diabetes. Does Insulin Type Matter? JAMA. 2017;318(1):31-32 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28672298 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2635610