title: 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.affiliation: Department of Endocrinology and Diabetes, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK. Electronic address: Jiten.vora@rlbuht.nhs.uk.
authors.forename: Jiten
authors.initials: J
authors.lastname: Vora
authors.affiliation: Clinique d'Endocrinologie, l'Institut du Thorax, CHU Nantes, Nantes, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Cariou
authors.affiliation: University Hospital Llandough, Cardiff, UK.
authors.forename: Marc
authors.initials: M
authors.lastname: Evans
authors.affiliation: Centro de Pesquisas em Diabetes, Porto Alegre, RS, Brazil.
authors.forename: Jorge Luiz
authors.initials: JL
authors.lastname: Gross
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
authors.forename: Stewart
authors.initials: S
authors.lastname: Harris
authors.affiliation: Karolinska Institute, Department of Clinical Sciences, Division of Medicine, Danderyd Hospital, Stockholm, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Landstedt-Hallin
authors.affiliation: Division of Endocrinology and Diabetes, Medanta the Medicity, Gurgaon, Haryana, India.
authors.forename: Ambrish
authors.initials: A
authors.lastname: Mithal
authors.affiliation: Department of Internal Medicine, University Hospital, National University of Cuyo, Mendoza, Argentina.
authors.forename: Martín Rodríguez
authors.initials: MR
authors.lastname: Rodriguez
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center and Parkland Health & Hospital System, Dallas, TX, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Meneghini
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced; D007328:Insulin / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069036:Insulin Glargine / Q000493:pharmacokinetics / Q000627:therapeutic use; D049528:Insulin, Long-Acting / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D001786:Blood Glucose; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; C571886:insulin degludec
keywords: Clinical practice; Diabetes; Dosing; Hypoglycaemia; Insulin; Insulin degludec