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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Insulin Degludec
Generic Name
Insulin Degludec
Active Ingredient
Insulin DegludecCategory
Insulin Analog [EPC]
Variants
5
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 100 U/mL | INJECTION, SOLUTION | SUBCUTANEOUS | 50090-7176 |
| 200 U/mL | INJECTION, SOLUTION | SUBCUTANEOUS | 73070-503 |
| 100 U/mL | INJECTION, SOLUTION | SUBCUTANEOUS |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Insulin Degludec, you must consult a qualified healthcare professional.
| 100 U/mL | INJECTION, SOLUTION | SUBCUTANEOUS | 73070-400 |
| 200 U/mL | INJECTION, SOLUTION | SUBCUTANEOUS | 50090-7175 |
Detailed information about Insulin Degludec
Insulin Degludec is an ultra-long-acting basal insulin analog used to improve glycemic control in patients with diabetes mellitus. It provides a steady glucose-lowering effect lasting over 42 hours.
The dosage of Insulin Degludec must be individualized based on the patient's metabolic needs, blood glucose monitoring results, and glycemic control goals.
Dosage adjustments should be made gradually, typically no more frequently than every 3 to 4 days, to allow the drug to reach a new steady state.
Insulin Degludec is approved for use in children and adolescents aged 1 year and older with Type 1 or Type 2 diabetes.
Patients with kidney disease (renal impairment) may require more frequent dose adjustments and intensive blood glucose monitoring. Insulin is partially cleared by the kidneys, and decreased renal function can lead to a longer duration of insulin action, increasing the risk of hypoglycemia.
Patients with liver disease (hepatic impairment) may also require dose adjustments. The liver plays a role in glucose production and insulin metabolism. Close monitoring is essential to prevent hypoglycemia in this population.
In patients 65 years and older, the initial dosing, increments, and maintenance dosage should be conservative. The risk of hypoglycemia is higher in the elderly due to potential co-morbidities and age-related declines in renal function.
If you miss a dose of Insulin Degludec, take it as soon as you remember, ensuring there are at least 8 hours between that dose and your next scheduled dose. Resume your regular once-daily dosing schedule thereafter. Do not take two doses at once to make up for a missed dose.
An overdose of insulin can lead to severe and potentially life-threatening hypoglycemia (low blood sugar) or hypokalemia (low potassium levels).
> Important: Follow your healthcare provider's dosing instructions precisely. Do not adjust your dose or stop taking Insulin Degludec without medical guidance.
The most frequently reported adverse reaction associated with Insulin Degludec is hypoglycemia (low blood sugar). Because Insulin Degludec is a potent glucose-lowering agent, nearly all patients will experience episodes of mild hypoglycemia at some point during treatment.
Insulin Degludec is a high-alert medication. Errors in dosing or administration can lead to severe medical complications. Patients must be educated on the signs of both high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia). It is critical to never share an Insulin Degludec FlexTouch pen or needles with another person, even if the needle is changed, as this poses a high risk for spreading infections like hepatitis or HIV.
There are currently no FDA black box warnings for Insulin Degludec. It is considered a safe and effective medication when used according to the prescribed guidelines and monitored by a healthcare professional.
While there are no absolute drug-drug contraindications that strictly forbid the use of Insulin Degludec, it should never be used during episodes of hypoglycemia. Additionally, the use of Rosiglitazone or Pioglitazone (TZDs) in patients with symptomatic heart failure is generally avoided in combination with insulin due to the high risk of fluid overload and exacerbation of heart failure symptoms.
Several classes of drugs can significantly alter the effect of Insulin Degludec, requiring close monitoring and potential dose adjustments:
Insulin Degludec must NEVER be used in the following circumstances:
Data on the use of Insulin Degludec in pregnant women are limited. However, maintaining good glycemic control during pregnancy is vital, as poorly controlled diabetes increases the risk of birth defects, stillbirth, and macrosomia (large birth weight).
Insulin Degludec is an ultra-long-acting basal insulin analog. Its primary action is the regulation of glucose metabolism. It binds to the insulin receptor, stimulating tyrosine kinase activity. This triggers a signaling cascade that results in the translocation of glucose transporter proteins (GLUT4) to the cell surface of muscle and adipose tissues. This allows glucose to enter the cells. Additionally, it inhibits hepatic glucose output by suppressing gluconeogenesis and glycogenolysis. The unique 'ultra-long' nature is due to the B29 lysine substitution with a fatty acid side chain, which promotes the formation of stable multi-hexamers in subcutaneous tissue.
The pharmacodynamic profile of Insulin Degludec is characterized by a stable, peakless glucose-lowering effect that lasts for more than 42 hours. This is significantly longer than the 24-hour window of first-generation basal insulins. This 'flat' profile reduces the variability in blood sugar levels from day to day. Tolerance does not typically develop; the drug remains effective as long as the patient's underlying insulin sensitivity does not change drastically.
| Parameter | Value |
Common questions about Insulin Degludec
Insulin Degludec is a prescription medication used to improve blood sugar control in adults and children (1 year and older) with Type 1 or Type 2 diabetes mellitus. As an ultra-long-acting basal insulin, it provides a steady, baseline level of insulin that works for over 42 hours. It helps prevent high blood sugar levels between meals and during sleep. It is not used to treat diabetic ketoacidosis or for rapid control of high blood sugar. Your doctor will determine if it should be used alone or with other diabetes medications.
The most common side effect of Insulin Degludec is hypoglycemia, or low blood sugar, which can cause symptoms like shakiness, sweating, and confusion. Other frequent side effects include injection site reactions such as redness, pain, or swelling. Some patients may experience weight gain as their glucose levels stabilize. Upper respiratory tract infections, like the common cold, have also been reported. Rarely, it can cause peripheral edema, which is swelling in the hands or feet due to fluid retention.
Drinking alcohol while using Insulin Degludec can be risky because alcohol can cause your blood sugar to drop unpredictably. It can also interfere with your liver's ability to release glucose, potentially leading to severe or prolonged hypoglycemia. Furthermore, alcohol may mask the symptoms of low blood sugar, making it harder for you to recognize and treat an episode. If you choose to drink, it should be done in moderation and always accompanied by food. You should discuss your alcohol consumption habits with your healthcare provider for personalized safety advice.
Insulin Degludec is generally considered safe during pregnancy when the benefits of maintaining stable blood sugar outweigh the potential risks. Clinical studies have not shown an increased risk of major birth defects or pregnancy complications compared to other insulins. However, insulin needs change frequently throughout pregnancy, requiring very close monitoring by a medical team. Many physicians may still prefer older insulins with more extensive long-term data for pregnant patients. Always inform your doctor immediately if you are pregnant or planning to become pregnant while using this medication.
Insulin Degludec starts to lower blood sugar within an hour or two of injection, but it does not reach its full, steady-state effect immediately. It typically takes 3 to 4 days of consistent, once-daily dosing to reach a stable level in your bloodstream. Because it is designed for long-term basal control, it does not have a 'peak' time like shorter-acting insulins. Instead, it provides a flat, consistent effect for at least 42 hours. It is not intended for use when rapid results are needed to correct a high blood sugar spike.
You should never stop taking Insulin Degludec suddenly without consulting your healthcare provider. For individuals with Type 1 diabetes, stopping insulin can lead to diabetic ketoacidosis (DKA), a life-threatening emergency where the body produces excess blood acids. For those with Type 2 diabetes, stopping the medication can lead to severely high blood sugar levels and long-term complications. If you need to change your medication, your doctor will provide a specific plan to transition you to a different insulin or treatment. Always ensure you have an adequate supply of insulin to avoid running out.
If you miss a dose of Insulin Degludec, you should take it as soon as you realize it, but you must ensure there are at least 8 hours between the missed dose and your next scheduled dose. After that, you can return to your regular once-daily schedule. Do not take two doses at the same time to make up for a missed one, as this significantly increases your risk of severe hypoglycemia. If you are unsure of what to do, contact your doctor or pharmacist for guidance. Keeping a daily log can help you stay on track with your injections.
Yes, weight gain is a common side effect of most insulin therapies, including Insulin Degludec. This happens for two main reasons: first, as your blood sugar is better controlled, your body stops losing excess sugar through your urine. Second, insulin is an anabolic hormone that promotes the storage of energy as fat. The amount of weight gain varies by individual and is often related to diet and physical activity levels. Working with a registered dietitian and maintaining a regular exercise routine can help manage this effect while you achieve your glycemic goals.
Insulin Degludec can be taken with many other medications, but several drugs can interfere with how it works. For example, steroids can raise blood sugar, while certain blood pressure meds like ACE inhibitors can lower it. Beta-blockers are particularly concerning because they can hide the symptoms of low blood sugar. It is also sometimes used in combination with oral diabetes pills or GLP-1 agonists. Because of these potential interactions, you must provide your doctor with a complete list of all prescription drugs, over-the-counter medicines, and herbal supplements you are using.
As of 2026, Insulin Degludec is primarily available under the brand name Tresiba. While the patents for some older insulin analogs have expired, allowing for 'biosimilars,' Insulin Degludec is a more recent innovation. Generic versions of complex biological drugs like insulin are called biosimilars rather than generics. Check with your pharmacist or insurance provider to see if a lower-cost biosimilar version has become available in your region. Always ensure that any substitute is approved by your doctor to maintain consistent blood sugar control.
Other drugs with the same active ingredient (Insulin Degludec)
> Warning: Stop taking Insulin Degludec and call your doctor immediately if you experience any of these serious symptoms:
With prolonged use, the most significant long-term concern is the management of weight and the potential for injection site skin changes. Chronic use of insulin requires diligent rotation of injection sites to maintain consistent absorption. There is no evidence that Insulin Degludec increases the risk of cardiovascular events or cancer over long periods; in fact, the DEVOTE trial (2017) demonstrated cardiovascular safety and a lower rate of nocturnal hypoglycemia over long-term use compared to insulin glargine.
No FDA black box warnings currently exist for Insulin Degludec. However, it carries significant warnings regarding the risk of hypoglycemia and the danger of sharing insulin pens between patients, which can lead to the transmission of bloodborne pathogens.
Report any unusual symptoms or persistent side effects to your healthcare provider immediately to ensure your treatment plan remains safe and effective.
Regular monitoring is essential for safety and efficacy:
Your ability to concentrate or react may be impaired if you have hypoglycemia. Do not drive or operate heavy machinery until you know how Insulin Degludec affects you and until your blood sugar levels are stable. Always check your blood sugar before driving long distances.
Alcohol can either increase or decrease the blood-glucose-lowering effect of insulin. It can also mask the warning signs of hypoglycemia and may lead to delayed, severe low blood sugar. If you choose to drink alcohol, do so in moderation and always consume food with your drink. Consult your doctor for specific guidance.
Never stop taking Insulin Degludec abruptly unless directed by your doctor. For Type 1 diabetics, stopping insulin can lead to Diabetic Ketoacidosis (DKA), a life-threatening condition. If the medication must be discontinued, your healthcare provider will provide a transition plan to another insulin product.
> Important: Discuss all your medical conditions, including any history of heart, kidney, or liver disease, with your healthcare provider before starting Insulin Degludec.
Insulin Degludec does not typically interfere with standard laboratory tests. However, it will naturally lower blood glucose and HbA1c levels, which are the intended therapeutic targets. It may also lead to lower serum potassium readings.
Mechanism of Interactions: Most interactions occur via pharmacodynamic mechanisms, where the second drug either mimics insulin's effect (increasing hypoglycemia risk) or opposes it (causing hyperglycemia). Unlike many oral drugs, Insulin Degludec does not rely on the CYP450 liver enzyme system for metabolism, so pharmacokinetic interactions involving enzyme inhibition or induction are rare.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. Keep an updated list to share at every medical appointment.
Conditions requiring careful risk-benefit analysis before using Insulin Degludec include:
Patients who have had allergic reactions to other insulin analogs (like Insulin Glargine or Insulin Detemir) should be monitored closely when starting Insulin Degludec. While the chemical structures are different, there is a theoretical risk of cross-reactivity to common preservatives used in insulin formulations, such as metacresol.
> Important: Your healthcare provider will evaluate your complete medical history and current health status before prescribing Insulin Degludec to ensure it is the safest option for you.
It is generally considered safe to use Insulin Degludec while breastfeeding. Insulin is a large protein molecule that is naturally present in human milk. Even if small amounts of Insulin Degludec pass into breast milk, it would likely be degraded in the infant's digestive tract and not absorbed into the baby's bloodstream. Breastfeeding mothers may find that their insulin requirements change, often decreasing, due to the energy expenditure of milk production.
Insulin Degludec is approved for use in pediatric patients aged 1 year and older with both Type 1 and Type 2 diabetes.
In clinical trials, a large number of patients over 65 used Insulin Degludec.
No formal pharmacokinetic studies have been conducted specifically for renal impairment with Degludec, but clinical experience shows that insulin requirements decrease as kidney function (measured by GFR) declines. Patients on dialysis may have highly variable insulin needs and require intensive monitoring.
In patients with hepatic impairment, the body's ability to produce glucose and break down insulin is altered. This increases the risk of hypoglycemia. Dose adjustments should be made based on frequent blood glucose readings rather than a standardized formula.
> Important: Special populations require individualized medical assessment and more frequent contact with their diabetes care team.
|---|---|
| Bioavailability | High (Subcutaneous) |
| Protein Binding | >99% (to Albumin) |
| Half-life | ~25 hours |
| Tmax | ~9 hours (at steady state) |
| Metabolism | Proteolytic degradation (no CYP involvement) |
| Excretion | Cellular degradation; minimal renal/fecal excretion |
Insulin Degludec is classified as an Insulin Analog [EPC]. It is specifically an ultra-long-acting basal insulin. Related medications include Insulin Glargine (Lantus, Toujeo) and Insulin Detemir (Levemir), though Degludec has a longer duration of action than both.