biology

Insulin degludec

Insulin degludec is a biology topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Insulin degludec rather than just read about it. In short: Insulin degludec (INN/USAN) is an ultralong-acting basal insulin analogue that was developed by Novo Nordisk under the brand name Tresiba. It is administered via subcutaneous injection to help control the blood sugar level of those with diabetes.

Key takeaways

Insulin degludec belongs to biology; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Insulin degludec to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Insulin degludec from memory before moving on to harder problems.

Reference excerpt

Insulin degludec (INN/USAN) is an ultralong-acting basal insulin analogue that was developed by Novo Nordisk under the brand name Tresiba. It is administered via subcutaneous injection to help control the blood sugar level of those with diabetes. It has a duration of action that lasts up to 42 hours (compared to 18 to 26 hours provided by other marketed long-acting insulins such as insulin glargine and insulin detemir), making it a once-daily basal insulin, that is one that provides a base insulin level, as opposed to the fast- and short-acting bolus insulins. Insulin degludec is a modified insulin that has one single amino acid deleted in comparison to human insulin, and is conjugated to hexadecanedioic acid via gamma-L-glutamyl spacer at the amino acid lysine at position B29. It is included on the World Health Organization's List of Essential Medicines as an equivalent to insulin glargine. In 2023, it was the 152nd most commonly prescribed medication in the United States, with more than 3 million prescriptions.

Medical uses Insulin degludec is indicated to improve glycemic control in people with diabetes. In a meta-analysis involving data from 3 randomized controlled trials having 1171 patients, thrice weekly insulin degludec had similar efficacy as daily insulin glargine injections with regards to the fasting blood glucose reduction, having similar safety and risk of low blood glucose (hypoglycaemia) profile. However the overall HbA1c reduction with thrice weekly insulin degludec injection was marginally lower than that of daily insulin glargine injections. Hence thrice weekly degludec injections can be considered in extremely needle prick phobic patients as a choice for basal insulin therapy.

Side effects A significant side effect of insulin therapy is hypoglycemia. A meta-analysis of clinical trials published in July 2012 found 39 to 47.9 events of hypoglycemia (defined as blood glucose <56 mg/dL) per patient year, with higher rates in the more concentrated degludec formulation. Rates of nocturnal hypoglycemia ranged from 3.7 to 5.1 events per patient year. A more recent Cochrane systematic review found there was no significant differences in rates of diurnal, nocturnal hypoglycemia or any other studies outcomes when using insulin degludec as compared to insulin glargine, insulin detemir and NPH insulin for the management of type 1 diabetes in either adults or children.

Pharmacology

Mechanism of action Insulin degludec is an ultra-long acting insulin that, unlike insulin glargine, is active at a physiologic pH. The addition of hexadecanedioic acid via an amide linkage to lysine at the B29 position allows for the formation of multi-hexamers in subcutaneous tissues. This allows for the formation of a subcutaneous depot that results in slow insulin release into the systemic circulation.

Pharmacokinetics Insulin degludec has an onset of action of 30–90 minutes (similar to insulin glargine and insulin detemir). There is no peak in activity, due to the slow release into systemic circulation. The duration of action of insulin degludec is reported as being longer than 24 hours. Because the half-life is longer than 24 hours, it is approved for daily dosing at any time each day - as long as more than 8 hours has elapsed since the previous dose. A missed dose is advised to be taken as soon as remembered, then return to a normal schedule.

Effectiveness profile Studies have shown that participants taking insulin degludec needed to take significantly smaller doses of basal insulin than those taking insulin glargine U100, while achieving similar blood glucose levels. However, in a systematic review no clinically significant differences in measures of effectiveness were found when using insulin degludec as compared to insulin glargine, insulin detemir, and NPH insulin for the management of type 1 diabetes in either adults or children. Insulin degludec also has the ability to be mixed with other insulins, thereby improving glycemic control. This cannot be done using other long-acting insulins. A physician involved in the trials was quoted as saying,

This allows the creation of a novel formulation that retains the smooth control of a long-acting basal with rapid-acting mealtime control from insulin aspart. This 2-component insulin retains the ultralow risk characteristics of degludec with simultaneous mealtime coverage.

History Insulin degludec has been filed for registration in the United States. After the completion of additional cardiac safety studies requested by the US Food and Drug Administration (FDA) in February 2013, it received FDA approval in September 2015 and marketing began in January 2016.

Clinical trial data

… excerpt ends here. Continue reading the full article.

Illustrations

Worked examples

Example 1 — a first encounter with Insulin degludec

Start with the simplest possible case. Write down what Insulin degludec claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In biology, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Insulin degludec before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Insulin degludec ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Insulin degludec

In research: Insulin degludec appears in biology research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Insulin degludec in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Insulin degludec is common in secondary-school and first-year university syllabi. It links to neighbouring topics Human proteins, Insulin analogues, Peptide hormones, so understanding it makes those chapters shorter.
In everyday life: Look for Insulin degludec outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Insulin degludec in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Insulin degludec means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Insulin degludec out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Insulin degludec in simple terms?

Why does Insulin degludec matter?

Because it connects several biology ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Insulin degludec?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Insulin degludec.