Insulin Degludec
About
Insulin Degludec belongs to a group of medication called 'anti-diabetic' primarily used for the treatment of type 1 and type 2 diabetes mellitus in both children (above 1 year of age) and adults. Diabetes is a disease where your body does not produce enough insulin to control the level of your blood sugar. Treatment with Insulin Degludec helps to prevent complications from your diabetes.
Insulin Degludec contains insulin degludec which is a fast-acting insulin that works rapidly to normalize blood sugar levels by helping the sugar move from the blood into other tissues of the body. It typically begins working after 60 minutes and is a long-acting insulin preparation (lasts for more than 24 hours). It prevents the risk of having severe complications of diabetes. It stimulates the recovery of sugar in muscle and fat cells and thus suppresses the production of sugar in the liver.
In patients with type 1 diabetes, Insulin Degludec must be used with another type of insulin (like with short-acting insulin). On the other hand, in patients with type 2 diabetes, Insulin Degludec can be used with another type of insulin or with oral antidiabetic medicines. The common side effects of Insulin Degludec are hypokalaemia (low potassium), hypoglycemia (low blood sugar level), local injection site reactions, lipodystrophy (fat deposition under the skin), rash, and pruritus (itch skin) which may occur at the injection site. Most of these side effects of Insulin Degludec do not require medical attention and gradually resolve over time. However, if the side effects are persistent, reach out to your doctor.
Try not to stop taking Insulin Degludec of your own. Let your doctor know about this, as it may cause withdrawal symptoms. Do not take Insulin Degludec if you have any low blood glucose levels, kidney, liver, or heart problems, or problems with alcohol or other prescription recreational drugs. Along with Insulin Degludec, you should take a healthy diet, do regular exercise, and maintain weight as advised by your doctor. Insulin Degludec is a cold chain medicine, and so it has to be stored in the refrigerator between 2-8 degrees Celsius else its efficiency might get lost. Do not store in the freezer of the fridge.
Uses of Insulin Degludec
Medicinal Benefits
Insulin Degludec works by ensuring rapid and consistent sugar control. Insulin Degludec is a long-acting synthetic form of insulin that helps lower blood sugar levels by replacing the insulin that is produced by the body naturally. This drug also helps in moving sugar from the blood into different parts of the body so that body can effectively use the sugar in producing energy. Prevents the risk of having severe complications of diabetes. It stimulates the recovery of sugar in muscle and fat cells and thus suppresses the production of sugar in the liver. Insulin Degludec helps in improving the glycaemic control which in turn decreases the risk of progression of complications of diabetes like damage of retina (retinopathy), damage of kidney (nephropathy), damage of nerve cells (neuropathy), delayed wound healing, diabetic foot ulcer, and others. Besides this, Insulin Degludec can be safely prescribed to the diabetic mother in the pregnancy as well as lactation stage.
Directions for Use
Storage
Side Effects of Insulin Degludec
- Hypokalaemia (low potassium)
- Hypoglycemia (low blood sugar level)
- Local injection site reactions
- Lipodystrophy (fat deposition under the skin)
- Rash
- Pruritus (itchy skin)
In-Depth Precautions and Warning
Drug Warnings
Insulin Degludec is for subcutaneous (under the skin) use only. However, in rare cases, it can be given via infusion intravenously under medical supervision. If you are changing the insulin brand or if you need to inject your insulin by another method, it should be done under strict medical supervision. Cases of heart failure have been reported when pioglitazone was used with insulin, especially in patients at high risk of cardiac heart failure. The first hyperglycemia symptoms (high blood sugar level) may include excessive thirst, dry mouth, increased frequency of urination, nausea, vomiting, drowsiness, flushed dry skin, loss of appetite, and acetone odour of the breath. You should closely monitor these symptoms. Symptoms like heart failure, weight gain, and oedema (fluid deposition in tissue) should not be overruled. It is advisable not to consume alcohol as it may either increase or decrease your blood glucose level. Care should be taken while travelling across more than two time zones. Your doctor may adjust your insulin schedule. Insulin Degludec may decrease the level of potassium, leading to a state of hypokalaemia that, if left untreated, may lead to respiratory paralysis, irregular heartbeat rhythm, coma, and even death. Do not take Insulin Degludec if you have any low blood glucose levels, kidney, liver, or heart problems, or problems with alcohol or other prescription recreational drugs.
Drug Interactions
Drug-Drug Interaction: Insulin Degludec may have an interaction with drugs that may increase the risk of antiarrhythmic (disopyramide), hemorheological agents (pentoxifylline), antidiabetic (pramlintide), bleeding disorder drugs (octreotide), antipsychotic (propoxyphene, phenothiazines), female sex hormones (progestogen, oestrogen), thyroid hormones (levothyroxine), anti-asthmatics (albuterol, epinephrine, terbutaline), an antidepressant (fluoxetine, lithium), lipid-lowering pills (reserpine, niacin, clonidine, fenofibrate, guanethidine), pain killers (aspirin), antibiotics (isoniazid), blood sugar enhancing pills (glucagon), male hormone testosterone analogue (danazol), antibiotic (pentamidine).
Drug-Food Interaction: Insulin Degludec may interact with an ayurvedic, homoeopathy, Unani, herbal supplements or OTC items. Tell your doctor if you are using these products. Try to avoid alcoholic beverages with Insulin Degludec as it may increase or decrease your blood sugar level.
Drug-Disease Interaction: Insulin Degludec should not be given to patients with kidney disease, liver disease, low blood sugar/glucose level (hypoglycaemia), and low potassium level (hypokalaemia).
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou are recommended not to consume alcohol along with Insulin Degludec to avoid unpleasant side-effects. Alcohol may either decrease or increase the blood sugar level which can be fatal.
Pregnancy
safe if prescribedInsulin Degludec can be used during pregnancy. Your insulin dose may need to be changed during pregnancy and after delivery.
Breast Feeding
safe if prescribedInsulin Degludec can be given safely to nursing mothers but only under the supervision of a physician.
Driving
unsafeDrive with caution, Insulin Degludec usually causes drowsiness and affects driving ability. Your ability to concentrate and react may be reduced if you have hypoglycaemia (low blood sugar).
Liver
cautionInsulin Degludec to be taken with caution, especially if you have a history of liver diseases/conditions. The dose may have to be adjusted by your doctor.
Kidney
cautionInsulin Degludec to be taken with caution, especially if you have a history of kidney diseases/conditions. The dose may have to be adjusted by your doctor.
Children
safe if prescribedInsulin Degludec can be given safely to children more than 1-year-old; dose has to be prescribed by a child specialist.
Habit Forming
Diet & Lifestyle Advise
- Exercise may lower your body’s need for insulin during and for some time after the physical activity.
- Exercise may also speed up the effect of an insulin dose, especially if the exercise involves the area of the injection site (for example, the leg should not be used for injection just prior to running).
- Discuss with your doctor how you should adjust your insulin regimen to accommodate exercise.
- Avoid eating sugar food and prefer food cooked food low in calories.
- When traveling across more than 2 time zones, you should talk to your doctor concerning adjustments in your insulin schedule.
Special Advise
- Your doctor may tell you to have a regular potassium level as prolonged administration causes a life-threatening condition of hypokalemia (low potassium).
- Do not mix Insulin Degludec with other insulin form or dilute it.
- Store Insulin Degludec between 2-8 degree celsius temperature only.
Patients Concern
Disease/Condition Glossary
Type 1 diabetes mellitus: In type 1 diabetes mellitus, our body does not make insulin (the hormone which helps to decrease sugar levels in the blood) to control blood sugar levels.
Type 2 diabetes mellitus: In type 2 diabetes mellitus, either the body stops producing enough insulin, or there is resistance to the action of insulin. As a result, insulin is produced in sufficient amounts but is unable to act on the tissues of the organs.
FAQs
Insulin Degludec is only a part of a complete diabetes control program that includes regular blood sugar testing, diet, exercise, weight control, and special medical care. So follow all the instructions given by the doctor.
It is advised to tell all the medicines that you are using like pioglitazone or rosiglitazone as taking other diabetes medicines may increase the risk of serious heart problems.
Insulin Degludec typically begins working after 60 minutes and will last for more than 24 hours.
Insulin Degludec can be given to treat both the condition of type 1 and type 2 diabetes mellitus. However, your doctor will decide whether Insulin Degludec can be given to you or not depending on your present condition. Insulin Degludec should be avoided in patients who are allergic to Insulin Degludec or other forms of insulin, patients with kidney disease, liver disease, low blood sugar/glucose level (hypoglycemia), and low potassium level (hypokalaemia).
Try to avoid intake of alcoholic beverages with Insulin Degludec as it may increase or decrease your blood sugar level.
Cold sweat; cool pale skin; headache; rapid heartbeat; feeling sick; feeling very hungry; temporary vision changes; drowsiness; unusual tiredness and weakness; nervousness or tremor; feeling anxious; feeling confused; difficulty in concentrating are some of the common signs of the low blood sugar level in an individual.
If you experience low blood sugar, eat glucose tablets, or another high sugar snack (e.g. sweets, biscuits, fruit juice). Measure your blood sugar if possible and rest. Always carry glucose tablets or high sugar snacks with you. You should give a call to any of your family members if you are feeling dizziness or drowsiness.
Local allergic reactions (pain, redness, hives, inflammation, bruising, swelling, and itching) at the injection site may occur. These usually disappear after a few weeks of taking your insulin. If they do not disappear, or if they spread throughout your body, talk to your doctor immediately.
You can inject Insulin Degludec in your upper arm, thigh, or stomach area. Do not inject Insulin Degludec into your vein or muscle. Try to change (rotate) the injection site with each dose to avoid skin irritation in the same injection site.
If you have opened the insulin pen once, it must be stored at room temperature (25-degree Celsius) and may be used for up to 56 days after its first use.
