CSA NA – FDA Approved – REMS (N) – Can Ship
How Does it Work
Insulin degludec, Tresiba works on liver, muscle and adipose (fat) tissue to regulate the metabolism of carbohydrates, protein, and fats. In the liver and muscles, it increases glycogen synthesis which is the immediate storage form of glucose. It increases fat production by increasing fatty acid release from the liver in the form of lipoproteins which adipose tissue converts to fatty acids than to triglycerides for storage whilst also stopping the metabolism of triglycerides (fat). Insulin also increases the cellular uptake of amino acids and some electrolytes such as potassium into the cell. In muscle tissue, protein synthesis is increased.
Normally insulin is produced by the pancreas however insulin products for pharmaceutical use have been produced via recombinant DNA technology using certain bacteria (they splice the gene for insulin production into bacterial DNA so the cell produces insulin – a gene is a portion of DNA or RNA that produces one specific protein). Insulin degludec is different from human insulin as it has some modifications to make it last longer. It involves the omission of the amino acid threonine in position B-30 of the B-chain, and the subsequent addition of a side chain composed of glutamic acid and a C16 fatty acid for a glycine (these are all names of amino acids which are the building blocks of proteins such as insulin).
Indications For Use
Insulin degludec, Tresiba is indicated for diabetes mellitus types 1 and 2
Before starting Insulin degludec, Tresiba makes sure your physician is aware of any allergies or medications you currently take if you have had bariatric surgery, cardiovascular disease, have kidney disease, liver disease, diabetic ketoacidosis, are pregnant or breastfeeding.
Insulin degludec, Tresiba is long-acting or basal insulin. It is injected subcutaneously once daily, whereas many other long-acting insulins require twice-daily dosing. In type 2 diabetes someone usually starts around 10 units per day or 0.1-0.2mg/kg/day and the dosage is slowly increased until glucose control is achieved. In type 1 diabetes 40-50% of total daily insulin is given as intermediate or long-acting with the rest divided into fast-acting mealtime insulin. If converting from another insulin the number of units given may need to be lowered as a precaution
Pharmacist Tips On Using
How to Take Insulin degludec, Tresiba: Follow instructions provided by physician/pharmacy label, use consistently at same times each day unless otherwise directed, refrigerate product, not in use (36-46 Fahrenheit, 2-8 Celsius), the vial in use may be kept at room temperature (below 86 Fahrenheit, 30 Celsius) for up to 28 days (discard if not used by this point). Injection generally into abdomen, thighs, buttocks, or arms with absorption rates varying from site to site. Be consistent with the part of the body you inject into but rotate the injection site to avoid redistribution of fat and excessive irritation to the area. For example, if you choose the abdomen which is the most common, inject in circular order at least 2 inches from the navel.
You Need to Avoid: Do not use if the solution seems viscous (thick) or appears cloudy, only use if clear, colourless and with no visible particles. Avoid injecting cold insulin as it may be painful.
Central nervous system: Headache (9% to 12%)
Endocrine & metabolic: Severe hypoglycemia (type 1 diabetics on combination insulin therapy: 10% to 18%; type 2 diabetics on combination therapy: ≤5%)
Immunologic: Antibody development
Respiratory: Nasopharyngitis (13% to 24%), upper respiratory tract infection (8% to 12%)
Note- this is not a complete list of side effects, only common ones, are dose-dependent and vary based on other medical conditions or state of health
Frequently Asked Questions
What is hypoglycemia?
Hypoglycemia is a condition of low blood sugar (>3.9mmol/L-Canada; 70mg/dL-US) which is considered a medical emergency whereas hyperglycemia is a slowly progressive condition. It generally occurs with irregularities in diet, exercise, and medications in diabetic patients. It is preferably treated with simple sugars such as dextrose; regular table sugar can work but is slower acting as it needs to be digested and if blood sugar is extremely low this delay can be a problem. Hypoglycemia has a large host of progressive symptoms from hunger, headache, nausea, sweating, palpitations, mood swings, irritability to seizure, coma and in severe cases, death.