TRESIBA (Insulin Degludec)

What is this medication?

TRESIBA (Insulin Degludec)
Long Acting Insulin

TRESIBA (Insulin Degludec) is indicated for diabetes mellitus types 1 and 2.

How does this medication work? 

TRESIBA (Insulin Degludec) 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 then 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).

How should I take this medication? 

TRESIBA (Insulin Degludec) 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

How to Take: Follow instructions provided by physician/pharmacy label, use consistently at same times each day unless otherwise directed. Injection generally into abdomen, thighs, buttocks, or arms with absorption rates varying from site to site.  Be consistent with the part of body you inject into but rotate injection site to avoid redistribution of fat and excessive irritation to the area.  For example, if you choose abdomen which is the most common, inject in circular order at least 2 inches from navel.

Note: Do not use if solution seems viscous (thick) or appears cloudy, only use if clear, colorless and with no visible particles.  Avoid injecting cold insulin as it may be painful.  

What should I watch for while using this medication? 

Before starting ITRESIBA (Insulin Degludec) make 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. 

What if I miss a dose?

Adult patients who miss a dose should inject their daily dose during waking hours upon discovering the missed dose, then continue with their regular dosing schedule. Ensure that at least 8 hours have elapsed between injections. 

How should I store this medication?

Before first use, store TRESIBA in a refrigerator at 2°C – 8°C. Keep away from the freezing element. Do not freeze.

After first opening or carried as a spare, TRESIBA can be stored at room temperature (not above 30°C) or in a refrigerator (2°C –8°C) for up to 8 weeks. Keep the cap on the pen in order to protect from light.

What are the possible side effects of using this medication?

Headache, severe hypoglycemia, antibody development, nasopharyngitis, upper respiratory tract infection.

Note this is not a complete list of side effects for TRESIBA (Insulin Degludec), only common ones.