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Indications

Insulin Degludec is a long-acting (basal) insulin used to control blood sugar in adults, adolescents and children from 1 year of age with diabetes mellitus. It is also available in a fixed combination with the rapid-acting Insulin Aspart, which covers both background needs and the rise in sugar after a main meal.

How It Works

Insulin helps sugar move from the blood into the body's cells, where it is used for energy, and stops the liver from releasing too much sugar. After injection under the skin, Insulin Degludec forms a store from which it is released slowly and steadily, giving a smooth effect that lasts more than 24 hours with a low risk of night-time low sugar.

Dosage and Administration

It is injected under the skin of the thigh, upper arm or abdomen, usually once a day, as prescribed. The dose is individual and adjusted by your doctor according to blood sugar readings. It is best taken at about the same time each day; if needed, the timing can be changed as long as there are at least 8 hours between doses. The combination with Insulin Aspart is injected with a main meal, once or twice a day as prescribed. Change the injection site each time. Never inject it into a vein or muscle or use it in an insulin pump.

Interactions

Other diabetes medicines, ACE inhibitors and some antibiotics can increase the risk of low blood sugar. Corticosteroids, thiazide diuretics, thyroid hormones and some antipsychotics can raise blood sugar. Beta blockers such as Propranolol can hide the warning signs of low sugar. Pioglitazone with insulin may increase the risk of heart failure. Alcohol can cause unpredictable low sugar.

Contraindications

Do not use if you are allergic to Insulin Degludec or any ingredient, or during an episode of low blood sugar (hypoglycaemia).

Side Effects

The most common side effect is low blood sugar, with signs such as sweating, shaking, fast heartbeat, hunger, headache, blurred vision or confusion. Others include:

• Redness, swelling or itching at the injection site
• Lumps or thickening of the skin if the same site is used repeatedly
• Swelling of the ankles or weight gain

Get urgent medical help for severe low blood sugar with confusion, fits or unconsciousness, or for signs of a serious allergy such as widespread rash, swelling of the face or throat, or difficulty breathing.

Pregnancy and Lactation

Insulin is the preferred treatment for diabetes in pregnancy, and Insulin Degludec may be used under specialist care. Insulin needs change during pregnancy and after delivery, so close monitoring is needed. It can be used while breastfeeding.

Precautions and Warnings

Check your blood sugar regularly, especially when changing dose, diet, exercise or during illness. Always carry sugar or sweets for low sugar episodes. Check the insulin name and strength before each injection to avoid mix-ups, and never share pens or needles. Take care when driving if you are prone to low sugar.

Overdose

Too much insulin causes low blood sugar. For mild symptoms, take 15 to 20 g of fast-acting sugar (such as glucose tablets, juice or sugar in water) and then a snack. Severe low sugar with unconsciousness is an emergency and needs Glucagon or glucose into a vein given by a trained person or health professional.

Therapeutic Class

Antidiabetic agent (long-acting basal insulin analogue).

Storage

Before first use, store in a refrigerator at 2 to 8°C. Do not freeze and keep away from the freezer compartment. Once in use, the pen can be kept at room temperature below 30°C for the period stated on the leaflet. Keep the cap on to protect from light, and keep out of the reach of children.