From the Guidelines
Degludec (brand name Tresiba) is a long-acting insulin that can be more effective than Lantus (insulin glargine) for lowering blood glucose, with a lower risk of hypoglycemia and more flexible dosing schedule, as demonstrated in recent clinical trials 1. When considering an alternative to Lantus, several factors come into play, including efficacy, safety, and patient convenience.
- Key advantages of degludec include:
- Longer duration of action (up to 42 hours) compared to glargine (up to 24 hours)
- Lower risk of nocturnal hypoglycemia
- More flexible dosing schedule
- Less day-to-day variability in glucose-lowering effect The improved efficacy of degludec is due to its unique molecular structure, which allows for a more gradual and consistent release from subcutaneous tissue, resulting in a flatter and more stable pharmacodynamic profile compared to glargine 1. Typical starting dose of degludec is 10 units once daily, adjusted based on individual patient needs, and it can be administered at any time of day, but should be given at the same time each day for consistency. When switching from glargine to degludec, it is recommended to start with the same total daily dose and monitor blood glucose closely, adjusting as needed, as some patients may require a lower dose of degludec to achieve the same glycemic control, highlighting the importance of individualized therapy and careful dose titration 1.
From the Research
Alternative to Lantus (Insulin Glargine)
- Insulin degludec is an alternative to Lantus (insulin glargine) with better efficacy for lowering blood glucose as a long-acting insulin 2, 3, 4, 5, 6
Characteristics of Insulin Degludec
- Ultra-long-acting insulin analogue with a flat and stable glucose-lowering profile 2
- Duration of action exceeding 30 hours 2
- Less inter-patient variation in glucose-lowering effect than insulin glargine 2
- Peakless, extended and highly predictable glucose-lowering effect 3
Benefits of Insulin Degludec
- Sustained glycaemic control with less hypoglycaemia 2, 4
- Potential for a simpler insulin regimen with fewer daily injections 2
- Lower rate of overall and nocturnal hypoglycaemia compared to insulin glargine 4
- Comparable efficacy to insulin glargine 6