From the Research
Insulin degludec should be administered at the same time each day for optimal glycemic control, but it can be taken at any time of day due to its ultra-long duration of action and flat, stable profile. The most recent and highest quality study, published in 2024 1, compared insulin efsitora alfa with degludec in type 2 diabetes without previous insulin treatment, and found that degludec was effective in reducing glycated hemoglobin levels.
Key Points
- Degludec offers flexibility in timing due to its ultra-long duration of action (over 42 hours) and flat, stable profile, making it suitable for patients with variable schedules or those who occasionally forget doses.
- If a dose is missed, it can be taken as soon as remembered, ensuring at least 8 hours between doses.
- Degludec works by forming soluble multi-hexamers upon subcutaneous injection, creating a depot that slowly releases insulin monomers into circulation, providing consistent blood glucose control with less risk of nocturnal hypoglycemia compared to other long-acting insulins.
- The steady-state concentration is typically achieved after 2-3 days of daily administration, and patients should still aim for consistency in timing when possible to maintain stable blood glucose levels.
Administration Timing
- Degludec can be administered at any time of day, but it is recommended to take it at the same time each day for optimal glycemic control.
- The flexibility in timing is particularly beneficial for patients with variable schedules or those who occasionally forget doses.
Comparison with Other Insulins
- Degludec has been compared with other insulins, such as insulin glargine, in several studies, including the DEVOTE trial 2, which found that degludec was noninferior to glargine with respect to the incidence of major cardiovascular events.
- Another study, published in 2021 3, compared tirzepatide with degludec and found that tirzepatide was superior to degludec in reducing HbA1c and bodyweight at week 52, with a lower risk of hypoglycemia.