How to Administer Insulin Degludec
Insulin degludec should be administered subcutaneously once daily at any time of day, with flexibility in timing allowed due to its ultra-long action profile of approximately 25 hours. 1, 2
Administration Technique
- Insulin degludec is administered via subcutaneous injection into the thigh, upper arm, or abdomen 1
- Prior to injection, visually inspect the insulin - it should appear clear and colorless 1
- Do not shake or roll the vial before drawing up the medication 1
- Injection sites should be rotated within the same anatomical region to reduce the risk of lipodystrophy and localized cutaneous amyloidosis 1
- Insulin degludec should not be diluted or mixed with any other insulin products 1
Dosing Considerations
- For insulin-naïve patients with type 2 diabetes, the recommended starting dose is 10 units once daily 3
- For patients already on insulin therapy who are switching to degludec, consider the previous basal insulin dose when initiating 3
- For patients receiving enteral feedings who require basal insulin, a starting dose of 10 units of insulin degludec daily is recommended 3
- Dose adjustments should be based on blood glucose monitoring results and individualized glycemic targets 3
Unique Features and Advantages
- Unlike other basal insulins, insulin degludec allows for flexible dosing times without compromising efficacy or safety 4, 2
- Studies have shown that insulin degludec can be administered at different times from day to day (with intervals between 8-40 hours) while maintaining glycemic control 2
- This flexibility may be particularly beneficial for patients with irregular schedules, those who travel frequently, or those dependent on healthcare professionals for insulin administration 4
Safety Considerations
- Insulin degludec has demonstrated a lower risk of nocturnal hypoglycemia compared to insulin glargine in clinical trials 5, 6
- The ultra-long action profile creates a steady-state profile with a lower peak-to-trough ratio than other basal insulins 4
- As with all insulins, patients should be educated about recognizing and managing hypoglycemia 3
- Patients should carry at least 15g of carbohydrate to treat potential hypoglycemic episodes 3
Storage and Handling
- Unopened insulin degludec vials should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C) 1
- Once in use, insulin degludec vials can be stored at room temperature for up to 56 days 1
- Do not use insulin degludec past the expiration date or beyond 56 days after first use 1
Special Situations
- For perioperative management, administer 60-80% of the usual degludec dose on the day of surgery 3
- For patients with type 1 diabetes, insulin degludec must be used in combination with mealtime insulin 5
- For patients receiving continuous enteral feedings, insulin degludec can be administered once daily as the basal component of an insulin regimen 3
Remember that regular blood glucose monitoring is essential for appropriate dose adjustments and optimal glycemic control when using insulin degludec 3.