Insulin Degludec

Tresiba

Insulin degludec is an ultra-long-acting basal analog insulin designed for an exceptionally steady, more-than-daily action. It is made by removing the last amino acid of the B-chain and attaching a fatty-acid (hexadecanedioic acid) side chain to lysine at B29 through a small glutamic-acid spacer. In the pen the insulin exists as stable dihexamers; once injected, the phenol from the formulation diffuses away and degludec self-assembles into long, soluble chains of multihexamers that form a depot under the skin. Zinc slowly diffuses out, individual hexamers detach from the ends of these chains, and monomers are released gradually — a slow-release mechanism built into the molecule itself. The result is a basal insulin with a very long half-life (roughly 25 hours) and a duration well beyond 42 hours, giving an extremely flat, consistent day-to-day profile at steady state. Because coverage overlaps from day to day, degludec allows flexible injection timing when needed, and clinical programs have shown low rates of nocturnal hypoglycemia relative to older basal insulins. The fatty-acid side chain also binds albumin in the circulation, adding to the buffering of its action. Degludec is used once daily as the background insulin in type 1 and type 2 diabetes, paired with mealtime insulin or other therapies, and is also available combined with a rapid-acting insulin or with the GLP-1 agonist liraglutide in fixed-ratio products. It is a prescription medicine whose main risk, like all insulins, is hypoglycemia; its long duration means dose changes take a couple of days to fully show their effect. It is used under medical guidance and is not a wellness product.