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Ultra-long-acting Insulin Analogue

Insulin Degludec

Brand names: Tresiba

Insulin degludec is an ultra-long-acting basal insulin analogue used once daily to provide background insulin cover in type 1 and type 2 diabetes.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

After injection it forms soluble multihexamers in the subcutaneous tissue that slowly release monomers, producing a flat, prolonged and consistent glucose-lowering effect.

Prescribing in practice

  • High-strength preparations exist and look-alike confusion can cause dangerous overdose, so prescribe units in words and specify the exact strength and device.
  • Its long duration gives flexibility in injection timing but means dose changes take several days to reach full effect.
  • Hypoglycaemia remains a risk; review concurrent glucose-lowering therapy against current prescribing references.

Monitoring

Monitor fasting and overall blood glucose and HbA1c, titrating slowly because the full effect of changes is delayed.

Counselling the patient

  • Take it once daily; if needed the time can vary slightly day to day but keep a regular routine.
  • Carry fast-acting carbohydrate and know the signs of hypoglycaemia.
  • Check you have the correct strength and device, and never share pens.

Evidence & guidelines

Insulin degludec provides stable basal cover with low nocturnal hypoglycaemia, as shown in its trial programme, and is recommended within NICE diabetes guidance.

Reference: NICE NG17; DEVOTE Trial (NEJM 2017); MHRA Insulin Safety Alert; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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