Tresiba(R) (Insulin Degludec) A New Basal Insulin For Adult Patients With Type 1 And Type 2 Diabetes Is Available In The UK

Main Category: Diabetes
Article Date: 06 Mar 2013 - 2:00 PST


Insulin degludec is indicated for the treatment of diabetes mellitus in adults[1].

Novo Nordisk UK has announced that insulin degludec (brand name Tresiba(R)), a new oncedaily basal insulin for adult patients with type 1 and type 2 diabetes, is available in the UK as a new treatment option.

Insulin degludec effectively reduces blood glucose levels in patients with type 1 and 2 diabetes[2],[3] while significantly reducing the risk of nighttime hypoglycaemia, compared with the most commonly prescribed basal insulin in the UK[4]:

• 25% reduction in nighttime hypoglycaemia for patients with type 1 diabetes [4.41 vs 5.86 episodes per patient year of exposure (PYE); p=0.02][3]
• 36% reduction in nighttime hypoglycaemia for insulin naive patients with type 2 diabetes [0.25 vs 0.39 episodes per PYE; p<0.04][2]
• There was no significant difference in the rate of confirmed overall hypoglycaemic episodes for insulin degludec versus insulin glargine in patients with type 1 diabetes (42.54 vs 40.18 episodes per patient year of exposure p=0.48)[3] or
• for insulin naive patients with type 2 diabetes (1.52 vs 1.85 per patient year of exposure; p=0.11)[2]

Insulin degludec is a oncedaily basal insulin which can be administered at any time of the day, however preferably at the same time every day. It is the first insulin to offer people with diabetes the flexibility in the timing of insulin administration on occasions when administration at the same time of day is not possible. A minimum of eight hours between injections should always be ensured[1],[5].

"Many of my patients tell me when I see them in clinic that they have difficulty taking their insulin at exactly the same time each day. This is often for reasons which we can all sympathise with and understand. For example picking children up from school or working irregular shifts at work. It is thus very useful that there is now an insulin which, because of its longer duration of action, is able to offer patients a bit more flexibility in terms of timing of their dose without compromising either their glycaemic control or risk of hypoglycaemia", commented Professor Melanie J Davies, Professor of Diabetes Medicine, University of Leicester and Honorary Consultant, University Hospitals of Leicester.

Hypoglycaemic episodes are one of the most common side effects of insulin treatment[6], and although insulin degludec significantly reduces nighttime hypoglycaemia, hypoglycaemia is still the most frequent side effect[1]. However, of particular concern is the risk of nighttime hypoglycaemia; often when the patient is sleeping and therefore less aware of the onset of symptoms[7].

While reduced risk of hypoglycaemia has obvious benefits for the person with diabetes, it is also important for society in general. The economic impact of hypoglycaemia in the UK is particularly significant[8]. In 2010/11, the estimated UK cost for severe hypoglycaemia was GBP30.4 million and for moderate hypoglycaemia GBP41.8 million[8]. Each severe hypoglycaemic episode involving hospitalisation, costs the NHS an estimated GBP2,153 per person[9],[10]. Almost 50% of severe hypoglycaemic episodes occur at night and the most severe nighttime episodes can be fatal if left untreated[7]. Severe episodes are estimated to be responsible for 6% of deaths in people with diabetes under the age of 40[7],[11].

Insulin degludec is available in two FlexTouch(R) pens: FlexTouch(R) U100, which is suitable for doses from 1 to 80 units per injection and dials in one unit increments, and FlexTouch(R) U200, which allows up to 160 units of insulin in one injection and dials in two unit increments. The U200 is the first prefilled pen that allows patients who need more than 80 units of basal insulin each day to inject only once.

"Novo Nordisk has a long heritage in changing the diabetes landscape with 90 years of innovation and leadership in diabetes care. Our focus is in developing treatments that address key challenges faced by patients and clinicians," said Peter Meeus, UK/IRE Managing Director, Novo Nordisk.

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