Learning About “Tresiba” A New Longer-Acting Insulin for Diabetes

Tresiba: A new longer-acting insulin for diabetes

tribesaLong-acting basal insulins help replace the background insulin in patients who have type 1 or type 2 diabetes.  The main purpose of these long-acting insulins is to provide background insulin that lasts around the clock, 24 hours a day to mimic a normally functioning pancreas as much as possible.  Tresiba is a new ultra long-acting insulin that was recently approved by the Food and Drug Administration (FDA).  Tresiba is also known as degludec insulin. The older basal insulins may work up to 24 hours, however in some patients they do not and twice a day dosing is required. Tresiba works up to 42 hours and therefore is only injected once a day.   Because it is only dosed once a day and is a peakless insulin (steady amount of insulin all day), the incidence of low blood sugar reactions (hypoglycemia) are lower than other insulins.

Like all basal insulins, Tresiba should be injected at the same time every day.  However, it has been studied at alternating dosing intervals from 8 hours to 40 hours and changing the dosing interval did not change how effective it was. In addition to anyone requiring basal insulin, this property may make it a good choice for patients that miss an occasional dose by mistake, work varying shifts, college students with varying schedules, international travelers or anyone that may have a challenge injecting exactly at the same time every day.  Another population that may benefit are those that live in an assisted living facility whose family has to come to the facility to administer the injection but can’t always make it at the same time each day.

Because Tresiba is absorbed slowly, dosing changes are made no sooner than every 3-4 days compared to some other insulins that can be adjusted daily.  Some providers may choose to adjust the dose weekly.

Tresiba comes in insulin pens with 2 different concentrations: U100 (100units/ml) and U200 (200units/ml).  The U100 pen can be dialed up to 80units per dose and the U200 pen can be dialed up to 160units per dose.  There is no difference between U100 degludec insulin and U200 degludec insulin except for the concentration.  Those using smaller doses may use the U100 pen and those on larger doses may use the U200 pen. The U200 pen delivers the same units of insulin with half the volume of insulin.  Anyone with diabetes requiring basal insulin can use either concentration.

Tresiba should be stored in the refrigerator until use. Once a pen has been used for the first time, it can be left at room temperature safely for up to 8 weeks.

Tresiba is a new ultra long-acting insulin that can be beneficial for patients with diabetes who require basal (background) insulin. Because of its long duration of action and other properties it has a lower risk for hypoglycemia and may be particularly helpful to those who require a concentrated insulin or more flexibility with daily dosing.  Your pharmacist or provider can provide education on how to use the pen.
This Article is Brought to you By Our Guest Staff Writers:
Allen Tsai, PharmD Candidate 2016, MCPHS University
Damian Bialonczyk, PharmD‎, MBA, Fellow, MCPHS University‎ ‎
Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP, Professor of Pharmacy Practice, MCPHS University, Clinical Pharmacist, Well Life Medical, Peabody

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