Ultra-Long Basal Insulin·Endocrinology - Insulins & Injectables

Insulin degludec

Type 1 and Type 2 Diabetes

Authority requiredPBSINSULINTresibaPre-filled pens for SC injec…+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

Titrated

Duration

42 HOURS

Timing

FLEXIBLE

Hypos

LOWER RISK

Cautions

Avoid / Cautions

Active hypoglycemia. Pregnancy Category B3.

Where it stands

Rapid Summary

Overview

Ultra-long-acting basal insulin. Forms multi-hexamer chains under the skin, taking days to absorb. Provides the flattest, most consistent 24-hour profile with the lowest risk of nocturnal hypos.

Clinical Focus

Because it lasts 42 hours, the injection timing is incredibly flexible. A patient can take it at 8 AM one day and 8 PM the next day without risking gaps or overlap.

Bottom Line

Insulin degludec is an ultra-long-acting basal insulin with the lowest hypoglycaemia risk and flexible dosing, but is more expensive and offers marginal benefit over glargine for most patients.

Formulation & Access

Brand Names

Tresiba

Parenteral

Pre-filled pens for SC injection (100 U/mL). Clear solution.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Type 1 and Type 2 Diabetes.

Clinical Place

The most advanced basal insulin. The absolute best choice for shift workers or teenagers with chaotic schedules who cannot take their insulin at the exact same time every day.

Quick reference

Class & Role

Ultra-Long Basal Insulin — Ultra-long-acting basal insulin.

Route / Formulation

Pre-filled pens for SC injection (100 U/mL). Clear solution. (Tresiba)

Usual Dose & Max

SC Administered ONCE daily at any time of day. Ensure at least 8 hours between doses. Titrated to fasting BSL.

Key Indication Doses

Type 1 / Type 2 Diabetes: SC Administered ONCE daily at any time of day. Ensure at least 8 hours between doses. Dose Adjustments: Because it takes 3-4 days to reach steady state, do NOT adjust the dose more frequently than every 3-4 days, or you will cause a stacking overdose.

Best Uses

Insulin degludec is an ultra-long-acting basal insulin with the lowest hypoglycaemia risk and flexible dosing, but is more expensive and offers marginal benefit over glargine for most patients.

Key Risks

Metabolic: Hypoglycemia. However, Degludec has a statistically significantly lower risk of severe nocturnal hypoglycemia compared to Glargine. Dermatological: Lipohypertrophy.

Key Interactions

Corticosteroids (spike BSL), Beta-blockers (mask hypos).

Monitoring

Monitor fasting BSL. Routine HbA1c.

Clinical Pearl

With Glargine, a 4-hour delay in injection causes a massive BSL spike, and taking it 4 hours early causes a severe overlap hypo. With Degludec, the 42-hour duration means the patient has a massive buffer. They can inject it whenever it is convenient that day.

Access

Authority requiredTresiba

Brand: Tresiba
PBS status: Authority required

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Ultra-Long Basal Insulin·Endocrinology - Insulins & Injectables

Insulin degludec

Type 1 and Type 2 Diabetes

Authority requiredPBSINSULINTresibaPre-filled pens for SC injec…+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

Titrated

Duration

42 HOURS

Timing

FLEXIBLE

Hypos

LOWER RISK

Cautions

Avoid / Cautions

Active hypoglycemia. Pregnancy Category B3.

Where it stands

Rapid Summary

Overview

Ultra-long-acting basal insulin. Forms multi-hexamer chains under the skin, taking days to absorb. Provides the flattest, most consistent 24-hour profile with the lowest risk of nocturnal hypos.

Clinical Focus

Because it lasts 42 hours, the injection timing is incredibly flexible. A patient can take it at 8 AM one day and 8 PM the next day without risking gaps or overlap.

Bottom Line

Insulin degludec is an ultra-long-acting basal insulin with the lowest hypoglycaemia risk and flexible dosing, but is more expensive and offers marginal benefit over glargine for most patients.

Formulation & Access

Brand Names

Tresiba

Parenteral

Pre-filled pens for SC injection (100 U/mL). Clear solution.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Type 1 and Type 2 Diabetes.

Clinical Place

The most advanced basal insulin. The absolute best choice for shift workers or teenagers with chaotic schedules who cannot take their insulin at the exact same time every day.

Quick reference

Class & Role

Ultra-Long Basal Insulin — Ultra-long-acting basal insulin.

Route / Formulation

Pre-filled pens for SC injection (100 U/mL). Clear solution. (Tresiba)

Usual Dose & Max

SC Administered ONCE daily at any time of day. Ensure at least 8 hours between doses. Titrated to fasting BSL.

Key Indication Doses

Best Uses

Insulin degludec is an ultra-long-acting basal insulin with the lowest hypoglycaemia risk and flexible dosing, but is more expensive and offers marginal benefit over glargine for most patients.

Key Risks

Metabolic: Hypoglycemia. However, Degludec has a statistically significantly lower risk of severe nocturnal hypoglycemia compared to Glargine. Dermatological: Lipohypertrophy.

Key Interactions

Corticosteroids (spike BSL), Beta-blockers (mask hypos).

Monitoring

Monitor fasting BSL. Routine HbA1c.

Clinical Pearl

Access

Authority requiredTresiba

Brand: Tresiba
PBS status: Authority required

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.