Short answer: Insulin degludec has a half-life of about 25 hours (at steady state). Levels peak median 9 hours (at steady state) after a dose. People vary, so treat these as estimates.
Insulin degludec is a long-acting (basal) insulin that forms a slow-release depot under the skin, so one daily injection covers blood sugar between meals and overnight. It is sold as Tresiba, and combined with liraglutide as Xultophy 100/3.6.
Also known as: Tresiba, Xultophy (with liraglutide).
Tresiba U-100 (100 units/mL) comes in a 3 mL FlexTouch pen (1-unit steps, up to 80 units per injection) and a 10 mL vial. Tresiba U-200 (200 units/mL) comes in a 3 mL FlexTouch pen (2-unit steps, up to 160 units). The pen dose window shows units, so no conversion is done.
The Tresiba label approves insulin degludec to improve blood sugar control in people 1 year and older with diabetes; it is not for diabetic ketoacidosis. Label dosing: adults inject once a day at any time of day, and children at the same time every day, under the skin of the thigh, upper arm or belly. Insulin-naive adults with type 2 diabetes start at 10 units once a day; in type 1 diabetes the start is about one-third to one-half of the total daily insulin, with mealtime insulin for the rest. Dose increases are 3 to 4 days apart. Adults who miss a dose inject it during waking hours when they notice, leaving at least 8 hours between doses; children who miss a dose contact their provider. It is never given into a vein or muscle, by pump, or mixed with other insulins, and is not drawn from the pen into a syringe.
Tresiba has no boxed warning. Low blood sugar is the most common side effect of every insulin, and severe lows can cause seizures or death. The labels also warn: never share a pen, cartridge or syringe, even with a new needle; changes in insulin type, maker, strength or injection site are made under medical supervision with more glucose checks; insulin mix-ups have happened, so the label is checked before each injection; insulin can lower potassium; and heart failure can worsen when insulin is used with a thiazolidinedione such as pioglitazone. Leaving low blood sugar aside, nasopharyngitis affected 23.9% of adults with type 1 and 12.9% with type 2 diabetes in the label's trials, injection site reactions 3.8%, and average weight gain was 1.8 to 3.0 kg over 52 weeks. See Tresiba side effects, Tresiba dosing schedule, missed Tresiba dose, how to store Tresiba, and the comparisons Lantus vs Tresiba, Toujeo vs Tresiba and Xultophy vs Tresiba.
The Tresiba label says the half-life after an injection under the skin is set mainly by how fast it is absorbed, and averages about 25 hours at steady state regardless of dose. After 8 daily doses of 0.4 units/kg in type 1 diabetes, levels peaked at a median of 9 hours, and insulin first appeared about 1 hour after the first dose. Steady state takes 3 to 4 days. The glucose-lowering effect peaked at a median of 12 hours and lasted at least 42 hours after the last of 8 daily injections.
Numbers shown are taken from the source above. Half-life varies from person to person.
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