Introduction

Insulin degludec (trade name: Tresiba) has been approved in Germany since January 2013 for the treatment of type 1 and type 2 diabetes in adults. The drug is a long-acting insulin. It is used to regulate blood sugar levels for up to 24 hours.

Diabetes mellitus is a metabolic disease that affects various parts of the body. In people with type 1 diabetes, the pancreas can only produce insulin in small quantities or not at all. They therefore have to inject insulin regularly. In type 2 diabetes, the pancreas does actually produce enough insulin at first, but the body’s cells are increasingly unable to absorb and process it. If blood sugar levels cannot be lowered sufficiently through a change of diet and exercise habits, medication is used.

The treatment aims to avoid strong fluctuations in blood sugar levels and the side effects of high and low blood sugar for people with diabetes mellitus. It also aims to prevent complications that can result from blood sugar levels being too high.

People with type 1 diabetes take the long-acting insulin degludec at meal times in combination with short-acting insulin. In people with type 2 diabetes it can be used on its own or together with a different short-acting insulin (taken with meals) or tablets to lower blood sugar levels. A triple combination with short-acting insulin and oral therapy is also possible.

Application

Insulin degludec is injected once a day using an insulin pen. The drug is available in ready-to-use pens in two different doses: 100 or 200 units per milliliter. The dose depends on a number of factors including additional blood sugar reducing therapy, blood sugar levels and the intended blood sugar level adjustment. It has to be adjusted individually.

Other treatments

Human insulin is used as a standard treatment for people with type 1 diabetes. Human insulin or a combination of human insulin and the drug metformin are possible options for people with type 2 diabetes.

Assessment

In 2014, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) assessed the possible advantages and disadvantages of insulin degludec for people with type 1 or type 2 diabetes, used either on its own or in approved combination with other blood sugar reducing medications, when compared to established standard therapies.

However, the manufacturer did not provide any suitable data to answer this question.

More information

This information summarizes the most important results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the "early benefit assessment of medications." On the basis of this review and the hearings received, G-BA passed a resolution on the added benefit of insulin degludec (Tresiba).

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