insulin degludec: clinical use

Prescribing considerations

• Confirm the exact insulin product and delivery device; switching insulins requires individual assessment and close glucose monitoring.
• Review injection technique, site rotation, hypoglycaemia recognition, sick-day planning and access to glucose and ketone testing.
• Use only subcutaneously; it is unsuitable for intravenous or intramuscular administration, mixing or insulin pumps.
• Intensify glucose monitoring in older people and those with renal or hepatic impairment.
• Record brand and batch details for biological-medicine traceability.

Contraindications and cautions

• Hypersensitivity to insulin degludec or any excipient.

Monitoring

• Capillary or sensor glucose and longer-term glycaemic control.
• Frequency, severity and awareness of hypoglycaemia.
• Ketones and clinical status during hyperglycaemia or intercurrent illness.
• Injection sites for lipodystrophy or cutaneous amyloidosis.
• Renal and hepatic function where changes could alter insulin requirements.

Clinical pharmacology

Insulin degludec is a long-acting insulin-receptor agonist. Soluble multihexamers form a subcutaneous depot, producing slow, stable absorption. Receptor activation increases peripheral glucose uptake and suppresses hepatic glucose output.

Formulation and product differences

• The selected Penfill presentation is a clear, colourless solution in a cartridge for compatible Novo Nordisk reusable delivery systems.
• The cartridge is for one person only, must not be refilled and should not be withdrawn into a syringe.
• Before use, refrigerate without freezing and protect from light. Once in use or carried as a spare, follow the product-specific room-temperature storage limit.