[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Insulins](https://durgical.com/en/pharmacology/classes/insulins/) › Insulin degludec [Pharmacology](https://durgical.com/en/pharmacology/) · [Insulins](https://durgical.com/en/pharmacology/classes/insulins/) # Insulin degludec An ultra-long-acting basal insulin. It forms chains of hexamers under the skin and lasts beyond a day, with a flat profile. Updated 2026-11-01 - Class: [Insulins](https://durgical.com/en/pharmacology/classes/insulins/) - Receptor: Insulin receptor - ATC code: A10AE06 - WHO Model List of Essential Medicines ## ⚠ High-alert medication An error with this medicine can cause serious harm: double checks and protocols are used. ◎**Insulin receptor**Insulin degludec ⓘ The figure shows human insulin bound to site 1 of an insulin receptor fragment. Degludec, once released as a monomer, binds the same receptor. **Target in 3D:** Insulin receptor. PDB structure 4OGA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4OGA) · Drag to rotate · pinch to zoom ## Mechanism of action Degludec lacks threonine B30 and carries a fatty diacid (hexadecanedioic acid) attached to lysine B29 through a glutamic acid spacer. After injection it assembles into long multi-hexamer chains that release monomers very slowly; the fatty chain also binds albumin. The free monomers activate the insulin receptor like human insulin. - Fatty diacid chain makes degludec form multi-hexamers under the skin - Monomers break off very slowly, also binding albumin - Activates the insulin receptor like human insulin - Flat basal effect that lasts beyond a day ## Pharmacokinetics **Absorption** Subcutaneous; very slow release from the depot. **Half-life** About 25 hours at steady state, set mainly by absorption from the depot. **Onset and duration** Steady state is reached after 3 to 4 days of daily injections, so dose changes take days to show their full effect. ## Indications - Basal insulin in type 1 diabetes, with mealtime insulin [Type 1 diabetes mellitus →](https://durgical.com/en/conditions/type-1-diabetes-mellitus/) - Basal insulin in type 2 diabetes [Type 2 diabetes mellitus →](https://durgical.com/en/conditions/type-2-diabetes-mellitus/) ## Adverse effects ### Common - Hypoglycemia - Weight gain - Injection-site reactions, lipodystrophy and localized cutaneous amyloidosis - Low potassium ### Serious (rare, important) - Severe hypoglycemia, which can last because of the long action - Severe allergic reactions (rare) ## Contraindications - During an episode of hypoglycemia - Hypersensitivity to insulin degludec or an excipient ## Key interactions **Beta-blockers, clonidine** Can blunt the warning signs of hypoglycemia. **Other glucose-lowering drugs** Raise the risk of hypoglycemia. **Corticosteroids, diuretics, atypical antipsychotics** Reduce the glucose-lowering effect. **Thiazolidinediones (pioglitazone)** Fluid retention and possible heart failure. ## What is monitored - Fasting blood glucose, assessed over several days after a dose change - HbA1c - Injection sites ## Administration and safety - Subcutaneous only: not given intravenously or in an insulin pump. - Never diluted or mixed with any other insulin or solution. - Pens come in more than one concentration: the pen delivers the dose shown, so syringes are never used to draw from a pen. - Pens, needles and syringes are never shared between patients. ## Nursing care - Before: fasting glucose and the time of the last dose. - After a dose change, judge the effect over several days, not the next morning. - Watch for prolonged hypoglycemia; it may recur after treatment. - Teach the signs of hypoglycemia and site rotation. ## Pregnancy and breastfeeding Data in pregnancy are more limited than for human insulin or other analogues; when used, glucose is checked often. ## Memory aid «Degludec = the decade-long insulin»: a fatty tail links hexamers into long chains under the skin, so it drips out slowly for more than a day. ## Test yourself Think of the answer, then tap the question to see it. ## How does degludec achieve its very long action? Its fatty diacid side chain makes it form multi-hexamer chains under the skin that release monomers very slowly; albumin binding adds to this. ## Why are degludec dose changes judged over several days? Steady state takes about 3 to 4 days, so the full effect of a change is not seen the next day. ## Can degludec be used in an insulin pump or intravenously? No. It is for subcutaneous injection only; pumps and IV infusions use rapid or regular insulin. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/insulin-degludec/) ## Related drugs - [Insulin glargine](https://durgical.com/en/pharmacology/insulin-glargine/) - [Insulin detemir](https://durgical.com/en/pharmacology/insulin-detemir/) ## Related conditions - [Type 1 diabetes mellitus](https://durgical.com/en/conditions/type-1-diabetes-mellitus/) - [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/) [← Back to the class: Insulins](https://durgical.com/en/pharmacology/classes/insulins/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Insulin Degludec (rDNA Origin) Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a615055.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - INSULIN DEGLUDEC injection, solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c1be283d-4b1d-4996-b2a7-4488dbff3037) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 51 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A10AE06) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/insulin-degludec/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/insulin-degludec/