Basal insulin degludec is a fairly new type of long-lasting insulin that may show promise in lessening the number of basal insulin shots required by diabetes mellitus patients. Here’s what you need to know.
Initially, physicians stated that one basal insulin shot provides enough hyperglycemic protection for 24 hours. But researchers found that one injection of nph basal insulin or basal insulin glargine (and other alternatives) doesn’t provide enough coverage to last the full day. They also can cause hypoglycemia during the night when diabetes mellitus patients are asleep, and spike blood sugar levels in the morning before breakfast.
Basal insulin degludec is a new insulin analog that boasts providing coverage for 42 hours. It can also be taken at any time in the day with a lower risk of blood sugar spikes in the morning and low blood sugar in the evening. That’s because once it’s injected into your bloodstream, it forms a very stable complex that houses the basal insulin and releases it slowly, which results in a steady supply of basal insulin for a long period of time. Basal insulin glargine attempts the same stable housing complex, but it deteriorates faster than basal insulin degludec’s, which leads to too much basal insulin being released and that can lead to hypoglycemia and insufficient coverage.
In fact, basal insulin degludec is 75 percent more stable than basal insulin glargine. This means the variability in basal insulin delivery is considerably lessened, which means there’s less likelihood that it will release significantly lower or higher amounts of basal insulin at any given time during coverage. In a 365-day clinical trial of 1030 diabetes mellitus patients, basal insulin degludec’s risk of hypoglycemia during nighttime sleep was 36 percent lower than basal insulin glargine’s. Even better – basal insulin degludec’s overall risk of severe hypoglycemia was 86 percent lower than that of basal insulin glargine’s.
The Downsides of Basal Insulin Degludec
Remember that basal insulin degludec is a relatively new drug, which means not all potential side effects are known at this point. It’s so new that it’s not even approved for use for anyone under 18 years old.
The National Institutes of Health found that regularly taking basal insulin degludec causes respiratory symptoms, like sneezing, coughing, and runny nose, in about 23 percent of diabetes mellitus patients. Eleven percent experienced headaches and upset stomach.
They also found that, on average, long-term administration of basal insulin degludec causes weight gain of about four pounds in diabetes mellitus type 1 patients. Diabetes mellitus type 2 patients, on average, gained almost 6.7 pounds.
The FDA also cautions the usage of basal insulin degludec because they’ve cited evidence that it may increase the risk of cardiovascular events by about 60 percent. But their evidence is lacking and not significant enough given the shortness and indirectness of the clinical trials involved. They say that for diabetes mellitus type 1 patients, there’s not a significant difference in effectiveness between basal insulin degludec and basal insulin glargine. They recommend that only diabetes mellitus type 2 patients use basal insulin degludec until more research can explore the new drug’s potential cardiovascular risks.
But a recent study involving over 7,500 diabetes mellitus patients for about two years found that basal insulin degludec carries only a minimal elevated risk of cardiovascular problems than basal insulin glargine.
This doesn’t mean that this new drug is completely safe — remember that it’s possible that not all of its adverse effects have come to light. In fact, experts are still cautioned (in some cases prohibited), from prescribing it to pregnant women because its effects on pregnancy are still somewhat unknown.
Important Matters to Keep in Mind Before Choosing Basal Insulin Degludec
You can’t get basal insulin degludec without a prescription, but even if it’s prescribed to you, there are things you should keep in mind to lower any possible risk of complications.
If you’re close to or living with other people who have diabetes mellitus, don’t share syringes or needles. Some non-STD diseases can be transmitted by blood, and sharing the same syringe is an unnecessary risk.
Because the drug is so new, it’s going to be significantly more expensive. If you’re not having a significant struggle with your current basal insulin prescription, then you can ask your doctor to keep you on it instead of incurring a larger financial burden that you may not be ready for.
But placing these cautionary matters and potential hidden dangers aside, this new drug seems to live up to its praise. Many doctors, like Dr. Steve Edelman, M.D., are convinced of the current clinical trials concerning basal insulin degludec and are currently prescribing it to their diabetes mellitus patients who are fit candidates. They remark that it is superior in terms of lowering the risk for hypoglycemia and providing a reliable supply of basal insulin throughout the day and even longer.
If you have diabetes mellitus type 2 and are having coverage issues with your current basal insulin medications, consider asking your doctor about basal insulin degludec. But also keep in mind that it’s a new drug with potentially unknown other side effects.