Insulin degludec is used on its own or together with other medicines to treat diabetes by keeping blood sugar in control.
Diabetes is a condition where your body is unable to produce enough insulin to control your blood sugar levels or insulin becomes ineffective (insulin resistance).
This medicine is meant to be used as part of a complete diabetes care programme that should include exercise, a healthy diet and regular monitoring of blood sugar.
Use Insulin degludec exactly as directed by your doctor or according to the instructions on the label. Do not administer more or less than instructed by your doctor as small changes in the amount of this medicine may affect your blood sugar level.
This medicine should be administered subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm or abdomen area). Try to administer it at the same time each day.
This medicine is available as an injection pen or as a solution for injection in a cartridge. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist. Insulin degludec may become ineffective if your insulin pen does not work properly.
If you are using the injection pen, follow these instructions:
- Prepare the injection pen as instructed by your doctor or nurse.
- Attach the needle to the injection pen. Ensure that the needle is screwed on securely.
- Dial the correct dose.
- Swab the injection site area with alcohol.
- Hold the injection pen with your thumb over the injection button.
- Press the injection pen against your body using the subcutaneous (under the skin) injection method.
- Use your thumb to push the injection button until it stops. Continue to hold the injection button in that position while slowly counting to 5 to get a full dose.
- Withdraw the injection pen from your body.
- Remove the needle from the pen. Never store the injection pen with the needle attached.
- Reset your pen as instructed by your doctor or nurse.
- Throw away the used needle. Recap your pen and store below 30°C or between 2 to 8°C.
- Use a new needle in every administration of Insulin degludec.
If you are using the solution for injection in a cartridge, follow these instructions:
- Prepare your insulin dose as instructed by your doctor or nurse.
- Swab the injection area with alcohol.
- Pinch the area and insert the needle. Push the plunger as far as it will go to deliver your dose.
- Remove the needle and apply gentle pressure over the injection site. Do NOT rub the area.
- Throw away the used needle as instructed by your doctor or nurse.
- Use a new needle for each injection.
Remember to rotate the injection sites. Do not inject into the same area all the time.
DO NOT administer Insulin degludec intravenously (into a vein), intramuscularly (into a muscle) or by infusion pump.
Do not dilute or mix this medicine with any other insulin formulation or solution.
Do not share your insulin injection with anyone else.
This medicine should be administered regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor. If you suddenly stop using this medicine, it may lead to hyperglycaemia (high blood sugar level).
If you missed a dose of Insulin degludec, administer the missed dose as soon as you remember. If it is almost time (less than 8 hours) to your next dose, skip the missed dose and return to your normal injection schedule. Check your blood sugar levels and ask your doctor on how to adjust your insulin doses if needed.
A missed dose may lead to hyperglycaemia (high blood sugar level). If you often forget to inject your medicine, let your doctor and pharmacist know. They can give you advise that can help you remember your dosing schedule.
DO NOT double a dose to make up for a missed dose.
Alert your doctor if you suspect hypoglycaemia (low blood sugar) is happening. Please see section “What should I take note while using this medicine?” below for more information about hypoglycaemia.
Inform your doctor if you have the following conditions:
- kidney disease
- liver disease
- diseases affecting the adrenal, pituitary and thyroid gland
This medicine is not intended for use in patients with diabetic ketoacidosis (complication of diabetes characterised by high level of blood acid in your body).
Let your doctor know if you are pregnant or breastfeeding.
If you have an infection or fever, inform your doctor as these conditions may affect your blood sugar level.
Exercise will also change your insulin requirement. Consult your doctor if you change your exercise routine or start a new exercise program.
Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.
For as long as you are using this medicine, you will need to have routine blood tests (e.g. blood sugar level, blood cholesterol level, kidney function tests, liver function tests) to check your body’s response to the medicine. Your doctor will advise you about how often you need to have these tests.
If you are using Insulin degludec, you may have been warned about hypoglycaemia (low blood sugar).
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is a medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, sweating. These signs are your body’s way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 grams of glucose tablet at first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 grams of glucose tablet.
If you don’t have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms did not improve after second serving.
Insulin degludec may cause hypoglycaemia (low blood sugar) which may affect your ability to concentrate and react. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects may include any of the following: headache, signs of upper respiratory tract infection (e.g. runny or stuffy nose, sneezing, sore throat, cough), excess or lack of fat in various regions of the body, itching, rash, and pain, redness, swelling at the injection site.
If you develop rashes, breathlessness, swollen mouth or eyes, stop taking Insulin degludec and inform your doctor immediately. These could be signs of an allergic reaction.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicines for diabetes e.g. pioglitazone
- birth control pills
- certain antibiotics e.g. sulfamethoxazole
- testosterone (sex hormone)
- medicines for high blood pressure e.g. metoprolol, enalapril
- medicines for depression e.g. phenelzine
- medicine for endometriosis (growth of tissues outside the lining of the uterus) e.g. danazol
- medicines for inflammation e.g. cortisone
- medicines for pain and mild fever e.g. aspirin
This list does not include all medicines that may interact with Insulin degludec.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
It is important for you to maintain a healthy diet and weight in order to help keep your diabetes under control.
It may be helpful to discuss your diet plan with your doctor or dietitian to manage your weight and blood sugar levels.
If you have not yet opened it, store Insulin degludec in a refrigerator between 2 to 8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used.
Once opened, this medicine may be stored in a refrigerator between 2 to 8°C or at room temperature below 30°C. It will expire 56 days after opening.
Make sure you know how to store your medicine. Insulin degludec may become ineffective if not stored properly. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Keep away from heat, sunlight and from the reach of children.
Medicines must not be used past the expiry date.