Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes.
Novolog 70/30 is here to stay, but a more advanced insulin called Degludec is on the horizon. And with Novo Nordisk "one-upping" themselves, they don’t have much to worry about as far as competition is concerned.
Novolog (fast-acting) mixtures were a welcome change from traditional mixtures of regular insulin, which were slow on the gas pedal. Unfortunately, some providers who are stuck in their ways continue to prescribe regular insulin in the 70/30 mixture when some individuals can clearly benefit from faster-acting insulin.
If insulin hasn't been working for you, you're not alone. Taking the dive from pills to shots may not do the trick initially—especially if your physician has you on a regimen that’s ineffective.
Degludec is the longest acting insulin available; when it’s paired with fast-acting insulin, it may be the ticket to your diabetes success story.
What is basal insulin?
If you're confused about insulin, it's okay—it's pretty normal. In fact, there are so many options out there, even healthcare providers get lost in the insulin shuffle.
Basal insulin’s goal is to mimic the pancreas, which slowly ekes out insulin on a regular basis to keep glucose levels in check.
Old school insulin (NPH) was replaced by Levemir and Lantus years ago. With a flat profile (no peaks and valleys) and lasting up to 24 hours, they quickly became popular.
Regardless of the lengthy interval of action these insulins have, many physicians are ordering them in divided doses twice daily for optimal blood glucose control. Levemir is approved for one to two times per day and Lantus is approved for one time per day injection. According to Diabetes Health and Dr. Richard Bernstein: “Lantus also usually works better if injected twice a day.”
Currently, Degludec is the longest acting insulin available. With a 42-hour profile of duration, its half-life performance is two times longer than what we’re accustomed to using. It’s labeled as an ultra-long basal insulin; who can complain about that?
A study by Fulcher et al examined the use of a combination drug (a fast-acting insulin plus this ultra-long insulin) versus traditional treatment (pre-mixed insulins or self-prepared injections of long and short-acting insulins).
This 26-week study confirmed a few facts about the individuals who took Degludec:
- Hemoglobin A1c values improved.
- There were improvements in fasting blood sugars.
- There was a decrease in low blood sugars, including overnight.