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12 Responses

  1. Melissa
    Melissa October 6, 2011 at 6:34 am | | Reply

    I don’t see how more type 2′s on insulin will necessarily mean better control. Type 1′s are all on insulin and struggle to no end. I think managing diet and exercise is a more promising route-even if a little insulin is taken.

    Anyway, Do you know if this new insulin has genetically modified components like Lantus does? Because if not then I would switch off of my beloved Lantus. Who knows what the genetically modified aspect is doing to me, who knows what is has done to my kids or will do to their kids.

  2. Scott S
    Scott S October 6, 2011 at 6:47 am | | Reply

    The fact is, degludec is Novo’s attempt to compete with Lantus in a meaningful way. Levemir is a competent insulin analogue, but the fact remains that most patients and endocrinologists alike consider it to be more of a 12-hour insulin than a 24-hour insulin (it does THAT well, but its not a true basal that lasts all day long regardless). But the bigger question is whether degludec will take off. Novo has already stated that the company does NOT plan to charge as much as they believe the product could get, and that is an acknowledgement that the market has changed. By next year, the patents for Lantus will expire, and many companies, including the Lilly/ Boehringer Ingelheim plan to sell either modified versions of Lantus, or in a more likely scenario, follow-on (biosimilar) versions of Lantus, meaning the best-selling basal insulin will be available for a much cheaper price, and insurance companies are likely to balk at paying a premium for degludec.

  3. Mary Dexter
    Mary Dexter October 6, 2011 at 7:12 am | | Reply

    Lantus does not last 24 hours for everyone. Certainly didn’t for me. For those of us for whom it doesn’t, we end up splitting the dose and then worrying how it will stack. Pre-pump, I would try to time the combined action curves to coincide with the times I needed a higher or lower basal. Obviously, my pump does this much better. If degludec is taken at differing intervals, is there a problem with stacking?

  4. David
    David October 6, 2011 at 7:31 am | | Reply

    Good news, although I am clearly missing something–I don’t get how it wouldn’t stack if you took it at different times.

  5. Ted
    Ted October 6, 2011 at 10:33 am | | Reply

    Scott -
    How can there be a modified version of Lantus in light of its PH level?
    Never heard that but am interested in learning more.
    In terms of the “ultra-long acting” benefit – I’ve talked to endos who don’t necessarily think that it is a benefit – especially if there is too much insulin on board. Granted – that’s a transient thing – but it is still an issue. The one endo that raised it with me talked at length about Ultralente and the panoply of problems he had with that insulin. I’m a PWD and never tried that (and I don’t think it’s on the market anymore, either). It could be that Degludec will set a new paradigm for ultra long acting – and I hope it does. But how much of an improvement it will be vis-a-vis Lantus remains to be seen.

  6. Ted
    Ted October 6, 2011 at 10:34 am | | Reply

    And one more thing – Delgludec will be in a new, apparently better, pen, too.

  7. Sysy
    Sysy October 6, 2011 at 7:11 pm | | Reply

    I’m with Scott. Besides, I don’t like pens, don’t know that I would remember something every other day versus every day, and I do like Lantus (although as someone stated I too worry about the genetically modified part). Lantus does not claim to work exactly 24 hours (aside from the generalized commercials). The pamphlet that comes with the bottle says it works for approximately 21 hours. So I take it at 9pm and around 6pm each night I know to either do a little exercise or just give a little more insulin with my dinner. Works like a charm. And it’s about to be cheaper? Hurray!

  8. katerina
    katerina October 7, 2011 at 3:44 am | | Reply

    Same here I prefer Once a day than once every two days this, I find, will be much harder to remember and keep track

  9. kelly close
    kelly close October 9, 2011 at 7:43 am | | Reply

    I agree about pricing, it sounds like there won’t be a major increase, which is really good. Degludec is supposed to have a flatter profile and as such, much less hypoglycemia. People with type 2 going on insulin is a step in the right direction if their A1cs warrant it – but some doctors historically haven’t persuaded their patients with very high A1cs (even over 10) to go on insulin. That has been for many reasons of course (fear, scared of hypoglycemia, weight gain, etc.) – and it takes a lot to learn to take insulin correctly. But, if you don’t play you can’t win. Type 2 diabetes is “progressive” and for some patients, diabetes becomes so advanced that insulin really is a requirement – here’s to getting more insulins out there that will make moving to insulin a little easier.

    As for timing, every patient is different, but Lantus lasts longer in general and it sounds like degludec will have a lot longer profile – my guess is that people will want to take it at the same time daily but if they can’t, it will be nice to have the option for more flexibility.

    It will be really interesting to see what happens with “biosimilars”, what kind of pens they are in, to make sure the manufacturing quality is very high, etc. Safety is the most important thing to me and after that having more alternatives is really important, especially for patients that don’t have insurance. I’m also interested to see what happens with degludec and exercise since that can be a challenging area for patients who do really intense exercise (eating to address it seems like the status quo but would be nice if that were not as necessary someday).

  10. Dinesh
    Dinesh October 12, 2011 at 9:12 am | | Reply

    Degludec definitely will give a superior control and more promising in the basal segment.

  11. joltdude
    joltdude October 13, 2011 at 9:38 pm | | Reply

    Degludec sounds like a good insulin to use with Dr. Steve Edelman’s Unteethered Regimen (wikipedia http://en.wikipedia.org/wiki/Untethered_regimen)

    If people are changing their reservoirs every 2 days.. it would be very easy to have a small amount of “backup” IOB from the degludec, while the pump handles your regular insulin needs

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