Insulin degludec

China [CN]

Diabetes is a global chronic metabolic disease that requires lifelong treatment. Under the influence of genetic or environmental factors, pancreatic islet B cells are unable to secrete insulin or secrete insufficient amounts, which can lead to diabetes. The islet B cells of patients with type 1 diabetes have been lost and will degrade proteins and fats as alternative energy sources, which can easily lead to ketoacidosis. Patients with type 2 diabetes have insulin resistance in their bodies, and their condition gradually worsens as the function of pancreatic islet B cells decreases. In the early stage of type 2 diabetes, the main treatment methods are exercise, diet control and combined oral hypoglycemic drugs. However, as the disease progresses, insulin is one of the necessary treatment methods for both type 1 and type 2 diabetes. At present, the three main types of long-acting insulin are glargine, detemir and degludec. Degu insulin was developed by NovoNordisk and was launched in Japan in October 2012. It has been approved for the treatment of type 1 and type 2 diabetes. Degu insulin is a super-long-acting basal insulin analogue obtained by removing threonine at B30 and attaching a 16-carbon adipic acid to lysine at B29 through an L-γ -glutamic acid linker. This unique molecular structure enables it to exist in the formulation in the form of a stable soluble, dihexamer before injection. The main mechanism of its long-term action is as follows: After subcutaneous injection, with the rapid dispersion of phenol in the preparation, Degu insulin self-aggregates through the adipic acid side chain to form a polyhexamer and forms a reservoir at the injection site, stably and persistently exerting its hypoglycemic effect; Thereafter, zinc ions gradually disperse, and the polyhamine slowly dissociates to release monomers that enter the bloodstream through capillaries. The added adipose acid side chain reversibly binds to plasma albumin, further slowing down its diffusion speed to target tissues and the bloodstream, thereby exerting its long-lasting hypoglycemic effect.