糖尿病 Diabetes mellitus
To improve glycemic control in patients ≥1 year of age with type 1 or type 2 diabetes mellitus

Insulin degludec: Long-acting Insulin; Insulin aspart: Rapid-acting Insulin
Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue.

Insulin degludec
Onset: ~1 hour
Protein binding: >99% (albumin)
Half-life elimination: ~25 hours (independent of dose)
Time to peak: 9 hours
Insulin aspart
Onset: ~0.2 to 0.3 hours
Protein binding: <10%
Half-life elimination: 1.1 hours
Time to peak: 40-50 minutes
Excretion: Urine

1. During episodes of hypoglycemia
2. Hypersensitivity to insulin degludec, Insulin aspart or any component of the formulation

1. Information specific to the use of insulin degludec in pregnancy is limited.
2. Insulin is the preferred treatment of type 1 and type 2 diabetes mellitus in pregnancy.
3. Poorly controlled diabetes during pregnancy can be associated with an increased risk of adverse maternal and fetal outcomes, including diabetic ketoacidosis, preeclampsia, spontaneous abortion, preterm delivery, delivery complications, major malformations, stillbirth, and macrosomia.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.

Glycemic control:
Hyper- or hypoglycemia may result from changes in insulin strength, manufacturer, type, and/or administration method.
Hypoglycemia:
Risk:
1. Changes in meal pattern (eg, macronutrient content, timing of meals), changes in the level of physical activity, increased work or exercise without eating, or changes to coadministered medications
2. Patients with renal or hepatic impairment
3. Use of long-acting insulin preparations may delay recovery
Symptoms: Convulsions, unconsciousness, temporary or permanent brain damage, or even death
Hypersensitivity:
1. Severe, life-threatening allergic reactions, including anaphylaxis, may occur.
2. If hypersensitivity reactions occur, discontinue therapy.
Hypokalemia:
Mechanism: Insulin causes a shift of potassium from the extracellular space to the intracellular space, possibly producing hypokalemia.
Symptoms: If left untreated, hypokalemia may result in respiratory paralysis, ventricular arrhythmia and even death.
Risk: Use with caution in patients at risk for hypokalemia (eg, loop diuretic use). Monitor serum potassium and supplement potassium when necessary.
Cardiac disease:
Mechanism: Concurrent use with peroxisome proliferator-activated receptor (PPAR)-gamma agonists, including thiazolidinediones, may cause dose-related fluid retention and lead to or exacerbate heart failure, particularly when used in combination with insulin.
Monitor:
1. If PPAR-gamma agonists are prescribed, monitor for signs and symptoms of heart failure.
2. If heart failure develops, consider PPAR-gamma agonist dosage reduction or therapy discontinuation.

80% of total daily dose

There are no dosage adjustments provided in the manufacturer's labeling; insulin requirements may be reduced due to changes in insulin clearance or metabolism; monitor blood glucose closely.

There are no dosage adjustments provided in the manufacturer's labeling; insulin requirements may be reduced due to changes in insulin clearance or metabolism; monitor blood glucose closely.