Long-Acting Insulin on the PBS

Insulin degludec (Tresiba®) is now available on the Pharmaceutical Benefits Scheme (PBS) for the treatment of type 1 diabetes mellitus.

Tresiba® is an ultra-long-acting basal insulin analogue with a duration of action of at least 42 hours. It is intended for once daily administration and may be given at any time of the day. While patients should be encouraged to administer doses at around the same time each day, the slow and consistent rate of absorption allows some dosing flexibility.

The SWITCH 1 and SWITCH 2 trials compared insulin degludec with insulin glargine (U100) in patients with type 1 and type 2 diabetes, respectively. Post hoc analysis of these trials found that improved glycaemic control increased hypoglycaemia risk regardless of the basal insulin used. However, for equivalent HbA1c reductions, degludec was associated with smaller increases in hypoglycaemia than glargine in both populations. These findings suggest that degludec may help patients achieve lower HbA1c targets with a lower risk of hypoglycaemia.

The PBS listing of degludec provides an additional basal insulin option for patients affected by the planned discontinuation of insulin detemir (Levemir®) from the Australian market later this year.