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This is a combination of two long-acting basal insulins, insulin degludec and insulin glargine. Both are recombinant human insulins modified to provide prolonged glucose-lowering activity. Insulin degludec forms multi-hexamers upon subcutaneous injection, resulting in a slow and steady release of active monomers into the bloodstream. Insulin glargine precipitates at physiological pH after injection, also providing sustained absorption. Both act by binding to the insulin receptor on target cells (primarily muscle and adipose tissue), stimulating tyrosine kinase activity that leads to increased glucose uptake from the blood, inhibition of hepatic glucose production, and regulation of carbohydrate, fat, and protein metabolism. The combination would be expected to provide an extended basal level of insulin for glycemic control in diabetes mellitus[1][4]. However, there is no evidence that a fixed-ratio or co-formulated product containing both these specific insulins together (without other agents) is commercially available or approved; they are typically studied separately or each combined with other agents.
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