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Technical details about insulin degludec, learn more about the structure, uses, toxicity, action, side effects and more

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2D Structure
Also known as: 844439-96-9, Degludec, Tresiba, Insulin degludec [usan:inn], Unii-54q18076qb, Nn 1250
Molecular Formula
C274H411N65O81S6
Molecular Weight
6104  g/mol
InChI Key
FYZPCMFQCNBYCY-WIWKJPBBSA-N

Insulin Degludec is a recombinant, long-acting analog of human insulin, with blood glucose-lowering activity. Upon subcutaneous injection, insulin degludec forms a multi-hexameric depot from which insulin monomers are slowly released into the systemic circulation. Insulin regulates glucose metabolism by binding to insulin receptors on muscle and fat cells, which stimulates the cellular uptake of glucose and lowers blood glucose levels. Insulin inhibits the liver's conversion of stored glycogen into glucose, which also contributes to lower blood glucose levels. In addition, insulin inhibits lipolysis in adipose tissue, inhibits proteolysis, and enhances protein synthesis. Insulin degludec doesn't contain the amino acid threonine that is found at position B30 in human insulin; additionally, the lysine at position B29 is conjugated to hexadecanedioic acid, which allows the formation of the multi-hexamers upon subcutaneous injection. The phenol and zinc present in the pharmaceutical formulation promote a di-hexameric state of insulin degludec.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
16-[[(1S)-4-[[(5S)-5-[[(2S)-1-[(2S,3R)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[2-[[(2S)-2-[[(2S)-2-[[2-[[(1R,6R,12S,15S,18S,21S,24S,27S,30S,33S,36S,39S,42R,47R,50S,53S,56S,59S,62S,65S,68S,71S,74R,77S,80S,83S,88R)-88-[[(2S)-5-amino-2-[[(2S)-2-[[(2S)-2-[[(2S,3S)-2-[(2-aminoacetyl)amino]-3-methylpentanoyl]amino]-3-methylbutanoyl]amino]-4-carboxybutanoyl]amino]-5-oxopentanoyl]amino]-6-[[(2S)-2-[[(2S)-2-[[(2S)-5-amino-2-[[(2S)-4-amino-2-[[(2S)-2-[[(2S)-2-amino-3-phenylpropanoyl]amino]-3-methylbutanoyl]amino]-4-oxobutanoyl]amino]-5-oxopentanoyl]amino]-3-(1H-imidazol-4-yl)propanoyl]amino]-4-methylpentanoyl]amino]-47-[[(1S)-3-amino-1-carboxy-3-oxopropyl]carbamoyl]-53-(2-amino-2-oxoethyl)-62-(3-amino-3-oxopropyl)-77-[(2S)-butan-2-yl]-24,56-bis(2-carboxyethyl)-83-[(1R)-1-hydroxyethyl]-12,71,80-tris(hydroxymethyl)-33,50,65-tris[(4-hydroxyphenyl)methyl]-15-(1H-imidazol-4-ylmethyl)-27-methyl-18,30,36,59,68-pentakis(2-methylpropyl)-7,10,13,16,19,22,25,28,31,34,37,40,49,52,55,58,61,64,67,70,73,76,79,82,85,87-hexacosaoxo-21,39-di(propan-2-yl)-3,4,44,45,90,91-hexathia-8,11,14,17,20,23,26,29,32,35,38,41,48,51,54,57,60,63,66,69,72,75,78,81,84,86-hexacosazabicyclo[72.11.7]dononacontane-42-carbonyl]amino]acetyl]amino]-4-carboxybutanoyl]amino]-5-carbamimidamidopentanoyl]amino]acetyl]amino]-3-phenylpropanoyl]amino]-3-phenylpropanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]amino]-3-hydroxybutanoyl]pyrrolidine-2-carbonyl]amino]-5-carboxypentyl]amino]-1-carboxy-4-oxobutyl]amino]-16-oxohexadecanoic acid
2.1.2 InChI
InChI=1S/C274H411N65O81S6/c1-28-146(23)223(331-210(357)119-275)268(412)335-222(145(21)22)264(408)305-172(89-97-218(369)370)234(378)300-169(84-92-204(279)351)238(382)326-198-131-424-425-132-199-259(403)323-193(126-341)256(400)312-177(103-138(7)8)241(385)313-183(110-154-66-74-160(345)75-67-154)244(388)301-167(82-90-202(277)349)235(379)308-176(102-137(5)6)239(383)303-171(88-96-217(367)368)237(381)320-189(116-205(280)352)251(395)316-185(112-156-70-78-162(347)79-71-156)247(391)327-197(258(402)322-191(273(419)420)118-207(282)354)130-423-422-129-196(231(375)290-122-211(358)295-166(86-94-215(363)364)233(377)299-165(62-53-99-288-274(283)284)229(373)289-123-212(359)297-181(108-152-57-45-41-46-58-152)243(387)315-182(109-153-59-47-42-48-60-153)246(390)317-186(113-157-72-80-163(348)81-73-157)254(398)338-226(150(27)344)270(414)339-100-54-63-201(339)262(406)306-173(271(415)416)61-51-52-98-287-208(355)93-85-174(272(417)418)296-209(356)64-49-38-36-34-32-30-31-33-35-37-39-50-65-214(361)362)329-266(410)221(144(19)20)334-252(396)179(105-140(11)12)310-245(389)184(111-155-68-76-161(346)77-69-155)314-240(384)175(101-136(3)4)307-227(371)148(25)294-232(376)170(87-95-216(365)366)304-263(407)220(143(17)18)333-253(397)180(106-141(13)14)311-249(393)188(115-159-121-286-135-293-159)319-255(399)192(125-340)298-213(360)124-291-230(374)195(128-421-426-133-200(328-260(198)404)261(405)337-225(149(26)343)269(413)324-194(127-342)257(401)336-224(147(24)29-2)267(411)330-199)325-242(386)178(104-139(9)10)309-248(392)187(114-158-120-285-134-292-158)318-236(380)168(83-91-203(278)350)302-250(394)190(117-206(281)353)321-265(409)219(142(15)16)332-228(372)164(276)107-151-55-43-40-44-56-151/h40-48,55-60,66-81,120-121,134-150,164-201,219-226,340-348H,28-39,49-54,61-65,82-119,122-133,275-276H2,1-27H3,(H2,277,349)(H2,278,350)(H2,279,351)(H2,280,352)(H2,281,353)(H2,282,354)(H,285,292)(H,286,293)(H,287,355)(H,289,373)(H,290,375)(H,291,374)(H,294,376)(H,295,358)(H,296,356)(H,297,359)(H,298,360)(H,299,377)(H,300,378)(H,301,388)(H,302,394)(H,303,383)(H,304,407)(H,305,408)(H,306,406)(H,307,371)(H,308,379)(H,309,392)(H,310,389)(H,311,393)(H,312,400)(H,313,385)(H,314,384)(H,315,387)(H,316,395)(H,317,390)(H,318,380)(H,319,399)(H,320,381)(H,321,409)(H,322,402)(H,323,403)(H,324,413)(H,325,386)(H,326,382)(H,327,391)(H,328,404)(H,329,410)(H,330,411)(H,331,357)(H,332,372)(H,333,397)(H,334,396)(H,335,412)(H,336,401)(H,337,405)(H,338,398)(H,361,362)(H,363,364)(H,365,366)(H,367,368)(H,369,370)(H,415,416)(H,417,418)(H,419,420)(H4,283,284,288)/t146-,147-,148-,149+,150+,164-,165-,166-,167-,168-,169-,170-,171-,172-,173-,174-,175-,176-,177-,178-,179-,180-,181-,182-,183-,184-,185-,186-,187-,188-,189-,190-,191-,192-,193-,194-,195-,196-,197-,198-,199-,200-,201-,219-,220-,221-,222-,223-,224-,225-,226-/m0/s1
2.1.3 InChI Key
FYZPCMFQCNBYCY-WIWKJPBBSA-N
2.1.4 Canonical SMILES
CCC(C)C1C(=O)NC2CSSCC(C(=O)NC(CSSCC(C(=O)NCC(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(CSSCC(NC(=O)C(NC(=O)C(NC(=O)C(NC(=O)C(NC(=O)C(NC(=O)C(NC(=O)C(NC(=O)C(NC2=O)CO)CC(C)C)CC3=CC=C(C=C3)O)CCC(=O)N)CC(C)C)CCC(=O)O)CC(=O)N)CC4=CC=C(C=C4)O)C(=O)NC(CC(=O)N)C(=O)O)C(=O)NCC(=O)NC(CCC(=O)O)C(=O)NC(CCCNC(=N)N)C(=O)NCC(=O)NC(CC5=CC=CC=C5)C(=O)NC(CC6=CC=CC=C6)C(=O)NC(CC7=CC=C(C=C7)O)C(=O)NC(C(C)O)C(=O)N8CCCC8C(=O)NC(CCCCNC(=O)CCC(C(=O)O)NC(=O)CCCCCCCCCCCCCCC(=O)O)C(=O)O)C(C)C)CC(C)C)CC9=CC=C(C=C9)O)CC(C)C)C)CCC(=O)O)C(C)C)CC(C)C)CC2=CNC=N2)CO)NC(=O)C(CC(C)C)NC(=O)C(CC2=CNC=N2)NC(=O)C(CCC(=O)N)NC(=O)C(CC(=O)N)NC(=O)C(C(C)C)NC(=O)C(CC2=CC=CC=C2)N)C(=O)NC(C(=O)NC(C(=O)N1)CO)C(C)O)NC(=O)C(CCC(=O)N)NC(=O)C(CCC(=O)O)NC(=O)C(C(C)C)NC(=O)C(C(C)CC)NC(=O)CN
2.1.5 Isomeric SMILES
CC[C@H](C)[C@H]1C(=O)N[C@H]2CSSC[C@@H](C(=O)N[C@@H](CSSC[C@@H](C(=O)NCC(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@@H](CSSC[C@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC2=O)CO)CC(C)C)CC3=CC=C(C=C3)O)CCC(=O)N)CC(C)C)CCC(=O)O)CC(=O)N)CC4=CC=C(C=C4)O)C(=O)N[C@@H](CC(=O)N)C(=O)O)C(=O)NCC(=O)N[C@@H](CCC(=O)O)C(=O)N[C@@H](CCCNC(=N)N)C(=O)NCC(=O)N[C@@H](CC5=CC=CC=C5)C(=O)N[C@@H](CC6=CC=CC=C6)C(=O)N[C@@H](CC7=CC=C(C=C7)O)C(=O)N[C@@H]([C@@H](C)O)C(=O)N8CCC[C@H]8C(=O)N[C@@H](CCCCNC(=O)CC[C@@H](C(=O)O)NC(=O)CCCCCCCCCCCCCCC(=O)O)C(=O)O)C(C)C)CC(C)C)CC9=CC=C(C=C9)O)CC(C)C)C)CCC(=O)O)C(C)C)CC(C)C)CC2=CNC=N2)CO)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC2=CNC=N2)NC(=O)[C@H](CCC(=O)N)NC(=O)[C@H](CC(=O)N)NC(=O)[C@H](C(C)C)NC(=O)[C@H](CC2=CC=CC=C2)N)C(=O)N[C@H](C(=O)N[C@H](C(=O)N1)CO)[C@@H](C)O)NC(=O)[C@H](CCC(=O)N)NC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](C(C)C)NC(=O)[C@H]([C@@H](C)CC)NC(=O)CN
2.2 Synonyms
2.2.1 MeSH Synonyms

1. (1a-21a),(1b-29b)-insulin (human), 29b-(n6-(n-(15-carboxy-1- Oxopentadecyl)-l-gamma- Glutamyl)-l-lysine)-

2. Degludec

2.2.2 Depositor-Supplied Synonyms

1. 844439-96-9

2. Degludec

3. Tresiba

4. Insulin Degludec [usan:inn]

5. Unii-54q18076qb

6. Nn 1250

7. Nn1250

8. B29n(epsilon)-omega-carboxypentadecanoyl-gamma-l-glutamyl Desb30 Human Insulin

9. 54q18076qb

10. (1a-21a),(1b-29b)-insulin (human), 29b-(n6-(n-(15-carboxy-1-oxopentadecyl)-l-gamma- Glutamyl)-l-lysine)-

2.3 Create Date
2016-04-10
3 Chemical and Physical Properties
Molecular Weight 6104 g/mol
Molecular Formula C274H411N65O81S6
XLogP3-4.9
Hydrogen Bond Donor Count79
Hydrogen Bond Acceptor Count92
Rotatable Bond Count197
Exact Mass6101.8431193 g/mol
Monoisotopic Mass6099.8364096 g/mol
Topological Polar Surface Area2510 Ų
Heavy Atom Count426
Formal Charge0
Complexity15300
Isotope Atom Count0
Defined Atom Stereocenter Count51
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Indication

Insulin degludec is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus.


FDA Label


Treatment of diabetes mellitus in adults.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Insulin is a natural hormone produced by beta cells of the pancreas. In non-diabetic individuals, the pancreas produces a continuous supply of low levels of basal insulin along with spikes of insulin following meals. Increased insulin secretion following meals is responsible for the metabolic changes that occur as the body transitions from a postabsorptive to absorptive state. Insulin promotes cellular uptake of glucose, particularly in muscle and adipose tissues, promotes energy storage via glycogenesis, opposes catabolism of energy stores, increases DNA replication and protein synthesis by stimulating amino acid uptake by the liver, muscle and adipose tissue, and modifies the activity of numerous enzymes involved in glycogen synthesis and glycolysis. Insulin also promotes growth and is required for the actions of growth hormone (e.g. protein synthesis, cell division, DNA synthesis). Insulin detemir is a long-acting insulin analogue with a flat and predictable action profile. It is used to mimic the basal levels of insulin in diabetic individuals. The onset of action of insulin detemir is 1 to 2 hours and its duration of action is up to 24 hours. Interestingly, it has a lower affinity (30%) for the insulin receptor than human insulin.


5.2 FDA Pharmacological Classification
5.2.1 Pharmacological Classes
Insulin [CS]; Insulin Analog [EPC]
5.3 ATC Code

A10AE06


A - Alimentary tract and metabolism

A10 - Drugs used in diabetes

A10A - Insulins and analogues

A10AE - Insulins and analogues for injection, long-acting

A10AE06 - Insulin degludec


5.4 Absorption, Distribution and Excretion

Absorption

In patients with type 1 diabetes, after 8 days of once daily subcutaneous dosing with 0.4 U/kg, maximum degludec concentrations of 4472 pmol/L were attained at a median of 9 hours (tmax). After the first dose of, median onset of appearance was around one hour. The glucose lowering effect lasted at least 42 hours after the last of 8 once-daily injections. Insulin degludec concentration reach steady state levels after 3-4 days.


Clearance

The mean apparent clearance of insulin degludec is 0.03 L/kg (2.1 L/h in 70 kg individual) after single subcutaneous dose of 0.4 units/kg.


5.5 Metabolism/Metabolites

All insulin degludec metabolites are inactive.


5.6 Biological Half-Life

The half-life after subcutaneous administration is determined primarily by the rate of absorption from the subcutaneous tissue. On average, the half-life at steady state is approximately 25 hours independent of dose.


5.7 Mechanism of Action

Insulin detemir binds to the insulin receptor (IR), a heterotetrameric protein consisting of two extracellular alpha units and two transmembrane beta units. The binding of insulin to the alpha subunit of IR stimulates the tyrosine kinase activity intrinsic to the beta subunit of the receptor. The bound receptor autophosphorylates and phosphorylates numerous intracellular substrates such as insulin receptor substrates (IRS) proteins, Cbl, APS, Shc and Gab 1. Activation of these proteins leads to the activation of downstream signalling molecules including PI3 kinase and Akt. Akt regulates the activity of glucose transporter 4 (GLUT4) and protein kinase C (PKC), both of which play critical roles in metabolism and catabolism.


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