From the Guidelines
Detemir insulin is a long-acting insulin analog that can be used to manage blood sugar levels in patients with diabetes, with a reduced risk of severe hypoglycemic events compared to NPH insulin 1, 2, 3. It is recommended to start with a dose of 0.1-0.2 units/kg once or twice daily, with or without a meal, and adjust as needed to achieve target blood glucose levels 4. The maximum dose is typically 0.5 units/kg per day. Detemir insulin should be administered subcutaneously, preferably at the same time every day, and can be used in combination with other diabetes medications, such as metformin or sulfonylureas. Some key benefits of detemir insulin include:
- Reduced risk of severe hypoglycemic events compared to NPH insulin 1, 2, 3
- Lower body weight compared to NPH insulin 1, 2, 3
- Can be used in combination with other diabetes medications 4 Patients should monitor their blood glucose levels regularly and report any changes or concerns to their healthcare provider. It's also important to consider the cost-effectiveness of different antihyperglycemic agents, as the price of insulin has increased substantially over the past decade 4.
From the FDA Drug Label
The primary activity of insulin detemir is the regulation of glucose metabolism. Insulins, including insulin detemir, exert their specific action through binding to insulin receptors. Insulin detemir is a soluble, long-acting basal human insulin analog with a relatively flat action profile. The mean duration of action of insulin detemir ranged from 5.7 hours at the lowest dose to 23. 2 hours at the highest dose (sampling period 24 hours).
Insulin detemir, also known as LEVEMIR, is a long-acting basal insulin analog with a duration of action of up to 24 hours. Its primary activity is the regulation of glucose metabolism through binding to insulin receptors. The duration of action of insulin detemir ranges from 5.7 hours at the lowest dose to 23.2 hours at the highest dose. 5
From the Research
Characteristics of Insulin Detemir
- Insulin detemir is a long-acting, neutral, and soluble insulin analogue with a lower within-subject variability of fasting plasma glucose levels than NPH insulin and insulin glargine 6, 7.
- It has a unique mechanism of action, binding to albumin via a fatty acid chain, providing slow absorption and a prolonged metabolic effect 8, 9.
- Insulin detemir has a less variable pharmacokinetic profile than insulin suspension isophane or insulin ultralente 8.
Efficacy and Safety
- Insulin detemir is at least as effective as NPH insulin in maintaining overall glycemic control in adult patients with type 1 or type 2 diabetes mellitus 7, 9.
- It reduces the risk of hypoglycemia, especially nocturnal hypoglycemia, compared to NPH insulin 6, 7, 8, 10, 9.
- Insulin detemir provides a smoother and more stable plasma glucose profile, with lower post-prandial plasma glucose levels when combined with mealtime insulin aspart 6.
- The use of insulin detemir is associated with less weight gain compared to NPH insulin 7, 10, 9.