What is Levemir (insulin detemir)?

From the Guidelines

Levemir is a long-acting insulin analog medication containing insulin detemir, which is recommended for use in adults with type 1 or type 2 diabetes who have frequent severe hypoglycemia with human insulin, due to its reduced risk of severe hypoglycemic events and lower body weight compared to NPH insulin, as shown in a high-quality study published in the Annals of Internal Medicine in 2018 1.

Key Characteristics of Levemir

• It is used to control blood sugar levels in people with diabetes by replacing the insulin that the body would normally produce.
• Levemir works by helping move glucose from the bloodstream into cells where it's used for energy.
• It is typically injected once or twice daily, providing a steady background level of insulin for approximately 24 hours with less pronounced peaks compared to older insulins.
• The dose is individualized based on blood sugar levels, weight, and other factors.
• Levemir should be injected subcutaneously in the thigh, abdomen, or upper arm, and injection sites should be rotated to prevent lipodystrophy.

Clinical Evidence Supporting Levemir Use

• A study published in the Annals of Internal Medicine in 2018 found that insulin detemir (Levemir) showed fewer severe hypoglycemic events in persons treated with detemir (OR, 0.37 [CI, 0.16 to 0.92]) compared to NPH insulin 1.
• The same study also found that body weight was lower with detemir than with NPH insulin (mean difference, −1.26 kg [CI, −1.78 to −0.73 kg]) 1.
• The World Health Organization guidelines recommend considering long-acting insulin analogues, such as Levemir, to manage blood glucose in adults with type 1 or type 2 diabetes who have frequent severe hypoglycemia with human insulin (weak recommendation, moderate-quality evidence) 1.

From the FDA Drug Label

What is Levemir? Levemir is a man-made long-acting insulin that is used to control high blood sugar in adults and children with diabetes mellitus. LEVEMIR® (insulin detemir [rDNA origin] injection) is a sterile solution of insulin detemir for use as an injection. Insulin detemir is a long-acting basal insulin analog, with up to 24 hours duration of action, produced by a process that includes expression of recombinant DNA in Saccharomyces cerevisiae followed by chemical modification

Levemir (insulin detemir) is a man-made long-acting insulin used to control high blood sugar in adults and children with diabetes mellitus. It is a basal insulin analog with a duration of action of up to 24 hours 2 2.

From the Research

What is Levemir Insulin?

• Levemir, also known as insulin detemir, is a soluble long-acting human insulin analogue acylated with a 14-carbon fatty acid 3, 4, 5, 6, 7.
• The fatty acid modification allows insulin detemir to reversibly bind to albumin, thereby providing slow absorption and a prolonged metabolic effect of up to 24 hours in patients with type 1 or type 2 diabetes mellitus 3, 4, 5, 7.

Mechanism of Action

• Insulin detemir has a more predictable, protracted, and consistent effect on blood glucose than neutral protamine Hagedorn (NPH) insulin, with less intrapatient variability in glycaemic control 3, 4, 5, 6.
• The protracted action of insulin detemir is explained by increased self-association and reversible binding to albumin, which slows its systemic absorption from the injection site 6, 7.

Clinical Benefits

• Insulin detemir is at least as effective as NPH insulin in maintaining overall glycaemic control, with a similar or lower risk of hypoglycaemia, especially nocturnal hypoglycaemia 3, 4, 5, 6.
• Insulin detemir provides the added clinical benefit of no appreciable body weight gain in patients with type 1 diabetes and less body weight gain than NPH insulin in patients with type 2 diabetes 3, 4, 5, 6.
• Insulin detemir is well tolerated and no specific safety concerns have been raised 5, 6.