differs from human insulin in that it has the terminal amino acid (B30) in the B-chain deleted, and a 14-carbon fatty acid attached at position B29
has a prolonged duration of action (up to 24 hours) mediated by two mechanisms:
mainly via , albumin binding via the fatty acid side-chain, which retains insulin in the subcutaneous depot
strong self-association of insulin detemir hexamers at the injection site
licensed for the treatment of diabetes, to be administered subcutaneously once or twice daily depending on patients' needs, in combination with meal-related short- or rapid-acting insulin
efficacy and safety of insulin detemir have not been studied in children and adolescents, nor is there any clinical trial experience in pregnancy
a review concluded that (1):
both insulin detemir and insulin glargine seem to result in glycaemic control that is at least comparable to that with isophane insulin
insulin detemir appears to reduce nocturnal hypoglycaemia and result in less weight gain than does isophane insulin in patients with type 1 diabetes
Reference:
Drug and Therapeutics Bulletin (2004); 42(10):77-80.
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