Insulin detemir

• 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:

1. Drug and Therapeutics Bulletin (2004); 42(10):77-80.