Insulin detemir, sold under the brand name Levemir among others, is a long-acting modified form of medical insulin used to treat both type 1 and type 2

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...

. It is used by

injection under the skin Subcutaneous administration is the insertion of medications beneath the skin either by injection or infusion. A subcutaneous injection is administered as a bolus into the subcutis, the layer of skin directly below the dermis and epidermis, col ...

. It is effective for up to 24 hours. Common side effects include

low blood sugar Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose belo ...

allergic reactions Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...

, pain at the site of injection, and weight gain. Use in

pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...

and

breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...

appears safe. It works by increasing the amount of

glucose Glucose is a simple sugar with the molecular formula . Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using ...

that tissues take in and decreasing the amount of glucose made by the liver. Insulin detemir was approved for medical use in the European Union in June 2004, and in the United States in June 2005. It is on the

World Health Organization's List of Essential Medicines The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health ...

. In 2020, it was the 124th most commonly prescribed medication in the United States, with more than 5million prescriptions.

Medical use

It is used to treat both type 1 and type 2

. A recent Cochrane systematic review also compared the effects of insulin detemir to

NPH insulin Neutral Protamine Hagedorn (NPH) insulin, also known as isophane insulin, is an intermediate-acting insulin given to help control blood sugar levels in people with diabetes. It is used by injection under the skin once to twice a day. Onset of ...

and other insulin analogues (

insulin glargine Insulin glargine, sold under the brand name Lantus among others, is a long-acting modified form of medical insulin, used in the management of type I and type II diabetes. It is typically the recommended long acting insulin in the United King ...

insulin degludec Insulin degludec ( INN/USAN) is an ultralong-acting basal insulin analogue that was developed by Novo Nordisk under the brand name Tresiba. It is administered via subcutaneous injection once daily to help control the blood sugar level of those ...

) in both children and adults with Type 1 diabetes. With respect to blood sugar management, it appears to work better than NPH insulin, however this finding was inconsistent across included and previous studies. In the same systematic review no other clinically significant differences were found between different insulin analogues in either adults nor children.

Side effects

Common side effects include

, pain at the site of injection, and weight gain. Use in

and

appears safe.

Chemistry

It is an insulin analogue in which a

fatty acid In chemistry, particularly in biochemistry, a fatty acid is a carboxylic acid with an aliphatic chain, which is either saturated or unsaturated. Most naturally occurring fatty acids have an unbranched chain of an even number of carbon atoms, fr ...

(

myristic acid Myristic acid (IUPAC name: tetradecanoic acid) is a common saturated fatty acid with the molecular formula CH3(CH2)12COOH. Its salts and esters are commonly referred to as myristates or tetradecanoates. It is named after the binomial name for nutm ...

) is bound to the

lysine Lysine (symbol Lys or K) is an α-amino acid that is a precursor to many proteins. It contains an α-amino group (which is in the protonated form under biological conditions), an α-carboxylic acid group (which is in the deprotonated −C ...

amino acid at position B29. It is quickly absorbed after which it binds to

albumin Albumin is a family of globular proteins, the most common of which are the serum albumins. All the proteins of the albumin family are water-soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Albumins ...

in the blood through its fatty acid at position B29. It then slowly dissociates from this complex.

Society and culture

On 13 June 2009, the U.S.

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...

(FDA) issued a public health advisory for insulin determir after learning that 129,000 stolen vials reappeared and were being sold in the U.S. market. The FDA warned that the stolen vials "may not have been stored and handled properly and may be dangerous for patients to use." The stolen vials were identified as lots XZF0036, XZF0037, and XZF0038.

References

External links

* {{DEFAULTSORT:Insulin Detemir Wikipedia medicine articles ready to translate Insulin receptor agonists Insulin therapies