Insulin detemir in the treatment of type 1 and type 2 diabetes.
Insulin detemir is a soluble long-acting human insulin analogue at neutral pH with a unique mechanism of action. Following subcutaneous injection, insulin detemir binds to albumin via fatty acid chain, thereby providing slow absorption and a prolonged metabolic effect. Insulin detemir has a less variable pharmacokinetic profile than insulin suspension isophane or insulin ultralente. The use of insulin detemir can reduce the risk of hypoglycemia (especially nocturnal hypoglycemia) in type 1 and type 2 diabetic patients. However, overall glycemic control, as assessed by glycated hemoglobin, is only marginally and not significantly improved compared with usual insulin therapy. The weight gain commonly associated with insulin therapy is rather limited when insulin detemir is used. In our experience, this new insulin analogue is preferably administrated at bedtime but can be proposed twice a day (in the morning and either before the dinner or at bedtime). Detemir is a promising option for basal insulin therapy in type 1 or type 2 diabetic patients.
Philips
Jean-Christophe
JC
Division of Diabetes, Nutrition & Metabolic Disorders, Department of Medicine, CHU Sart-Tilman, University of Liège, Liège, Belgium. jcphilips@chu.ulg.ac.be
Scheen
André
A
D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000819:agonists* / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069057:Insulin Detemir