The Medical Letter on Drugs and Therapeutics
Insulin Detemir (Levemir), a New Long-Acting Insulin
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Insulin detemir (Levemir – Novo Nordisk) is the second long-acting basal insulin analog to be marketed in the US for treatment of both type 1 and type 2 diabetes. Detemir differs from human insulin by the elimination of the amino acid threonine in position B30 and the addition of a 14-carbon fatty acid chain at position B29. Insulin glargine (Lantus), the first long-acting insulin analog, has been available since 2001 and is usually given once daily.1 NPH insulin is an intermediate-acting basal insulin given twice daily. Basal insulins are usually combined with prandial doses of a rapid-acting insulin.2

PHARMACOLOGY — Insulin detemir is absorbed slowly from the injection site and is more than 98% reversibly bound to albumin in the blood, which further prolongs its action and clearance. Absorption is less variable with detemir, which is soluble at physiologic ... more      

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