Detemir

Insulin detemir is a long-acting recombinant insulin analog used to improve glycemic control in people with diabetes mellitus. It is marketed under brand names such as Levemir and is available in vials and prefilled pens for subcutaneous injection. It is produced using recombinant DNA technology.

Chemistry and mechanism: Insulin detemir differs from human insulin by the addition of a fatty acid side chain, a myristoyl group, attached to the B30 region of the molecule. This modification promotes reversible binding to albumin after subcutaneous injection, which slows absorption and provides a relatively steady, prolonged basal insulin effect. The result is a longer duration of action with less pronounced peaks compared with many shorter-acting insulins.

Pharmacokinetics and use: Detemir is designed to function as a basal insulin, with onset typically within 1–2 hours after injection and a duration that can extend up to about 24 hours or longer, depending on the dose and individual factors. It is intended for subcutaneous dosing once or twice daily, as part of a broader diabetes management plan that may include rapid- or short-acting insulin for meals. It should not be administered intravenously, and dosing should be individualized to achieve target blood glucose levels.

Safety and handling: Common adverse effects include hypoglycemia, weight gain, and injection-site reactions. Lipodystrophy can occur with repeated injections, so rotation of injection sites is advised. Detemir is typically used with appropriate monitoring for changes in glucose control or signs of allergy.

Storage: Unopened insulin detemir vials or pens are usually stored in a refrigerator. After first use, products can be kept at room temperature for a defined period as specified by the labeling, and should not be used beyond the expiration date.