Detemir

Detemir Levmir Novo-Nordisk U-100 3-4 hours Flat Up to 24 1 0 mL vial, 3 mL cartridge, 3 mL Innolet, 3 mL disposable FlexPen... 

Insulin Detemir (insulin with a fatty acid molecule attached Chapter 11)... 

Levemir (Insulin detemir) Recombinant long-acting human insulin analogue produced in S. cerevisiae Engineered devoid of B30 threonine and a C14 fatty acid is covalently attached to B29 lysine Novo Nordisk 2004 (EU)... 

Home, P. and Kurtzhals, P. 2006. Insulin detemir from concept to clinical experience. Expert Opinion on Pharmacotherapy 7(3), 325-343. 

Levemir (insulin detemir) Yes Vial, 3-mL pen cartridge and InnoLet... 

Glargine and detemir are long-acting peakless human insulin analogs that result in less nocturnal hypoglycemia than NPH insulin when given at bedtime. 

The basal insulin component may be provided by once- or twice-daily NPH or detemir, or once-daily insulin glargine. Most type 1 DM patients require two injections of all insulins except insulin glargine. All of the insulins (with the exception of insulin glargine) have some degree of peak effect that must be considered in planning meals and activity. Insulin glargine or insulin detemir is a feasible basal insulin supplement for most patients. 

Another approach to the development of long-lasting insulin is illustrated in an experimental product known as insulin detemir. This insulin analog is produced by adding a fatty acid to the end of the B-chain, increasing its ability to bond to albumin in the blood. After this bonding occurs, the insulin is released at a slow and constant rate over a period of at least 24 hours. 

Injection 100 unites/mL (insulin detemir [rDNA]) (Rx) Levem/r(Novo Nordisk)... 

Insulin detemir Treatment of adult and pediatric patients with type 1 diabetes mellitus or adult patients with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia. 

Insulin lispro, insulin aspart, insulin detemir, insulin glargine and insuline glulisine are human in-sullin analogues with the same mechanism of action. It should be noted however that the potency of insulin detemir was decreased four fold compared to human insulin. By changing amino acids on some locations absorption rates and the duration of action may be changed compared to human insulin. 

Detemir needs some special attention here. Insulin detemir differs from human insulin in that one amino acid has been omitted from the end of the B chain, and a fatty acid has been attached. Detemir s action is extended because its altered form makes that it is slowly released from the subcutaneous depot. More than 98% of detemir in the bloodstream is bound to albumin. Because it slowly dissociates from the albumin, it is available to the body over an extended period. 

Brand Name(s) Rong-Acting Insulin Glargine (Rantus Ultralente), Insulin Detemir (Revemir)... 

Insulin detemir, Levemir (Novo Nordisk) Human analog U100... 

Disposable insulin pens are also available for selected formulations. These are regular insulin, insulin lispro, insulin aspart, insulin glulisine, insulin glargine, insulin detemir, and several mixtures of NPH with regular, lispro, or aspart insulin (Table 41-4). They have been well accepted by patients because they eliminate the need to carry syringes and bottles of insulin to the workplace and while traveling. 

Plank 1 et al A double-blind, randomized, dose-response study investigating the pharmacodynamic and pharmacokinetic properties of the long-acting insulin analog detemir. Diabetes Care 2005 28 1107. [PMID 15855574]... 

An alternative method of altering the duration of action of insulin is to use analogues in which there are amino acid substitutions. Analogues are listed in Table 3. Insulin aspart, insulin detemir, insulin glargine, and insulin lispro are all covered in separate monographs. 

Insulin aspart Insulin defalan Insulin detemir... 

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