Back to Browse Journals » Clinical Pharmacology: Advances and Applications » Volume 3

Detemir as a once-daily basal insulin in type 2 diabetes

Authors Nelson SE

Published Date August 2011 Volume 2011:3 Pages 27—37

DOI http://dx.doi.org/10.2147/CPAA.S19539

Published 18 August 2011

Scott E Nelson
Cleveland Family Medicine, Cleveland, Mississippi, USA

Background: Insulin detemir, a long-acting basal insulin analog, is labeled for once-daily or twice-daily dosing in patients with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Protocols for some earlier clinical studies of detemir evaluated twice-daily dosing, which may have generated the misperception that detemir should be prescribed twice daily for most patients. This review examines pharmacokinetic and pharmacodynamic (PK/PD), observational, and controlled studies that have evaluated once-daily and twice-daily detemir in patients with T2DM to determine the efficacy and safety of once-daily dosing.
Methods: PubMed was searched using the keywords “detemir,” “once daily,” “twice daily,” and “type 2 diabetes” with the limits of clinical trial, human, and English.
Results: Detemir has a relatively flat time–action profile and duration of action of up to 24 hours for patients with T2DM. Once-daily dosing is the most commonly used detemir regimen reported in observational studies, and controlled clinical studies indicate that once-daily dosing controls glycosylated hemoglobin when detemir is administered alone or in combination with a prandial insulin or oral antidiabetes drugs. In comparative clinical trials, detemir had a similar time–action profile and duration of action to another long-acting insulin analog, glargine, with less within-subject variability. Once-daily detemir was associated with no weight gain or less weight gain than comparator regimens. For patients who had not achieved glycemic control with a basal dose of once-daily detemir, adding a prandial insulin provided better glycemic control, less postprandial hypoglycemia, and a lower total daily dose of detemir than twice-daily detemir. Involvement of a multidisciplinary team and the use of a holistic approach for the treatment of T2DM patients are recommended to achieve and maintain the best patient outcomes.
Conclusion: Results from PK/PD, observational, and controlled clinical studies support a once-daily detemir regimen alone or in combination with a prandial insulin or oral antidiabetes drugs.

Keywords: basal insulin, detemir, type 2 diabetes mellitus, pharmacokinetics, pharmacodynamics

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Changing basal insulin from NPH to detemir or glargine in patients with type 1 diabetes and a history of severe hypoglycemia

Odd Erik Johansen, Pål Johan Vanberg, Bente Kvarv Kilhovd, Anders Palmstrøm Jørgensen

Vascular Health and Risk Management 2009, 5:121-128

Published Date: 18 December 2008

Management of superficial basal cell carcinoma: focus on imiquimod

Beverly Raasch

Clinical, Cosmetic and Investigational Dermatology 2009, 2:65-75

Published Date: 11 June 2009

A retrospective database analysis of insulin use patterns in insulin-naïve patients with type 2 diabetes initiating basal insulin or mixtures

Machaon MK Bonafede, Anupama Kalsekar, Manjiri Pawaskar, et al

Patient Preference and Adherence 2010, 4:147-156

Published Date: 24 June 2010

The interaction between clopidogrel and proton pump inhibitors (PPI): is there any clinical relevance?

Rakesh K Sharma, Hanumanth K Reddy, Rohit K Sharma, et al

Clinical Pharmacology: Advances and Applications 2010, 2:155-162

Published Date: 6 September 2010

Glargine and detemir: Safety and efficacy profiles of the long-acting basal insulin analogs

Kitty Poon, Allen B King

Drug, Healthcare and Patient Safety 2010, 2:213-223

Published Date: 28 October 2010