Insulin detemir: a long-acting insulin analog for the treatment of Type 1 and 2 diabetes

Luigi F Meneghini

Many patients are apprehensive about initiating insulin. Worries about injections, hypoglycemia and weight gain as a result of insulin therapy may contribute to their concerns, and consequently pose a challenge to achieving or maintaining optimal glycemic control. Basal insulin replacement has proven to be effective and safe for initiating insulin therapy in Type 2 diabetes. With increasing β-cell dysfunction, the addition of rapid-acting prandial insulin to basal insulin therapy represents the gold standard for physiologic insulin replacement. Insulin detemir’s beneficial profile in terms of offering less weight gain and a reduced risk of hypoglycemic episodes compared with neutral protamine Hagedorn insulin makes it an attractive alternative for basal insulin therapy. This review provides a comprehensive update on the pharmacology, clinical efficacy and safety of insulin detemir in Type 1 and 2 diabetes.