| INSULIN DETEMIR
Classifications: hormone; antidiabetic agent; insulin, long-acting; Therapeutic: antidiabetic; insulin
Prototype: Insulin injection
Pregnancy Category: C
100 units/mL available in 10 mL multidose vials and 3 mL prefilled syringes
Insulin detemir, a long-acting insulin, exerts its action by binding to insulin receptors. Receptor-bound insulin lowers
blood glucose by facilitating cellular uptake of glucose into skeletal muscle and fat, and inhibiting the output of glucose
from the liver.
Insulin detemir is effective as a glucose-lowering agent, with glycemic control equivalent to that of NPH insulin.
Treatment of type 1 and type 2 diabetes mellitus.
Hypersensitivity to insulin detemir, or cresol; use in insulin infusion pumps; diabetic ketoacidosis, coma, hyperosmolar
hyperglycemic state, hypoglycemia; pregnancy C. Safe and effective use in children with type 2 diabetes has not been established.
Renal and hepatic impairment; older adults; cardiac disease, CHF, concurrent use of beta-blocking agent(s); lactation.
Route & Dosage
Adult/Child: SC Insulin-na?ve patients: 0.10.2 units/kg q.d. in evening or 10 units q.d. or b.i.d. in evenly spaced doses. For those
taking a basal insulin product (i.e., NPH insulin, insulin glargine), a unit-to-unit dose conversion can be used.
- Once-daily injections should be given with the evening meal or at bedtime. With twice-daily dosing, the evening dose may
be given with the evening meal, at bedtime, or 12 h after the morning dose.
- Do not administer IV or IM. With thin patients, inject at a 45-degree angle into a pinched fold of skin to avoid IM injection.
- Do not mix with any other type of insulin. Do not use with an insulin infusion pump.
- Store unopened vials under refrigeration at 2°8° C (36°46° F). Once removed from refrigeration,
pens, cartridges, and other delivery devices must be kept at room temperature (not to exceed 30° C or 85° F) and
either used within 42 d or discarded.
INCOMPATIBILITIES Solution/additive: Insulin detemir should not be mixed with any other insulin preparations.
Adverse Effects (≥1%)[See INSULIN (REGULAR)] Body as a Whole:
Allergic reactions. Metabolic: Hypoglycemia
, weight gain. Skin:
Lipodystrophy, pruritus, rash.
Diagnostic Test Interference
See INSULIN INJECTION (REGULAR).
See INSULIN INJECTION (REGULAR)
. Herbal: Garlic
and green tea
may potentiate hypoglycemic effects.
Slow, prolonged absorption over 24 h. Peak:
68 h. Distribution:
9899% protein bound. Half-Life:
Assessment & Drug Effects
- Monitor for S&S of hypoglycemia (see Appendix F), especially after changes in insulin dose or type.
- Lab tests: Periodic fasting blood glucose and HbA1C; periodic serum potassium with concurrent potassium-lowering drugs.
- Monitor weight periodically.
Patient & Family Education
- Follow directions for taking the drug (see Administration). Rotate injection sites and never inject into an area with redness,
swelling, itching, or dimpling.
- Know parameters for withholding drug. Check blood sugar as prescribed; notify physician of fasting blood glucose below 80
or above 120 mg/dL.
- Ingest some form of sugar (e.g., orange juice, dissolved table sugar, honey) if symptoms of hypoglycemia develop; and seek
- Notify the physician of any of the following: fever, infection, trauma, diarrhea, nausea, or vomiting.
- Do not take any other medication unless approved by physician.