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Abstract
The recent evidence-based shift towards an algorithm of early initiation and aggressive titration of insulin therapy in the management of type 2 diabetes requires the use of an effective insulin formulation that is both safe and acceptable to patients and physicians alike. The advent of the long-acting insulin analogues, insulin detemir and glargine, in the last decade has revolutionized insulin therapy in type 2 diabetes. Their unique pharmacokinetic and pharmacodynamic properties have offered tangible advantage over the conventional intermediate and long-acting insulin preparations in terms of improving glucose control as well as reducing risk of hypoglycemia and weight gain. This review focuses on the pharmacodynamic properties of the long-acting insulin analogue detemir, the outcome of studies on its relative efficacy and safety as well as its proposed place in the management of type 2 diabetes.
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Acknowledgements
Support for the NIHR Manchester Biomedical Research Centre is acknowledged.
Disclosures
Yared N Demssie has no conflict of interest to declare. Handrean Soran and Naveed Younis have received grant support, lecture and consultation fees from several pharmaceutical manufacturers including Novo Nordisk.
The authors were invited by the Editorial board of Vascular Health and Risk Management to write this review. No fee has been received for preparation of the manuscript.