The role of insulin detemir in overweight type 2 diabetes management

Figures & data

Table 1 Pharmacokinetics of intermediate and long-acting insulin preparations

Type of insulin	Onset	Peak effect	Duration (hours)
Intermediate-acting
Semilente	0.5–1	4–6	8–12
Lente	2–4	6–10	12–24
Isophane/NPH	2–4	6–10	12–24
Long-acting
Ultralente	3–4	8–20	20–36
Protamine zinc	3–4	14–20	24–36
Long-acting analogues
Glargine	2	no pronounced peak	22
Detemir	2	no pronounced peak	20 for doses >0.4 units/kg

Figure 1 Insulin detemir.

Table 2 Randomized trials comparing insulin detemir to NPH and glargine in basal-bolus regimen and as add-on to OADS

Study	Study duration (weeks)	Number of patients	Insulin therapy	Change in HbA1c (%)	Incidence (%) of hypoglycemia	Change in weight (kg)
						Majora	Nocturnal
Philis-Tsimikas et al^Citation38	20	165	detemird	−1.6	0	2.4	+1.2
		169	detemire	−1.5	1.2	4.7	+1.5
		164	NPH	−1.7	0	13.4	+1.6
Hermansen et al^Citation37	26	227	detemir + OADs	−1.8	NA	55% less	+1.2
		225	NPH + OADs	−1.9	NA	NA	+2.8
Rosenstock et al^Citation39	52	291	detemir + OAD	−1.4	0/pt-yr	1.3/pt-yr	+3.0
		291	Glargine	−1.5	NA	1.3/pt-yr	+3.9
Haak et al^Citation36	26	341	detemir + aspart	−0.2	<2	15.8	+1.0
		164	NPH + aspart	−0.4	<2	23.6	+1.8
Raslova et al^Citation35	22	195	detemir and aspart	−0.7	1.1	14.9	+0.51
		199	NPH and RHI	−0.6	0.5	17.5	+1.13
Rosenstock et al^Citation39	52	582	detemir and OAD	−1.4	no significant difference		+3.0
			glargine and OAD	−1.5			+3.9

^a Major hypoglycemia is where patients are not able to treat themselves.

^d Insulin detemir administered in the morning.

^e Insulin detemir administered in the evening.

Philis-TsimikasACharpentierGClausonPComparison of once-daily insulin detemir with NPH insulin added to a regimen of oral antidiabetic drugs in poorly controlled type 2 diabetesClin Ther2006281569158117157113

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HermansenKDaviesMDerezinskiTA 26 week, randomized, parallel, treat to target trail comparing insulin detemir with NPH insulin ass add-on therapy to oral glucose-lowering drugs in insulin-naïve people with type 2 diabetesDiabetes Care2006291269127416732007

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RosenstockJDaviesMHomePDA randomized treat to target trial comparing insulin detemir with insulin glargine when administered as add-on to glucose lowering drugs in insulin-naïve people with type 2 diabetesDiabetologia20085140841618204830

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HaakTTiengoADraegerESuntumMWaldhausWLower within-subject variability of fasting blood glucose and reduced weight gain with insulin detemir compared to NPH insulin in patients with type 2 diabetesDiabetes Obes Metab20057566415642076

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RaslovaKBogoevMRazIInsulin detemir and insulin aspart: a promising basal-bolus regimen for type 2 diabetesDiabetes Res Clin Pract20046619320115533587

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