Chapman Therese M, Perry Caroline M
Adis International Limited, Auckland, New Zealand.
Drugs. 2004;64(22):2577-95. doi: 10.2165/00003495-200464220-00008.
Insulin detemir (Levemir) is a soluble long-acting human insulin analogue acylated with a 14-carbon fatty acid. The fatty acid modification allows insulin detemir to reversibly bind to albumin, thereby providing slow absorption and a prolonged and consistent metabolic effect of up to 24 hours in patients with type 1 or type 2 diabetes mellitus. Insulin detemir has a more predictable, protracted and consistent effect on blood glucose than neutral protamine Hagedorn (NPH) insulin, with less intrapatient variability in glycaemic control, compared with NPH insulin or insulin glargine. Insulin detemir, administered once or twice daily, is at least as effective as NPH insulin in maintaining overall glycaemic control, with a similar or lower risk of hypoglycaemia, especially nocturnal hypoglycaemia, compared with NPH insulin in patients with type 1 or type 2 diabetes. Insulin detemir also provides the added clinical benefit of no appreciable bodyweight gain in patients with type 1 diabetes and less bodyweight gain than NPH insulin in patients with type 2 diabetes. Insulin detemir is, therefore, a promising new option for basal insulin therapy in patients with type 1 or 2 diabetes.
地特胰岛素（来得时）是一种经14碳脂肪酸酰化的可溶性长效人胰岛素类似物。脂肪酸修饰使地特胰岛素能够与白蛋白可逆性结合，从而在1型或2型糖尿病患者中实现缓慢吸收，并产生长达24小时的持久且稳定的代谢效应。与中性精蛋白锌胰岛素（NPH胰岛素）相比，地特胰岛素对血糖的影响更可预测、更持久且更稳定，与NPH胰岛素或甘精胰岛素相比，其血糖控制的患者内变异性更小。在1型或2型糖尿病患者中，每日注射一次或两次地特胰岛素，在维持总体血糖控制方面至少与NPH胰岛素一样有效，低血糖风险与NPH胰岛素相似或更低，尤其是夜间低血糖。地特胰岛素还具有额外的临床益处，即1型糖尿病患者体重无明显增加，2型糖尿病患者体重增加比NPH胰岛素少。因此，地特胰岛素是1型或2型糖尿病患者基础胰岛素治疗的一个有前景的新选择。
