Scheen A J, Radermecker R P, Philips J C, Paquot N
Service de Diabétologie, Nutrition et Maladies métaboliques, Département de Médecine, CHU Sart Tilman, Liège.
Rev Med Liege. 2005 Oct;60(10):814-9.
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 metabolic effect (up to 24 hours) with low variability. Indeed, in patients with type 1 or type 2 diabetes mellitus, insulin detemir has a more predictable, protracted and consistent effect, with less intrapatient variability in glycaemic control (particularly fasting plasma glucose levels), compared with NPH (Neutral Protamine Hagedorn) insulin. Insulin detemir, is at least as effective as NPH insulin in maintaining overall glycaemic control, with a lower risk of nocturnal hypoglycaemia. It also provides the additional benefit of less body weight gain as compared to other basal insulins. Levemir, presented in cartridges for the pen device NovoPen 3 and administered preferably at bedtime (if necessary morning and evening), is a promising new option for basal insulin therapy in diabetic patients, especially those on a basal-bolus scheme.
地特胰岛素（Levemir）是一种可溶的长效人胰岛素类似物，经14碳脂肪酸酰化修饰。脂肪酸修饰使地特胰岛素能够与白蛋白可逆性结合，从而实现缓慢吸收并产生延长至24小时的代谢效应，且变异性低。实际上，在1型或2型糖尿病患者中，与中性鱼精蛋白锌胰岛素（NPH）相比，地特胰岛素具有更可预测、持久且稳定的效果，血糖控制（尤其是空腹血糖水平）的患者内变异性更小。在维持总体血糖控制方面，地特胰岛素至少与NPH胰岛素一样有效，且夜间低血糖风险更低。与其他基础胰岛素相比，它还具有体重增加较少的额外益处。Levemir以笔芯形式提供，用于诺和笔3注射装置，最好在睡前给药（必要时早晚各一次），对于糖尿病患者，尤其是采用基础-餐时方案的患者而言，是基础胰岛素治疗的一个有前景的新选择。
