Dorchy H, Sternon J
Clinique de Diabétologie, Hôpital Universitaire Des Enfants Reine Fabiola.
Rev Med Brux. 2006 Mar-Apr;27(2):89-94.
Insulin detemir (Levemir) is a soluble long-acting human insulin analogue acylated with a 14-carbon fatty acid. Insulin detemir is 98-99% albumin bound in plasma. It has a more predictable glucose-lowering effect than NPH insulin or insulin glargin. There is a dose-response relationship, but at the dose of 0.4 units/ kg (an average normal dose), the duration of action reaches nearly 24 h. Therefore, detemir, most often injected once per day at bedtime, seems to be the ideal basal insulin in the basal-prandial therapy for type 1 diabetic patients. The boli of insulin, in order to cover the meals, may be done with a rapid acting human insulin and/or a fast acting analogue. In comparison with NPH insulin, detemir has been shown to reduce the risk of (severe) hypoglycaemias, particularly nocturnal (up to 50%). Fasting hyperglycaemia is often lower, but it is not necessarily true for glycated haemoglobin. In addition, detemir has been associated with less weight gain than NPH insulin. Detemir is well tolerated and no specific safety concerns have been raised.
地特胰岛素（Levemir）是一种用14碳脂肪酸酰化的可溶性长效人胰岛素类似物。地特胰岛素在血浆中与白蛋白的结合率为98% - 99%。与中性鱼精蛋白锌胰岛素（NPH胰岛素）或甘精胰岛素相比，它具有更可预测的降糖效果。存在剂量 - 反应关系，但在0.4单位/千克的剂量（平均正常剂量）下，作用持续时间接近24小时。因此，地特胰岛素通常在睡前每天注射一次，似乎是1型糖尿病患者基础 - 餐时治疗中理想的基础胰岛素。为了覆盖餐食的胰岛素推注可以使用速效人胰岛素和/或速效类似物来进行。与NPH胰岛素相比，地特胰岛素已被证明可降低（严重）低血糖的风险，尤其是夜间低血糖（降低多达50%）。空腹血糖通常较低，但糖化血红蛋白不一定如此。此外，与NPH胰岛素相比，地特胰岛素导致的体重增加较少。地特胰岛素耐受性良好，未出现特定的安全问题。
