Insulin detemir, Levemir
Description: Long Acting Insulin
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does it Work
Insulin detemir, Levemir works on the liver, muscle, and adipose (fat) tissue to regulate the metabolism of carbohydrates, protein, and fats. In the liver and muscles, it increases glycogen synthesis which is the immediate storage form of glucose. It increases fat production by increasing fatty acid release from the liver in the form of lipoproteins which adipose tissue converts to fatty acids than to triglycerides for storage whilst also stopping the metabolism of triglycerides (fat). Insulin also increases the cellular uptake of amino acids and some electrolytes such as potassium into the cell. In muscle tissue, protein synthesis is increased.
Normally insulin is produced by the pancreas however insulin products for pharmaceutical use have been produced via recombinant DNA technology using certain bacteria (they splice the gene for insulin production into bacterial DNA so the cell produces insulin – a gene is a portion of DNA or RNA that produces one specific protein). Insulin detemir is different from human insulin as it has some modifications to make it last longer. It involves the omission of threonine in position B30 and the addition of a C14 fatty acid chain to the amino acid located at position B29 (these are all names of amino acids which are the building blocks of proteins such as insulin).
Indications For Use
Insulin detemir, Levemir is indicated for diabetes mellitus types 1 and 2
Before starting Insulin detemir, Levemir makes sure your physician is aware of any allergies or medications you currently take if you have had bariatric surgery, cardiovascular disease, have kidney disease, liver disease, diabetic ketoacidosis, are pregnant, or breastfeeding.
Insulin detemir, Levemir is long-acting or basal insulin. It is given subcutaneously in one or usually two daily injections. In type 2 diabetes someone usually starts around 10 units per day or 0.1-0.2mg/kg/day and the dosage is slowly increased until glucose control is achieved. In type 1 diabetes 40-50% of total daily insulin is given as intermediate or long-acting with the rest divided into fast-acting mealtime insulin. If converting from another insulin the number of units given may need to be lowered as a precaution.
Pharmacist Tips On Using
How to Take Insulin detemir, Levemir: Follow instructions provided by physician/pharmacy label, use consistently at same times each day unless otherwise directed, refrigerate product, not in use (36-46 Fahrenheit, 2-8 Celsius), the vial in use may be kept at room temperature (below 86 Fahrenheit, 30 Celsius) for up to 28 days (discard if not used by this point). Injection generally into abdomen, thighs, buttocks, or arms with absorption rates varying from site to site. Be consistent with the part of the body you inject into but rotate the injection site to avoid redistribution of fat and excessive irritation to the area. For example, if you choose the abdomen which is the most common, inject in circular order at least 2 inches from the navel.
You Need to Avoid: Do not use if the solution seems viscous (thick) or appears cloudy, only use if clear, colorless, and with no visible particles. Avoid injecting cold insulin as it may be painful.
Headache and hypoglycemia are the most common side effects in adults for this medication.
Frequently Asked questions
What is hypoglycemia?
Hypoglycemia is a condition of low blood sugar (>3.9mmol/L-Canada; 70mg/dL-US) which is considered a medical emergency whereas hyperglycemia is a slowly progressive condition. It generally occurs with irregularities in diet, exercise, and medications in diabetic patients. It is preferably treated with simple sugars such as dextrose; regular table sugar can work but is slower acting as it needs to be digested and if blood sugar is extremely low this delay can be a problem. Hypoglycemia has a large host of progressive symptoms from hunger, headache, nausea, sweating, palpitations, mood swings, irritability to seizure, coma and in severe cases, death.