Detemir as a once-daily basal insulin in type 2 diabetes

Scott E NelsonCleveland Family Medicine, Cleveland, Mississippi, USABackground: Insulin detemir, a long-acting basal insulin analog, is labeled for once-daily or twice-daily dosing in patients with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Protocols for some earlier clinical studies of detem...

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Autor principal:	Nelson SE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/ad47ba1e910c475d90a90f63ba67946a
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spelling	oai:doaj.org-article:ad47ba1e910c475d90a90f63ba67946a2021-12-02T03:09:57ZDetemir as a once-daily basal insulin in type 2 diabetes1179-1438https://doaj.org/article/ad47ba1e910c475d90a90f63ba67946a2011-08-01T00:00:00Zhttp://www.dovepress.com/detemir-as-a-once-daily-basal-insulin-in-type-2-diabetes-a8097https://doaj.org/toc/1179-1438Scott E NelsonCleveland Family Medicine, Cleveland, Mississippi, USABackground: Insulin detemir, a long-acting basal insulin analog, is labeled for once-daily or twice-daily dosing in patients with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Protocols for some earlier clinical studies of detemir evaluated twice-daily dosing, which may have generated the misperception that detemir should be prescribed twice daily for most patients. This review examines pharmacokinetic and pharmacodynamic (PK/PD), observational, and controlled studies that have evaluated once-daily and twice-daily detemir in patients with T2DM to determine the efficacy and safety of once-daily dosing.Methods: PubMed was searched using the keywords &ldquo;detemir,&rdquo; &ldquo;once daily,&rdquo; &ldquo;twice daily,&rdquo; and &ldquo;type 2 diabetes&rdquo; with the limits of clinical trial, human, and English.Results: Detemir has a relatively flat time&ndash;action profile and duration of action of up to 24 hours for patients with T2DM. Once-daily dosing is the most commonly used detemir regimen reported in observational studies, and controlled clinical studies indicate that once-daily dosing controls glycosylated hemoglobin when detemir is administered alone or in combination with a prandial insulin or oral antidiabetes drugs. In comparative clinical trials, detemir had a similar time&ndash;action profile and duration of action to another long-acting insulin analog, glargine, with less within-subject variability. Once-daily detemir was associated with no weight gain or less weight gain than comparator regimens. For patients who had not achieved glycemic control with a basal dose of once-daily detemir, adding a prandial insulin provided better glycemic control, less postprandial hypoglycemia, and a lower total daily dose of detemir than twice-daily detemir. Involvement of a multidisciplinary team and the use of a holistic approach for the treatment of T2DM patients are recommended to achieve and maintain the best patient outcomes.Conclusion: Results from PK/PD, observational, and controlled clinical studies support a once-daily detemir regimen alone or in combination with a prandial insulin or oral antidiabetes drugs.Keywords: basal insulin, detemir, type 2 diabetes mellitus, pharmacokinetics, pharmacodynamicsNelson SEDove Medical PressarticleTherapeutics. PharmacologyRM1-950ENClinical Pharmacology: Advances and Applications, Vol 2011, Iss default, Pp 27-37 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Therapeutics. Pharmacology RM1-950
spellingShingle	Therapeutics. Pharmacology RM1-950 Nelson SE Detemir as a once-daily basal insulin in type 2 diabetes
description	Scott E NelsonCleveland Family Medicine, Cleveland, Mississippi, USABackground: Insulin detemir, a long-acting basal insulin analog, is labeled for once-daily or twice-daily dosing in patients with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Protocols for some earlier clinical studies of detemir evaluated twice-daily dosing, which may have generated the misperception that detemir should be prescribed twice daily for most patients. This review examines pharmacokinetic and pharmacodynamic (PK/PD), observational, and controlled studies that have evaluated once-daily and twice-daily detemir in patients with T2DM to determine the efficacy and safety of once-daily dosing.Methods: PubMed was searched using the keywords &ldquo;detemir,&rdquo; &ldquo;once daily,&rdquo; &ldquo;twice daily,&rdquo; and &ldquo;type 2 diabetes&rdquo; with the limits of clinical trial, human, and English.Results: Detemir has a relatively flat time&ndash;action profile and duration of action of up to 24 hours for patients with T2DM. Once-daily dosing is the most commonly used detemir regimen reported in observational studies, and controlled clinical studies indicate that once-daily dosing controls glycosylated hemoglobin when detemir is administered alone or in combination with a prandial insulin or oral antidiabetes drugs. In comparative clinical trials, detemir had a similar time&ndash;action profile and duration of action to another long-acting insulin analog, glargine, with less within-subject variability. Once-daily detemir was associated with no weight gain or less weight gain than comparator regimens. For patients who had not achieved glycemic control with a basal dose of once-daily detemir, adding a prandial insulin provided better glycemic control, less postprandial hypoglycemia, and a lower total daily dose of detemir than twice-daily detemir. Involvement of a multidisciplinary team and the use of a holistic approach for the treatment of T2DM patients are recommended to achieve and maintain the best patient outcomes.Conclusion: Results from PK/PD, observational, and controlled clinical studies support a once-daily detemir regimen alone or in combination with a prandial insulin or oral antidiabetes drugs.Keywords: basal insulin, detemir, type 2 diabetes mellitus, pharmacokinetics, pharmacodynamics
format	article
author	Nelson SE
author_facet	Nelson SE
author_sort	Nelson SE
title	Detemir as a once-daily basal insulin in type 2 diabetes
title_short	Detemir as a once-daily basal insulin in type 2 diabetes
title_full	Detemir as a once-daily basal insulin in type 2 diabetes
title_fullStr	Detemir as a once-daily basal insulin in type 2 diabetes
title_full_unstemmed	Detemir as a once-daily basal insulin in type 2 diabetes
title_sort	detemir as a once-daily basal insulin in type 2 diabetes
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/ad47ba1e910c475d90a90f63ba67946a
work_keys_str_mv	AT nelsonse detemirasaoncedailybasalinsulinintype2diabetes
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Detemir as a once-daily basal insulin in type 2 diabetes

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