Insulin detemir !
A long-acting basal insulin with a fatty acid tail that binds albumin, which slows its release. Often given once or twice a day.
Updated 2026-11-01
The figure shows human insulin bound to site 1 of an insulin receptor fragment. Detemir, once free of albumin, binds the same receptor.
Mechanism of action
Detemir carries a myristic acid (a saturated fatty acid) attached to lysine B29. After injection the fatty chain binds albumin, so the insulin is released slowly from the injection site and from albumin in the blood. The free hormone activates the insulin receptor like human insulin.
- Myristic acid on B29 makes detemir bind albumin
- Slow release from the injection site and from albumin
- Free detemir activates the insulin receptor
- Smooth basal effect, with less variability than NPH
Pharmacokinetics
- Absorption
- Subcutaneous; slow and relatively steady absorption.
- Distribution
- Largely bound to albumin through its fatty acid chain.
- Onset and duration
- Long acting; its duration is shorter than glargine's in some patients, so it is often given twice a day.
Indications
- Basal insulin in type 1 diabetes Type 1 diabetes mellitus →
- Basal insulin in type 2 diabetes Type 2 diabetes mellitus →
Adverse effects
Common
- Hypoglycemia (less frequent than with NPH)
- Weight gain
- Injection-site reactions and lipodystrophy
Contraindications
- During an episode of hypoglycemia
- Hypersensitivity to insulin detemir or an excipient
Key interactions
- Beta-blockers, clonidine
- Can blunt the warning signs of hypoglycemia.
- Other glucose-lowering drugs
- Raise the risk of hypoglycemia.
- Corticosteroids, diuretics, atypical antipsychotics
- Reduce the glucose-lowering effect.
What is monitored
- Fasting and pre-evening-meal blood glucose
- HbA1c
- Injection sites
Administration and safety
- Subcutaneous only; never into a vein or muscle.
- Not diluted or mixed with other insulins.
- Clear and colorless: if cloudy, colored or with particles it is not used.
- Given with the evening meal or at bedtime when once daily; morning and evening when twice daily.
Nursing care
- Before: blood glucose and the timing of the previous dose.
- Watch for hypoglycemia, especially overnight.
- Rotate injection sites within an area.
- Teach that it is a basal insulin and not used to correct a high reading.
Pregnancy and breastfeeding
Insulin is the usual treatment for diabetes in pregnancy; the choice of analogue is individualized and glucose is checked often.
Test yourself
Think of the answer, then tap the question to see it.
How does the fatty acid on detemir prolong its action?
Myristic acid on lysine B29 binds albumin, so detemir is released slowly from the injection site and from albumin in the blood.
Why is detemir sometimes given twice a day while glargine is usually once?
Detemir's duration is often somewhat shorter, so a second dose may be needed for full 24-hour coverage.
Can detemir be mixed with a rapid-acting insulin in one syringe?
No. It is not diluted or mixed with other insulins.
Related drugs
Related conditions
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Insulin Detemir (rDNA Origin) Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 51 (McGraw Hill, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.