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# 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

- Class: [Insulins](https://durgical.com/en/pharmacology/classes/insulins/)
- Receptor: Insulin receptor
- ATC code: A10AE05
- WHO Model List of Essential Medicines

## ⚠ High-alert medication

An error with this medicine can cause serious harm: double checks and protocols are used.

◎**Insulin receptor**Insulin detemir

ⓘ The figure shows human insulin bound to site 1 of an insulin receptor fragment. Detemir, once free of albumin, binds the same receptor.

**Target in 3D:** Insulin receptor. PDB structure 4OGA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4OGA) · Drag to rotate · pinch to zoom

## 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 →](https://durgical.com/en/conditions/type-1-diabetes-mellitus/)
- Basal insulin in type 2 diabetes [Type 2 diabetes mellitus →](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

## Adverse effects

### Common

- Hypoglycemia (less frequent than with NPH)
- Weight gain
- Injection-site reactions and lipodystrophy

### Serious (rare, important)

- Severe hypoglycemia
- Severe allergic reactions (rare)

## 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.

## Memory aid

«Detemir rides the albumin bus»: its fatty tail hitches a ride on albumin, so it gets off slowly all day.

## 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.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/insulin-detemir/)

## Related drugs

- [Insulin glargine](https://durgical.com/en/pharmacology/insulin-glargine/)
- [Insulin degludec](https://durgical.com/en/pharmacology/insulin-degludec/)
- [Isophane (NPH) insulin](https://durgical.com/en/pharmacology/isophane-insulin/)

## Related conditions

- [Type 1 diabetes mellitus](https://durgical.com/en/conditions/type-1-diabetes-mellitus/)
- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

[← Back to the class: Insulins](https://durgical.com/en/pharmacology/classes/insulins/)

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](https://medlineplus.gov/druginfo/meds/a606012.html) (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](https://atcddd.fhi.no/atc_ddd_index/?code=A10AE05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/insulin-detemir/