Levemir® [Insulin detemir]
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Pharmacological properties
levemir flexpen is a soluble analog of basal insulin with a prolonged action profile, which is used as basal insulin.
The predicted effect of the drug Levemir Flexpen is more pronounced than that of neutral protamine-insulin Hagedorn (NPH) and insulin glargine. The prolonged action of the drug Levemir Flexpen is due to the close interconnection of the detemir insulin molecules at the injection sites and the addition of albumin to them through the side chain of the fatty acid. Compared to insulin NPH, insulin detemir is more slowly distributed in peripheral target tissues. This combined mechanism of prolongation of action determines the more predicted absorption and profile of the drug Levemir Flexpen than insulin NPH. The hypoglycemic effect of the drug consists in promoting the absorption of glucose by tissues after binding of insulin to receptors of muscle and fat cells, as well as inhibition of the release of glucose from the liver.
The duration of the drug up to 24 hours (depending on the dose) allows you to be limited to one or two injections per day. With the introduction of 2 times a day, glycemic stabilization is achieved after 2-3 injections. With the introduction of the drug Levemir Flexpen at the rate of 0.2-0.4 U / kg body weight, 50% of the maximum effect is achieved after 3-4 hours and lasts about 14 hours after the injection.
After sc administration of the drug, the pharmacological effect (maximum effect, duration of action, general effect) is proportional to the dose of the drug.
In the course of long-term clinical studies, the use of Levemir Flexpen provided less daily fluctuations in fasting glucose compared with insulin NPH.
According to studies conducted in patients with type II diabetes mellitus who received basal insulin in combination with oral hypoglycemic agents, it was found that the effectiveness of glycemic control (HbA1c) with Levemir Flexpen is comparable to NPH-insulin and insulin glargine; at the same time, a smaller increase in body weight was noted (Table 1).
Table 1Changes in body weight after insulin treatment
| The duration of the study, weeks | Detemir insulin 1 time per day | Detemir insulin 2 times a day | NPH-insulin | Insulin glargine |
|---|---|---|---|---|
| 20 | +0.7 kg | – | +1.6 kg | – |
| 26 | – | +1.2 kg | + 2.8 kg | – |
| 52 | +2.3 kg | +3.7 kg | – | + 4.0 kg |
In the group of patients who received combined treatment with hypoglycemic drugs and Levemir Flexpen, episodes of hypoglycemia at night occurred 61–65% less than with NPH-insulin.
An open, randomized clinical trial conducted in patients with type II diabetes mellitus in a cat
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2020-07-30
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