Hypoglycemia is the most common adverse effect of insulins.

Absorption after intramuscular administration is both faster and more extensive than absorption after subcutaneous administration.

LEVEMIR should not be diluted or mixed with any other insulin preparations

Insulin may cause sodium retention and edema, particularly if previously poor metabolic control is improved by intensified insulin therapy.

Lipodystrophy and hypersensitivity are among potential clinical adverse effects associated with the use of all insulins.

As with all insulin preparations, the time course of LEVEMIR action may vary in different individuals or at different times in the same individual and is dependent on site of injection, blood supply, temperature, and physical activity.

Adjustment of dosage of any insulin may be necessary if patients change their physical activity or their usual meal plan.


Hypoglycemia
As with all insulin preparations, hypoglycemic reactions may be associated with the administration of LEVEMIR.

The dose of LANTUS must be individualized based on clinical response.

There, the recombinant bacteria use the gene to begin producing human insulin.

The relevance of these observations in dogs to humans is unknown.



Although studies have not been performed in patients with diabetes and hepatic impairment, a reduction in the LANTUS dose may be required in patients with hepatic impairment because of reduced capacity for gluconeogenesis and reduced insulin metabolism, similar to observations found with other insulins.

The risk of hypoglycemia increases with intensive glycemic control.



The following are examples of drugs that may increase the blood-glucose-lowering effect of insulins including LANTUS and, therefore, increase the susceptibility to hypoglycemia: oral anti-diabetic products, pramlintide, angiotensin converting enzyme (ACE) inhibitors, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, propoxyphene, pentoxifylline, salicylates, somatostatin analogs, and sulfonamide antibiotics.

The following are examples of drugs that may reduce the blood-glucose-lowering effect of insulins including LANTUS: corticosteroids, niacin, danazol, diuretics, sympathomimetic agents (e.g., epinephrine, albuterol, terbutaline), glucagon, isoniazid, phenothiazine derivatives, somatropin, thyroid hormones, estrogens, progestogens (e.g., in oral contraceptives), protease inhibitors and atypical antipsychotic medications (e.g.

Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis.

Insulin synthesis and secretion process

LEVEMIR, after subcutaneous administration, has a terminal half-life of 5 to7 hours depending on dose.


Special Populations
Children and Adolescents- The pharmacokinetic properties of LEVEMIR were investigated in children (6 to 12 years) and adolescents (13 to 17 years) and adults with type 1 diabetes.

Insulin Synthesis, Secretion, and Regulation | drbeen

Insulins, including insulin detemir, exert their specific action through binding to insulin receptors.

Receptor-bound insulin lowers blood glucose by facilitating cellular uptake of glucose into skeletal muscle and fat and by inhibiting the output of glucose from the liver.

As with all insulins, the timing of hypoglycemia may differ among various insulin formulations.

Synthesis | Insulin Resistance | Hiv/Aids

Insulin inhibits lipolysis in the adipocyte, inhibits proteolysis, and enhances protein synthesis.


Pharmacodynamics
Insulin detemir is a soluble, long-acting basal human insulin analog with a relatively flat action profile.

Chemical Synthesis of Insulin Analogs through a Novel Precursor

The mean duration of action of insulin detemir ranged from 5.7 hours at the lowest dose to 23.2 hours at the highest dose (sampling period 24 hours).

The prolonged action of LEVEMIR is mediated by the slow systemic absorption of insulin detemir molecules from the injection site due to strong self-association of the drug molecules and albumin binding.

Green Synthesis of Metallic Nanoparticles via ..

Insulin detemir is distributed more slowly to peripheral target tissues since insulin detemir in the bloodstream is highly bound to albumin.

For doses in the interval of 0.2 to 0.4 U/kg, LEVEMIR exerts more than 50% of its maximum effect from 3 to 4 hours up to approximately 14 hours after dose administration.

Pharmacokinetics ----------------------------------
Absorption
After subcutaneous injection of insulin detemir in healthy subjects and in patients with diabetes, insulin detemir serum concentrations indicated a slower, more prolonged absorption over 24 hours in comparison to NPH human insulin.

Maximum serum concentration (Cmax) is reached between 6 and 8 hours after administration.
The absolute bioavailability of insulin detemir is approximately 60%.


Distribution and Elimination
More than 98% insulin detemir in the bloodstream is bound to albumin.