Insulin Detemir

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Molecule Description

Insulin Detemir is a long-acting man-made insulin medication used to control high blood sugar commonly in Type 1 diabetes and less commonly in Type 2 diabetes.

Uses

It is used in the treatment of high blood sugars (diabetes) in adults, children and adolescents aged one year and above.

Contraindications

When should one not use Insulin Detemir

If you have an allergy to Insulin Detemir or other ingredients used in the medicine.

Side effects

Common side effects of this drug are:

Low blood sugar (hypoglycaemia) is the most common side effect of rapid heartbeat, cold sweat and skin, vision problems, feeling hungry, feeling sick, anxiety, confusion, etc.
Severe low blood sugars can be life-threatening and lead to brain damage, unconsciousness, seizures, etc. The patient may die if not provided emergency medical care
Fluid retention - swelling in your hands and feet, breathing difficulty, weight gain
Injection site reactions – pain, redness, swelling, bruising
Temporary vision disturbances (usually at the start of the treatment), if this problem persists, consult the doctor as it may lead to permanent damage to eyes and loss of vision (diabetic retinopathy)
Shrinking or thickening of fat below the skin where you take the injection (lipodystrophy)
Swelling near ankles and other joints
Severe allergic reactions causing swelling of face, lips, throat, breathing and swallowing difficulty with or without rash, itching, skin blisters and peeling, rapid heartbeat

Precautions and Warnings

Pregnancy

Insulin Detemir can be given in pregnancy if it is necessary. Persistently high levels of blood sugar during pregnancy are not beneficial for the mother.

Breast Feeding

It is unknown if Insulin Detemir secretes in breast milk. This medicine can be given to breastfeeding mothers if their sugars are not controlled adequately with other available drugs.

Driving

A patient on Insulin Detemir should not drive if prone to low blood sugars (hypoglycaemia), which is especially common during the start of treatment. It is advised to carry sugar or a bar of chocolate with you all the time and consume as soon as you are feeling dizzy, cold sweat, rapid heartbeat, confusion, etc.

Alcohol

Consumption of alcohol may lead to an increased risk of both low and high blood sugar levels. Consumption of alcohol should be kept to a minimum (occasional drinking) while taking Insulin Detemir.

Other General Warnings

Talk to your doctor if

You have liver or kidney problems
You have problems with adrenal gland (situated on top of the kidney), pituitary gland (in the brain) or the thyroid gland
Changes in diet, physical activity or exercise
You are traveling abroad (different time zones), consult your doctor and note the exact timings on how and when to take the medicine
You have deficient albumin levels
You experience any fever or illness, do not stop taking insulin without consulting your doctor

Mode of Action

How Does It Work?

Insulin Detemir imitates the action of the insulin naturally produced in the body. It lowers blood sugars by stimulating glucose uptake by cells, tissue and muscles, especially by skeletal muscles and fat. It also reduces glucose production by the liver and increases the conversion of foods into other substances such as proteins.

Interactions

Interactions with other medicines

Selegeline, Rasagiline, Fluoxetine (medicines used to treat depression)
Propanolol, Atenolol, Ramipril, Lisinopril, Losartan (for high blood pressure), water pills (Furosemide, Hydrochlorothiazide)
Aspirin
Testosterone supplements, Cotrimoxazole and related antibiotics
Thyroid hormones, birth control pills
Medicines that suppress immune response (Corticosteroids, e.g. Prednisone and Methylprednisolone)
Medicines used to treat asthma or relax blood vessels (Epinephrine, Terbutaline, Salbutamol)
Growth hormone, medicines that suppress growth hormone (Octreotide, Lanreotide), Danazol (to treat female reproductive problems)

Interactions with food items

As this is a long-acting insulin, Insulin Detemir can be taken with or without meals.

Dietary Restrictions

Have regular diet and exercise habits.

Dosage

Overdose

Accidental or low overdose may not be harmful. But if you develop symptoms such as sweating, cold skin, rapid heart rate, hungry, weakness, tremors or confusion which are mild, have some sweets or sugar; this will usually help. In case of severe symptoms like altered consciousness, seizures, fainting, etc. visit the hospital without delay.

Missed a Dose

If you missed any dose, take it as early as you remember. Skip the missed dose if its time almost over & do not take extra medicine or double dose to make up for the missed dose. Ideally, an 8-hour gap is recommended between 2 dosages.

Frequently Asked Questions (FAQs)

Basal insulin is usually a long-acting or intermediate-acting insulin that is taken once or twice a day. Its primary purpose is to maintain the blood sugar at constant levels and is taken at the same dose depending on your condition. It mainly acts on the liver and reduces the production of glucoseBolus insulin is a short or rapid-acting insulin and is generally taken immediately before or after meals to prevent any rise in blood glucose levels. It improves the efficiency of the basal insulin and helps achieve better controlA basal-bolus regimen (combining both the regimens) is more convenient as one can be flexible with food timings, and efficacy may also be better as our body also releases insulin just after a meal. However, this regimen may not be as effective in school-going children

Insulin Detemir is a long-acting insulin, which means it has acted up to 24 hours. It will start acting 3-4 hours after consumptionThis medicine can be used in combination with other tablets or short-acting (bolus) insulin injections given to treat diabetesThis injection must be given only subcutaneously (under the skin) and is generally given under the skin of the stomach, thigh, upper part of the hand or hip regionChange the injection site every time to reduce the risk of injection site rashes or other side effectsInsulin Detemir is not for intravenous useIt can be taken at any time of the day but is preferably taken at the same time each for better sugar controlIf you are taking the injection twice a day, take the evening dose at bedtimeUse a new needle for each injectionDo not share the insulin pen even if you are using different needlesDo not stop taking or adjust the dose of Insulin Detemir without the knowledge of your doctor

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