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Levemir® mechanism of action

Levemir® provides a prolonged duration of action1

Levemir® is the only basal insulin that remains soluble both before and after injection. Unlike insulin glargine, Levemir® does not form microprecipitates or crystals when injected.1

Structure affects mode of action

Levemir Mechanism of Action

Watch a presentation demonstrating the Levemir® MOA.

Watch the eDetail

Levemir®

  • Soluble at neutral pH
  • More than 98% of Levemir® in the bloodstream is bound to albumin

Insulin glargine

  • Insoluble at neutral pH3

Levemir® molecules are absorbed from the injection site at a slow, sustained rate due to strong molecular self-association and binding to a small amount of albumin. The albumin binding of Levemir® can act as a buffer against rapid or irregular changes, for instance, in insulin absorption.1

The results of in-vitro and in-vivo protein binding studies demonstrate that there is no clinically relevant interaction between insulin detemir and fatty acids or other protein-bound drugs.

In the bloodstream, the Levemir® molecules are transported to target tissues, where they interact with the insulin receptors.1

Related Support

Take a closer look at Levemir® and IGF-1 receptor affinity Watch Bruce W. Bode, MD, discuss insulin structure and affinity for the IGF-1 receptor and review clinical data on insulins. You can also download this audio program and take it with you.

View an interactive timeline of literature about IGF-1 receptor affinity Access selected publications about IGF-1 receptor affinity and cancer risk in diabetes treatment.

Up Next

Learn about 24/7 glucose control in type 2 diabetes and review the efficacy of Levemir®

References:

  1. Kurtzhals P. Engineering predictability and protraction in a basal insulin analogue: the pharmacology of insulin detemir. Int J Obes Relat Metab Disord. 2004;28(suppl 2):S23-S28.
  2. Data on file, Novo Nordisk, Inc., Princeton, NJ.
  3. Boehm BO, Vaz JA, Brøndsted L, Home PD. Long-term efficacy and safety of biphasic insulin aspart in patients with type 2 diabetes. Eur J Intern Med. 2004;15(8):496-502.

  1. Levemir® (insulin detemir [rDNA origin] injection) Indications and Usage

    Levemir® is indicated for once- or twice-daily subcutaneous administration for the treatment of adult and pediatric patients with type 1 diabetes mellitus or adult patients with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia.

    Levemir® Important Safety Information

    Levemir® is contraindicated in patients hypersensitive to insulin detemir or one of its excipients.

    Levemir® should not be diluted or mixed with any other insulin preparations.

    Hypoglycemia is the most common adverse effect of all insulin therapies, including Levemir®. As with other insulins, the timing of hypoglycemic events may differ among various insulin preparations. Glucose monitoring is recommended for all patients with diabetes. Levemir® is not to be used in insulin infusion pumps. Any change of insulin dose should be made cautiously and only under medical supervision. Concomitant oral antidiabetes treatment may require adjustment.

    Needles and Levemir® FlexPen® must not be shared.

    Inadequate dosing or discontinuation of treatment may lead to hyperglycemia and, in patients with type 1 diabetes, diabetic ketoacidosis. Insulin may cause sodium retention and edema, particularly if previously poor metabolic control is improved by intensified insulin therapy. Dose and timing of administration may need to be adjusted to reduce the risk of hypoglycemia in patients being switched to Levemir® from other intermediate or long-acting insulin preparations. The dose of Levemir® may need to be adjusted in patients with renal or hepatic impairment.

    Other adverse events commonly associated with insulin therapy may include injection site reactions (on average, 3% to 4% of patients in clinical trials) such as lipodystrophy, redness, pain, itching, hives, swelling, and inflammation. Less common but more serious are severe cases of generalized allergy, including anaphylactic reaction, which may be life threatening.

    *Whether these observed differences represent true differences in the effects of Levemir®, NPH insulin, and insulin glargine is not known since these trials were not blinded and the protocols (e.g., diet and exercise instructions and monitoring) were not specifically directed at exploring hypotheses related to weight effects of the treatments compared. The clinical significance of the observed differences in weight has not been established.

    Please click hereclick here for Prescribing Information.

FlexPen® and Levemir® are registered trademarks of Novo Nordisk.
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