Insulin detemir

Long-acting insulin analogue

ATC code: A10AE05

Brand names: Levemir

Updated 23 Sep 2026 · Methodology

Indications

Type 1 diabetes mellitus

First line

Detemir serves as the basal insulin in a basal-bolus regimen for type 1 diabetes and is approved from 1 year of age in the AEMPS Levemir label. Its feature is dose-dependent duration: at a small daily dose the action does not cover 24 hours, and then two injections are used, morning and evening. A twice-daily schedule covers dawn hyperglycaemia more precisely than a single injection. Weight gain on detemir is usually smaller than on NPH or glargine, which is an argument when weight matters to the patient. Fasting glucose stays the titration reference, and meals are still covered by a rapid insulin.

Sources

ICD-10: E10 · ICD-11: 5A10

Gestational diabetes mellitus

Second line

When diet and activity no longer hold target glucose in diabetes during pregnancy, insulin is added. Detemir has more pregnancy data than most basal analogues: the AEMPS Levemir label reports a randomised trial in pregnant women with type 1 diabetes where detemir did not differ from NPH in pregnancy outcomes or neonatal condition. Insulin does not cross the placenta, and the requirement shifts by trimester: usually lower in the first and rising from the second. The dose is revisited at every stage and cut sharply after delivery, when the requirement returns to its pre-pregnancy level.

Sources

ICD-10: O24.4 · ICD-11: JA63.2

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Detemir carries myristic acid attached to lysine B29, with threonine B30 removed. The fatty acid tail binds the molecule to albumin, first in subcutaneous tissue and then in blood, where over 98% of the drug is bound. Only a small free fraction remains and it drives the effect, so the action curve is flat and day-to-day variability is lower than with NPH. Duration depends on dose: at low doses the action falls short of 24 hours and the product is then given twice daily. Albumin binding also explains the smaller weight gain compared with other basal insulins.

Safety

Contraindications

Hypoglycaemia
Hypersensitivity to insulin or to any excipient of the product

Serious adverse effects

Severe hypoglycaemia with loss of consciousness and seizures
Hypokalaemia in overdose, up to rhythm disturbance
Anaphylaxis and generalised insulin allergy
Oedema and decompensated heart failure when combined with pioglitazone

Common adverse effects

Hypoglycaemia: sweating, tremor, palpitations, hunger, confusion
Injection site reactions: redness, swelling, itching
Lipohypertrophy when injections stay in one spot
Weight gain early in treatment

Pregnancy: can you take Insulin detemir?

Insulin does not cross the placenta and remains the mainstay of glycaemic control in pregnancy. Requirements shift by trimester: usually lower in the first, rising from the second, and falling sharply after delivery. The dose is revisited at every stage.

Breastfeeding: can you take Insulin detemir?

The label sets no restriction during breastfeeding: insulin is broken down in the infant's gut and does not reach the bloodstream. Insulin requirements often fall during lactation, so the dose is retitrated.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Label mentions9 mentions

Verbatim lines from the interaction sections, in the language of the label

From this drug’s label

ModeratePioglitazone
«Combinación de Levemir y pioglitazona: Cuando pioglitazona fue utilizada en combinación con insulina, se notificaron casos de insuficiencia cardiaca, especialmente en pacientes con factores de riesgo…»
AEMPS, section 4.4 · Open on CIMA
anticonceptivos hormonalesclass named in the label
«Anticonceptivos orales, tiazidas, glucocorticoides, hormonas tiroideas, simpaticomiméticos, hormona de crecimiento y danazol.»
AEMPS, section 4.5 · Open on CIMA
antidiabéticos oralesclass named in the label
«Antidiabéticos orales, agonistas del receptor de GLP-1, inhibidores de la monoamino oxidasa (IMAO), betabloqueantes, inhibidores de la enzima conversora de la angiotensina (ECA), salicilatos…»
AEMPS, section 4.5 · Open on CIMA
betabloqueantesclass named in the label
«Antidiabéticos orales, agonistas del receptor de GLP-1, inhibidores de la monoamino oxidasa (IMAO), betabloqueantes, inhibidores de la enzima conversora de la angiotensina (ECA), salicilatos…»
AEMPS, section 4.5 · Open on CIMA
corticosteroidesclass named in the label
«Anticonceptivos orales, tiazidas, glucocorticoides, hormonas tiroideas, simpaticomiméticos, hormona de crecimiento y danazol.»
AEMPS, section 4.5 · Open on CIMA
IMAOclass named in the label
«Antidiabéticos orales, agonistas del receptor de GLP-1, inhibidores de la monoamino oxidasa (IMAO), betabloqueantes, inhibidores de la enzima conversora de la angiotensina (ECA), salicilatos…»
AEMPS, section 4.5 · Open on CIMA
simpaticomiméticosclass named in the label
«Anticonceptivos orales, tiazidas, glucocorticoides, hormonas tiroideas, simpaticomiméticos, hormona de crecimiento y danazol.»
AEMPS, section 4.5 · Open on CIMA
tiazidasclass named in the label
«Anticonceptivos orales, tiazidas, glucocorticoides, hormonas tiroideas, simpaticomiméticos, hormona de crecimiento y danazol.»
AEMPS, section 4.5 · Open on CIMA

From other drugs’ labels

Liraglutide
«Insulina: No se han observado interacciones farmacocinéticas o farmacodinámicas entre liraglutida e insulina detemir, cuando se administra una dosis única de insulina detemir 0,5 U/kg con liraglutida…»
AEMPS, section 4.5 · Open on CIMA

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Frequently asked

What is Insulin detemir used for?

Insulin detemir is evaluated for the following indications with varying evidence strength: Type 1 diabetes mellitus (evidence tier A), Gestational diabetes mellitus (evidence tier B). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Insulin detemir?

Common side effects of Insulin detemir (≥ 1 in 100): Hypoglycaemia: sweating, tremor, palpitations, hunger, confusion, Injection site reactions: redness, swelling, itching, Lipohypertrophy when injections stay in one spot, Weight gain early in treatment. See the Safety section for uncommon and serious reactions.

Is Insulin detemir safe during pregnancy?

Is Insulin detemir compatible with breastfeeding?

Who should not take Insulin detemir?

Insulin detemir is contraindicated in: Hypoglycaemia; Hypersensitivity to insulin or to any excipient of the product. Full list in the Safety section.

Official sources

Direct links to regulator labels. Open in a new tab.

AEMPS / CIMA

Other drugs in this group

Insulin glargine, Insulin glulisine, Insulin human isophane (NPH), Insulin lispro, Repaglinide, Vildagliptin, Gliclazide, Linagliptin