Insulin detemir

also known as: Levemir, NN304

Novo Nordisk's fatty-acid-acylated basal insulin (Levemir, 2005) — the myristoyl chain enables reversible albumin binding, extending the half-life; Novo Nordisk announced global discontinuation in December 2023 (US supply ended 2024).

A once- or twice-daily basal insulin analog (Levemir, Novo Nordisk, FDA-approved 2005) created by removing threonine from B30 and acylating lysine at B29 with a 14-carbon myristic acid; this fatty-acid tag enables reversible albumin binding that prolongs action to approximately 16–24 hours. Novo Nordisk announced global discontinuation in December 2023, with US commercial supply ending 2024 — a significant clinical event given Levemir's role in pregnancy-related diabetes.

Mechanism of action

Insulin receptor agonism with action extended by reversible albumin binding via the myristic acid moiety — roughly 98% of circulating drug is albumin-bound, creating a slow-release reservoir. The remaining free fraction provides the pharmacologically active pool.

Primary uses

Type 1 diabetes mellitus (basal, historical)
Type 2 diabetes mellitus (basal, historical)
Gestational diabetes (notable — widely used in pregnancy before discontinuation)

Typical dosing

once or twice daily (subcutaneous)

Often required BID dosing in T1DM for 24-hour coverage.

Regulatory status

FDA-approved 2005 as Levemir (Novo Nordisk). Novo Nordisk announced global discontinuation December 2023, citing manufacturing capacity prioritization for GLP-1 products; commercial supply wound down through 2024.

References

[fda-pi] FDA. Levemir (insulin detemir) prescribing information. Novo Nordisk.
[manufacturer] Novo Nordisk. Announcement: discontinuation of Levemir globally, December 2023.
[pubmed] Havelund S, et al. "The mechanism of protraction of insulin detemir, a long-acting, acylated analog of human insulin." Pharm Res, 2004;21:1498-1504.

Related peptides

Insulin glargine

The dominant once-daily basal insulin for two decades (Lantus, Sanofi, 2000) — the pI-shift design causes microprecipitation in subcutaneous tissue for a nearly peakless 24-hour absorption profile; Toujeo (U-300) is the same molecule at 3× concentration.

Insulin degludec

Novo Nordisk's ultra-long-acting insulin (Tresiba, 2015) — forms soluble multi-hexamers in SC tissue that slowly dissociate for a >42-hour half-life and a flat, forgiving dosing window; the basal insulin with the lowest hypoglycemia risk profile.

NPH insulin (isophane)

The classical intermediate-acting insulin — regular human insulin co-crystallized with protamine to produce ~12-hour action; still widely used for cost reasons despite being largely superseded by analog basal insulins for T1DM.

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.