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Insulin Detemir Dosage

This dosage information may not include all the information needed to use Insulin Detemir safely and effectively. See additional information for Insulin Detemir.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 2

Initiation of insulin detemir therapy:
---The recommended starting dose of insulin detemir in patients with type 1 diabetes should be approximately one-third of the total daily insulin requirements. Rapid acting or short acting, pre-meal insulin should be used for the remainder of the daily insulin requirements.
---Initial dose in patients with type 2 diabetes inadequately controlled on oral antidiabetic medications: 10 Units (or 0.1 to 0.2 Units/kg) given once daily in the evening or divided into a twice daily regimen.
---Initial dose in patients with type 2 diabetes inadequately controlled on a GLP-1 receptor agonist: 10 Units given once daily in the evening.
---Doses should be adjusted based on blood glucose measurements. Dosages of should be individualized under the supervision of a healthcare provider.

Converting to insulin detemir from other insulin therapies:
---If converting from insulin glargine, the change can be done on a unit-to-unit basis.
---If converting from NPH insulin, the change can be done on a unit-to-unit basis. However, some patients with type 2 diabetes may require more insulin detemir than NPH insulin.
---As with all insulins, close glucose monitoring is recommended during the transition and in the initial weeks thereafter. Doses and timing of concurrent rapid acting or short acting insulins or other concomitant antidiabetic treatment may need to be adjusted.

Usual Adult Dose for Diabetes Type 1

Initiation of insulin detemir therapy:
---The recommended starting dose of insulin detemir in patients with type 1 diabetes should be approximately one-third of the total daily insulin requirements. Rapid acting or short acting, pre-meal insulin should be used for the remainder of the daily insulin requirements.
---Initial dose in patients with type 2 diabetes inadequately controlled on oral antidiabetic medications: 10 Units (or 0.1 to 0.2 Units/kg) given once daily in the evening or divided into a twice daily regimen.
---Initial dose in patients with type 2 diabetes inadequately controlled on a GLP-1 receptor agonist: 10 Units given once daily in the evening.
---Doses should be adjusted based on blood glucose measurements. Dosages of should be individualized under the supervision of a healthcare provider.

Converting to insulin detemir from other insulin therapies:
---If converting from insulin glargine, the change can be done on a unit-to-unit basis.
---If converting from NPH insulin, the change can be done on a unit-to-unit basis. However, some patients with type 2 diabetes may require more insulin detemir than NPH insulin.
---As with all insulins, close glucose monitoring is recommended during the transition and in the initial weeks thereafter. Doses and timing of concurrent rapid acting or short acting insulins or other concomitant antidiabetic treatment may need to be adjusted.

Usual Pediatric Dose for Diabetes Type 1

For use in pediatric patients ages 2 to 17 years of age with type 1 diabetes (not approved for use in pediatric patients with type 2 diabetes):

Initiation of insulin detemir therapy:
---The recommended starting dose of insulin detemir in patients with type 1 diabetes should be approximately one-third of the total daily insulin requirements. Rapid acting or short acting, pre-meal insulin should be used for the remainder of the daily insulin requirements.
---Doses should be adjusted based on blood glucose measurements. Dosages of should be individualized under the supervision of a healthcare provider.

Converting to insulin detemir from other insulin therapies:
---If converting from insulin glargine, the change can be done on a unit-to-unit basis.
---If converting from NPH insulin, the change can be done on a unit-to-unit basis.
---As with all insulins, close glucose monitoring is recommended during the transition and in the initial weeks thereafter. Doses and timing of concurrent rapid acting or short acting insulins or other concomitant antidiabetic treatment may need to be adjusted.

Renal Dose Adjustments

Decreased dosage may be required. Careful blood glucose monitoring and dose adjustment are recommended.

Liver Dose Adjustments

Decreased dosage may be required. Careful blood glucose monitoring and dose adjustment are recommended.

Dose Adjustments

Daily insulin requirements may be higher during illness, stress, pregnancy, in obese patients, trauma, during concurrent use with medications having hyperglycemic effects, or after surgery, and lower with exercise, weight loss, calorie restricted diets, or during concurrent use of medications having hypoglycemic effects. Total daily doses should not be adjusted by more than 10% increments.

Supplemental doses may be prescribed during illness or to correct high preprandial blood glucose.

Dosage adjustments may be required when the brand, type, or species of insulin is changed.


Patients adjusting the amount or timing of dosing should only do so under medical supervision with appropriate glucose monitoring.

Precautions

Insulin detemir should not be mixed or diluted with any other insulin preparations.

Hypoglycemia may be difficult to diagnose in the elderly; therefore, the initial dosing, dose increments, and maintenance dosage should be conservative to avoid this potential complication.

Insulin detemir is not recommended for the treatment of diabetic ketoacidosis. Intravenous rapid acting or short acting insulin is the preferred treatment for this condition.

Safety and effectiveness of subcutaneous injections have been established in pediatric patients (age 2 to 17 years) with type 1 diabetes. Safety and effectiveness have not been established in pediatric patients younger than 2 years of age with type 1 diabetes. Insulin detemir has not been studied in pediatric patients with type 2 diabetes.

Dialysis

Data not available

Other Comments

At least twice weekly blood glucose monitoring is recommended for type I and II diabetes on conventional insulin therapy. Blood glucose is measured 3 or more times daily before meals during intensive insulin regimens. More frequent monitoring is necessary during illness or stress.

Urine ketone testing is recommended for patients with type I diabetes if they develop symptoms of colds, influenza, nausea, vomiting, or other illnesses, polyuria, or if blood glucose levels are unexpectedly high or inconsistent.

Glycosylated hemoglobin measurements are recommended every 3 months.

At least yearly serum creatinine, BUN, ECG determinations, and ophthalmologic examinations are recommended.

Patients treated with insulin detemir once daily should administer the dose with the evening meal or at bedtime. Patients treated with twice daily dosing can administer the evening dose with the evening meal, at bedtime, or 12 hours after the morning dose.

As with all insulins, injection sites should be rotated within the same region (abdomen, thigh, or deltoid) from one injection to the next to reduce the risk of lipodystrophy.

Insulin detemir can be injected subcutaneously in the thigh, abdominal wall, or upper arm. As with all insulins, the rate of absorption, and consequently the onset and duration of action, may be affected by exercise and other variables, such as stress, intercurrent illness, or changes in coadministered medications or timing of meals.

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