Clinical, and Health Systems Intervention

doi:10.1111/j.1745-7599.2007.00258.x Purpose: To highlight the pharmacology, clinical data, and practical application for the use of insulin detemir, a new long-acting insulin analog in the treatment of type 2 diabetes. Data sources: Published clinical, pharmacokinetic, and pharmacodynamic studies of insulin detemir, as well as contemporary studies and reviews about the management of patients with type 2 diabetes. Conclusions: Insulin therapy, if titrated appropriately, is the most physiological and effective intervention for lowering blood glucose and may help preserve b-cell function in patients with type 2 diabetes. Insulin detemir, in comparative clinical trials, has been shown to provide effective glycemic control and a con-sistent blood glucose–lowering response for up to 24 h, a decreased incidence of nocturnal hypoglycemia, and less weight gain than other basal insulin formulations. Implications for practice: Insulin therapy is often met with resistance from both patients and healthcare providers because of concerns about its effective-ness, hypoglycemia, injections, and weight gain. Insulin detemir, designed to closely mimic basal insulin secretion, may help overcome some of the barriers to effective diabetes management, i.e., hypoglycemia and weight gain, and lead to better outcomes