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Insulin detemir for the treatment of obese patients with type 2 diabetes.
MedLine Citation:
PMID:  22291472     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The risk for developing type 2 diabetes (T2DM) is greater among obese individuals. Following onset of the disease, patients with T2DM become more likely to be afflicted with diabetic micro- and macrovascular complications. Decreasing body weight has been shown to lower glycosylated hemoglobin and improve other metabolic parameters in patients with T2DM. Medications used to lower blood glucose may increase body weight in patients with T2DM and this has been repeatedly shown to be the case for conventional, human insulin formulations. Insulin detemir is a neutral, soluble, long-acting insulin analog in which threonine-30 of the insulin B-chain is deleted, and the C-terminal lysine is acetylated with myristic acid, a C14 fatty acid chain. Insulin detemir binds to albumin, a property that enhances its pharmacokinetic/pharmacodynamic profile. Results from clinical trials have demonstrated that treatment with insulin detemir is associated with less weight gain than either insulin glargine or neutral protamine Hagedorn insulin. There are many potential reasons for the lower weight gain observed among patients treated with insulin detemir, including lower risk for hypoglycemia and therefore decreased defensive eating due to concern about this adverse event, along with other effects that may be related to the albumin binding of this insulin that may account for lower within-patient variability and consistent action. These might include faster transport across the blood-brain barrier, induction of satiety signaling in the brain, and preferential inhibition of hepatic glucose production versus peripheral glucose uptake. Experiments in diabetic rats have also indicated that insulin detemir increases adiponectin levels, which is associated with both weight loss and decreased eating.
Authors:
Priscilla A Hollander
Publication Detail:
Type:  Journal Article     Date:  2012-01-10
Journal Detail:
Title:  Diabetes, metabolic syndrome and obesity : targets and therapy     Volume:  5     ISSN:  1178-7007     ISO Abbreviation:  Diabetes Metab Syndr Obes     Publication Date:  2012  
Date Detail:
Created Date:  2012-01-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101515585     Medline TA:  Diabetes Metab Syndr Obes     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  11-9     Citation Subset:  -    
Affiliation:
Baylor Endocrine Center, Dallas, Texas, USA.
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