A comparison between insulin detemir and insulin NPH

This article compared the efficacy and safety of two insulin types often used in the treatment of diabetic patients; insulin detemir (Levemir) versus insulin NPH (Humulin N, Novolin N).

Insulin analogues are often employed in the treatment of diabetes mellitus, a disease characterized by reduced production of insulin or lack of cellular response to insulin. Many types of insulin analogues exist, each providing different levels of insulin for different periods of time. Both neutral protamine hagedorn insulin (insulin NPH) and insulin detemir are considered basal insulins, used to provide base levels of insulin throughout the day. Insulin NPH has an intermediate duration of action, while insulin detemir is a long-acting insulin. While different types of insulin show a varying response among different patients, all insulin treatments are associated with the risk of hypoglycemia (dangerously low blood glucose levels). This review compared insulin detemir and insulin NPH to determine the most beneficial effects in respect to blood glucose levels, HbA1c levels (a measurement of average blood glucose levels over the past 3 months), body weight variations and the rate of hypoglycemic events.

This review analyzed results from 14 studies, including more than 5000 patients with type 1 or type 2 diabetes and treated with either insulin detemir or insulin NPH.

Results showed that, while insulin detemir was associated with greater reductions in blood glucose levels after fasting, insulin NPH  and insulin detemir were equally effective at reducing HbA1c levels among both type 1 and type 2 diabetic patients. The risk of hypoglycemic events was found to be reduced by 22% among type 1 diabetics treated with insulin detemir compared to patients treated with insulin NPH. In all trials reviewed, insulin NPH was associated with significant weight gain. In comparison, among type 1 diabetic patients treated with insulin detemir most studies demonstrated significant weight loss. Among type 2 diabetic patients, insulin detemir was associated with significantly less weight gain (average gain 0.5 kg to 1.2 kg) compared to that observed with insulin NPH treatment (average gain 1.1 kg to 2.8 kg).

This review concluded that insulin detemir and insulin NPH provide similar reductions in HbA1c levels. However, insulin detemir exhibited a higher safety profile and was found to significantly reduce the risk of hypoglycemic events and weight gain compared to insulin NPH.

Consult with your physician regarding the optimal type of insulin regimen suited for your condition.