Insulin detemir is used on its own or together with other medicines to help treat your diabetes by keeping your blood sugar under control.
This medicine is meant to be used as part of a complete diabetes care programme that should include exercise, a healthy diet and regular monitoring of blood sugar levels.
Use Insulin detemir exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor as small changes in the amount of this medicine may affect your blood sugar levels.
This medicine is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm or abdomen area).
Your doctor will discuss with you how often should you use Insulin detemir depending on your dosing regimen. If you need a once daily regimen, administer this medicine with an evening meal or at bedtime. If you need twice daily dosing, the evening dose may be given either with an evening meal or at bedtime or 12 hours after the morning dose. Try to administer it at the same time each day.
Insulin detemir is available as a vial, pre-filled pen, or as a solution for injection in a cartridge. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist. This medicine may become ineffective if your insulin pen or cartridge does not work properly.
How to use the insulin vial:
- Gather all the supplies you will need for injection (e.g. vial, syringe, alcohol swab, cotton).
- Wash your hands with soap and water.
- Pull off the protective colour cap of the medicine (on the top of the vial) then you will see a grey rubber stopper. Wipe the top of the grey rubber stopper with alcohol swab.
- Roll the vial between your hands in a horizontal (flat) position until the insulin solution is evenly mixed. Do not shake the vial.
- Remove the needle cover of the syringe recommended by your doctor. Draw air, equal to your required dose, into the syringe by pulling back the plunger.
- Put the vial on a flat surface then insert the needle down the grey rubber stopper.
- Push the plunger of the syringe down to inject the air and keep the needle inside the vial.
- Turn the vial upside down. Slowly pull back the plunger to fill the syringe with your dose.
- Keep the needle inside the vial. To remove air bubbles, gently tap the syringe with your fingers until the air bubbles rise to the top of the syringe then slowly push the plunger up. Pull the plunger back down to measure your required dose.
- Remove the prepared syringe and needle from the vial and hold it in your hand that will inject the medicine.
- Wipe the selected injection site with alcohol swab and pinch the skin using your other hand. Push the plunger of the syringe as far as it will go to deliver your dose.
- Slowly let go of the skin and gently pull the needle out of the skin. Do not recap the needle.
- Place a cotton ball over the injection site and press for several seconds.
- Dispose your used needles and syringes according to your doctor or pharmacist's instructions. Use a new needle and syringe for each injection.
Ensure that you are using the correct type of syringe. Check with your doctor or nurse if you are not sure.
How to use the insulin pre-filled pen:
- Prepare the injection pen as instructed by your doctor or nurse.
- Attach the needle to the injection pen. Ensure that the needle is screwed on securely.
- Dial the correct dose.
- Swab the injection site area with alcohol.
- Hold the injection pen with your thumb over the injection button.
- Press the injection pen against your body using the subcutaneous (under the skin) injection method.
- Use your thumb to push the injection button until it stops. Continue to hold the injection button in that position while slowly counting to 6 to get a full dose.
- Withdraw the injection pen from your body.
- Remove the needle from the pen. Never store the injection pen with the needle attached.
- Reset your pen as instructed by your doctor or nurse.
- Throw away the used needle. Recap your pen and store below 30°C or between 2 to 8°C.
- Use a new needle in every administration of this medicine.
Remember to rotate the injection sites. Do not inject into the same area all the time. Do not inject near the navel (belly button). New injection sites should be at least 1.5 inches away from the previous injection site.
Do not dilute or mix Insulin detemir with any other insulin formulation or solution.
DO NOT administer this medicine intravenously (into a vein), intramuscularly (into a muscle) or by infusion pump.
Do not share your insulin injection with anyone else.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of your treatment depending on your condition and response to the medication.
Insulin detemir must be administered regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor. If you suddenly stop using this medicine, it may lead to hyperglycaemia (high blood sugar level).
If you missed a dose of Insulin detemir, administer the dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal injection schedule. Check your blood sugar levels and ask your doctor on how to adjust your insulin doses if needed.
A missed dose may lead to hyperglycaemia (high blood sugar level). If you often forget to inject your medicine, let your doctor and pharmacist know. They can give you advice that can help you remember your dosing schedule.
DO NOT double a dose to make up for a missed dose.
Do not use Insulin detemir if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.
Alert your doctor if you experience episodes of hypoglycaemia (low blood sugar) as Insulin detemir may not be suitable for you.
Inform your doctor if you have the following conditions:
- heart disease
- diseases of the thyroid, adrenal and pituitary gland
- severely low levels of albumin (a type of protein) in the blood
- liver disease
- kidney disease
Insulin detemir is not intended for the treatment of diabetic ketoacidosis (complication of diabetes characterised by high level of blood acid in your body).
Let your doctor know if you are pregnant or breastfeeding.
If you are under stress, have an injury, infection, or fever, inform your doctor as these conditions may affect your blood sugar level.
Exercise will also change your insulin requirement. Consult your doctor if you change your exercise routine or start on a new exercise program.
Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.
Do not change the brand or type of insulin you are using without first consulting your doctor.
If you are travelling, discuss with your doctor about how to adjust your injection schedule. Carry your insulin in your hand-carry luggage. Do not put insulin in your check-in luggage as it may freeze.
For as long as you are using this medicine, you will need to have regular blood tests (e.g. blood sugar level, liver and kidney function) to check your body's response to the medicine. Your doctor will advise you about how often you need to have these tests.
If you are using Insulin detemir, you may have been warned about hypoglycaemia (low blood sugar).
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, sweating. These signs are your body's way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 grams of glucose tablet at first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 grams of glucose tablet.
If you don't have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms did not improve after second serving.
Insulin detemir may cause hypoglycaemia (low blood sugar) which may affect your ability to concentrate and react. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, cough, sore throat, stomach pain or discomfort, nausea, vomiting, and itching, pain, redness, swelling, bruising or skin thickening at the injection site.
Some side effect may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- muscle pain or weakness, muscle cramps, or abnormal heartbeat
- increased thirst or urination, confusion, drowsiness, flushing, breath that smells like fruit
If you develop rashes, breathlessness, swollen mouth or eyes, stop using Insulin detemir and inform your doctor immediately. These could be signs of an allergic reaction.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of the following medicines:
- other medicines for diabetes e.g. pioglitazone, pramlintide
- medicines for high blood pressure e.g. clonidine, guanethidine, reserpine
- medicines for mood disorder e.g. clozapine, olanzapine, lithium
- asthma medicines e.g. salbutamol, terbutaline
This list does not include all medicines that may interact with Insulin detemir.
Inform your doctor if you are currently taking birth control pills as this can reduce the effectiveness of Insulin detemir. You should not stop or start any birth control pills without first informing your doctor. Ask your doctor about using non-hormonal birth control as an alternative while being treated with this medicine.
Always notify your doctor or pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
It is important for you to maintain a healthy diet and weight in order to help keep your diabetes under control.
It may be helpful to discuss your diet plan with your doctor or dietitian to manage your weight and blood sugar levels.
If you have not yet opened it, store Insulin detemir in a refrigerator between 2 to 8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used.
Once opened, this medicine may be stored at room temperature (below 30°C). It will expire 42 days after opening.
Storage recommendations may vary among different preparations. Refer to specific product guidelines.
Do not use Insulin detemir if it has changed colour, has a frosted appearance or if you see lumps floating in the liquid or stuck to the side of the glass. Throw away any unused portion.
Make sure you know how to store your medicine. This medicine may become ineffective if not stored properly. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Keep away from heat, light, and from the reach of children.
Medicines must not be used past the expiry date.