Double-Blind, Randomized, Dose-Response Study Investigating the Pharmacodynamic and Pharmacokinetic Properties of the Long-Acting Insulin Analog Detemir
OBJECTIVE:--To investigate the pharmacodynamic profile and duration of action for five subcutaneous doses of insulin detemir (0.1, 0.2, 0.4, 0.8, and 1.6 units/kg; 1 unit = 24 nmol) and one subcutaneous dose of NPH insulin (0.3 IU/kg; 1 IU = 6 nmol). RESEARCH DESIGN AND METHODS--This single-center,...
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creator | Plank, Johannes Bodenlenz, Manfred Sinner, Frank Magnes, Christoph Görzer, Evelyn Regittnig, Werner Endahl, Lars A Draeger, Eberhard Zdravkovic, Milan Pieber, Thomas R |
description | OBJECTIVE:--To investigate the pharmacodynamic profile and duration of action for five subcutaneous doses of insulin detemir (0.1, 0.2, 0.4, 0.8, and 1.6 units/kg; 1 unit = 24 nmol) and one subcutaneous dose of NPH insulin (0.3 IU/kg; 1 IU = 6 nmol). RESEARCH DESIGN AND METHODS--This single-center, randomized, double-blind, six-period, crossover study was carried out as a 24-h isoglycemic clamp (7.2 mmol/l) in 12 type 1 diabetic patients. RESULTS:--Duration of action for insulin detemir was dose dependent and varied from 5.7, to 12.1, to 19.9, to 22.7, to 23.2 h for 0.1, 0.2, 0.4, 0.8, and 1.6 units/kg, respectively. Interpolation of the dose-response relationships for AUC[subscript GIR] (area under the glucose infusion rate curve) revealed that a detemir dose of 0.29 units/kg would provide the same effect as 0.3 IU/kg NPH but has a longer duration of action (16.9 vs. 12.7 h, respectively). Lower between-subject variability was observed for insulin detemir on duration of action (0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, P < 0.05) and GIR[subscript max] (maximal glucose infusion rate) (0.2 and 0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, both P < 0.05). Assessment of endogenous glucose production (EGP) and peripheral glucose uptake (PGU) resulted in an AOC[subscript EGP] (area over the EGP curve) of 636 mg/kg (95% CI 279-879) vs. 584 (323-846) and an AUC[subscript PGU] (area under the PGU curve) of 173 (47-316) vs. 328 (39-617) for 0.29 units/kg detemir vs. 0.3 IU/kg NPH, respectively. CONCLUSIONS:--This study shows that insulin detemir provides a flat and protracted pharmacodynamic profile. |
doi_str_mv | 10.2337/diacare.28.5.1107 |
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RESEARCH DESIGN AND METHODS--This single-center, randomized, double-blind, six-period, crossover study was carried out as a 24-h isoglycemic clamp (7.2 mmol/l) in 12 type 1 diabetic patients. RESULTS:--Duration of action for insulin detemir was dose dependent and varied from 5.7, to 12.1, to 19.9, to 22.7, to 23.2 h for 0.1, 0.2, 0.4, 0.8, and 1.6 units/kg, respectively. Interpolation of the dose-response relationships for AUC[subscript GIR] (area under the glucose infusion rate curve) revealed that a detemir dose of 0.29 units/kg would provide the same effect as 0.3 IU/kg NPH but has a longer duration of action (16.9 vs. 12.7 h, respectively). Lower between-subject variability was observed for insulin detemir on duration of action (0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, P < 0.05) and GIR[subscript max] (maximal glucose infusion rate) (0.2 and 0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, both P < 0.05). Assessment of endogenous glucose production (EGP) and peripheral glucose uptake (PGU) resulted in an AOC[subscript EGP] (area over the EGP curve) of 636 mg/kg (95% CI 279-879) vs. 584 (323-846) and an AUC[subscript PGU] (area under the PGU curve) of 173 (47-316) vs. 328 (39-617) for 0.29 units/kg detemir vs. 0.3 IU/kg NPH, respectively. CONCLUSIONS:--This study shows that insulin detemir provides a flat and protracted pharmacodynamic profile.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/diacare.28.5.1107</identifier><identifier>PMID: 15855574</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Chemical properties ; Cross-Over Studies ; Diabetes ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes. Impaired glucose tolerance ; Dosage and administration ; Double-Blind Method ; Drug dosages ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Fatty Acids, Nonesterified - blood ; Female ; Glucose - pharmacokinetics ; Glucose Clamp Technique ; Humans ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - pharmacokinetics ; Injections, Subcutaneous ; Insulin ; Insulin - administration & dosage ; Insulin - analogs & derivatives ; Insulin - pharmacokinetics ; Insulin Detemir ; Insulin, Isophane - administration & dosage ; Insulin, Isophane - pharmacokinetics ; Insulin, Long-Acting ; Male ; Medical sciences</subject><ispartof>Diabetes care, 2005-05, Vol.28 (5), p.1107-1112</ispartof><rights>2005 INIST-CNRS</rights><rights>COPYRIGHT 2005 American Diabetes Association</rights><rights>Copyright American Diabetes Association May 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c535t-17bf16fae747b905159151704bd9b3c1626db15e7b57e1dac5bebf418791d8873</citedby><cites>FETCH-LOGICAL-c535t-17bf16fae747b905159151704bd9b3c1626db15e7b57e1dac5bebf418791d8873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16724308$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15855574$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Plank, Johannes</creatorcontrib><creatorcontrib>Bodenlenz, Manfred</creatorcontrib><creatorcontrib>Sinner, Frank</creatorcontrib><creatorcontrib>Magnes, Christoph</creatorcontrib><creatorcontrib>Görzer, Evelyn</creatorcontrib><creatorcontrib>Regittnig, Werner</creatorcontrib><creatorcontrib>Endahl, Lars A</creatorcontrib><creatorcontrib>Draeger, Eberhard</creatorcontrib><creatorcontrib>Zdravkovic, Milan</creatorcontrib><creatorcontrib>Pieber, Thomas R</creatorcontrib><title>Double-Blind, Randomized, Dose-Response Study Investigating the Pharmacodynamic and Pharmacokinetic Properties of the Long-Acting Insulin Analog Detemir</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE:--To investigate the pharmacodynamic profile and duration of action for five subcutaneous doses of insulin detemir (0.1, 0.2, 0.4, 0.8, and 1.6 units/kg; 1 unit = 24 nmol) and one subcutaneous dose of NPH insulin (0.3 IU/kg; 1 IU = 6 nmol). RESEARCH DESIGN AND METHODS--This single-center, randomized, double-blind, six-period, crossover study was carried out as a 24-h isoglycemic clamp (7.2 mmol/l) in 12 type 1 diabetic patients. RESULTS:--Duration of action for insulin detemir was dose dependent and varied from 5.7, to 12.1, to 19.9, to 22.7, to 23.2 h for 0.1, 0.2, 0.4, 0.8, and 1.6 units/kg, respectively. Interpolation of the dose-response relationships for AUC[subscript GIR] (area under the glucose infusion rate curve) revealed that a detemir dose of 0.29 units/kg would provide the same effect as 0.3 IU/kg NPH but has a longer duration of action (16.9 vs. 12.7 h, respectively). Lower between-subject variability was observed for insulin detemir on duration of action (0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, P < 0.05) and GIR[subscript max] (maximal glucose infusion rate) (0.2 and 0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, both P < 0.05). Assessment of endogenous glucose production (EGP) and peripheral glucose uptake (PGU) resulted in an AOC[subscript EGP] (area over the EGP curve) of 636 mg/kg (95% CI 279-879) vs. 584 (323-846) and an AUC[subscript PGU] (area under the PGU curve) of 173 (47-316) vs. 328 (39-617) for 0.29 units/kg detemir vs. 0.3 IU/kg NPH, respectively. CONCLUSIONS:--This study shows that insulin detemir provides a flat and protracted pharmacodynamic profile.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Chemical properties</subject><subject>Cross-Over Studies</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Dosage and administration</subject><subject>Double-Blind Method</subject><subject>Drug dosages</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Fatty Acids, Nonesterified - blood</subject><subject>Female</subject><subject>Glucose - pharmacokinetics</subject><subject>Glucose Clamp Technique</subject><subject>Humans</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - pharmacokinetics</subject><subject>Injections, Subcutaneous</subject><subject>Insulin</subject><subject>Insulin - administration & dosage</subject><subject>Insulin - analogs & derivatives</subject><subject>Insulin - pharmacokinetics</subject><subject>Insulin Detemir</subject><subject>Insulin, Isophane - administration & dosage</subject><subject>Insulin, Isophane - pharmacokinetics</subject><subject>Insulin, Long-Acting</subject><subject>Male</subject><subject>Medical sciences</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptks2O0zAUhSMEYsrAA7CBCAkWiBQ7tmN7Wab8VKrEaIZZW45zk3pI7GInoPIkPC7utGIkVHlh6-o791zbJ8ueYzQvCeHvG6uNDjAvxZzNMUb8QTbDkrCCMSoeZjOEqSyYlOVZ9iTGW4QQpUI8zs4wE4wxTmfZn6Wf6h6KD711zbv8SrvGD_Y3pPPSRyiuIG69i5Bfj1Ozy1fuJ8TRdnq0rsvHDeSXGx0GbXyzc3qwJk8N_tW-Wwdjql0Gv4UwWoi5b-9Ua--6YmHuuqxcnJJ7vnC6912-hBEGG55mj1rdR3h23M-zm08fv118KdZfP68uFuvCMMLGAvO6xVWrgVNeS8Qwk5hhjmjdyJoYXJVVU2MGvGYccKMNq6FuKRZc4kYITs6zN4e-2-B_TOlyarDRQN9rB36KquJccFyyBL76D7z1U0gzR1WWBFFEZJmg4gB1ugdlXevHoE0HDkK6nIPWpvICk5JiSSuR-PkJPq0mvYE5KcAHgQk-xgCt2gY76LBTGKl9KNQxFKoUiql9KJLmxXHyqR6guVccU5CA10dAR6P7NmhnbLznKl5Sgvbmbw_cxnabXzaZJLM6_Vc86fryALfaK92F1PDmukSYICSFpJyTv8Jr2b8</recordid><startdate>20050501</startdate><enddate>20050501</enddate><creator>Plank, Johannes</creator><creator>Bodenlenz, Manfred</creator><creator>Sinner, Frank</creator><creator>Magnes, Christoph</creator><creator>Görzer, Evelyn</creator><creator>Regittnig, Werner</creator><creator>Endahl, Lars A</creator><creator>Draeger, Eberhard</creator><creator>Zdravkovic, Milan</creator><creator>Pieber, Thomas R</creator><general>American Diabetes Association</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20050501</creationdate><title>Double-Blind, Randomized, Dose-Response Study Investigating the Pharmacodynamic and Pharmacokinetic Properties of the Long-Acting Insulin Analog Detemir</title><author>Plank, Johannes ; Bodenlenz, Manfred ; Sinner, Frank ; Magnes, Christoph ; Görzer, Evelyn ; Regittnig, Werner ; Endahl, Lars A ; Draeger, Eberhard ; Zdravkovic, Milan ; Pieber, Thomas R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c535t-17bf16fae747b905159151704bd9b3c1626db15e7b57e1dac5bebf418791d8873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Chemical properties</topic><topic>Cross-Over Studies</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Dosage and administration</topic><topic>Double-Blind Method</topic><topic>Drug dosages</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Fatty Acids, Nonesterified - blood</topic><topic>Female</topic><topic>Glucose - pharmacokinetics</topic><topic>Glucose Clamp Technique</topic><topic>Humans</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - pharmacokinetics</topic><topic>Injections, Subcutaneous</topic><topic>Insulin</topic><topic>Insulin - administration & dosage</topic><topic>Insulin - analogs & derivatives</topic><topic>Insulin - pharmacokinetics</topic><topic>Insulin Detemir</topic><topic>Insulin, Isophane - administration & dosage</topic><topic>Insulin, Isophane - pharmacokinetics</topic><topic>Insulin, Long-Acting</topic><topic>Male</topic><topic>Medical sciences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Plank, Johannes</creatorcontrib><creatorcontrib>Bodenlenz, Manfred</creatorcontrib><creatorcontrib>Sinner, Frank</creatorcontrib><creatorcontrib>Magnes, Christoph</creatorcontrib><creatorcontrib>Görzer, Evelyn</creatorcontrib><creatorcontrib>Regittnig, Werner</creatorcontrib><creatorcontrib>Endahl, Lars A</creatorcontrib><creatorcontrib>Draeger, Eberhard</creatorcontrib><creatorcontrib>Zdravkovic, Milan</creatorcontrib><creatorcontrib>Pieber, Thomas R</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Agricultural Science Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Plank, Johannes</au><au>Bodenlenz, Manfred</au><au>Sinner, Frank</au><au>Magnes, Christoph</au><au>Görzer, Evelyn</au><au>Regittnig, Werner</au><au>Endahl, Lars A</au><au>Draeger, Eberhard</au><au>Zdravkovic, Milan</au><au>Pieber, Thomas R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Double-Blind, Randomized, Dose-Response Study Investigating the Pharmacodynamic and Pharmacokinetic Properties of the Long-Acting Insulin Analog Detemir</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2005-05-01</date><risdate>2005</risdate><volume>28</volume><issue>5</issue><spage>1107</spage><epage>1112</epage><pages>1107-1112</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>OBJECTIVE:--To investigate the pharmacodynamic profile and duration of action for five subcutaneous doses of insulin detemir (0.1, 0.2, 0.4, 0.8, and 1.6 units/kg; 1 unit = 24 nmol) and one subcutaneous dose of NPH insulin (0.3 IU/kg; 1 IU = 6 nmol). RESEARCH DESIGN AND METHODS--This single-center, randomized, double-blind, six-period, crossover study was carried out as a 24-h isoglycemic clamp (7.2 mmol/l) in 12 type 1 diabetic patients. RESULTS:--Duration of action for insulin detemir was dose dependent and varied from 5.7, to 12.1, to 19.9, to 22.7, to 23.2 h for 0.1, 0.2, 0.4, 0.8, and 1.6 units/kg, respectively. Interpolation of the dose-response relationships for AUC[subscript GIR] (area under the glucose infusion rate curve) revealed that a detemir dose of 0.29 units/kg would provide the same effect as 0.3 IU/kg NPH but has a longer duration of action (16.9 vs. 12.7 h, respectively). Lower between-subject variability was observed for insulin detemir on duration of action (0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, P < 0.05) and GIR[subscript max] (maximal glucose infusion rate) (0.2 and 0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, both P < 0.05). Assessment of endogenous glucose production (EGP) and peripheral glucose uptake (PGU) resulted in an AOC[subscript EGP] (area over the EGP curve) of 636 mg/kg (95% CI 279-879) vs. 584 (323-846) and an AUC[subscript PGU] (area under the PGU curve) of 173 (47-316) vs. 328 (39-617) for 0.29 units/kg detemir vs. 0.3 IU/kg NPH, respectively. CONCLUSIONS:--This study shows that insulin detemir provides a flat and protracted pharmacodynamic profile.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>15855574</pmid><doi>10.2337/diacare.28.5.1107</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Biological and medical sciences Blood Glucose - drug effects Blood Glucose - metabolism Chemical properties Cross-Over Studies Diabetes Diabetes Mellitus, Type 1 - drug therapy Diabetes. Impaired glucose tolerance Dosage and administration Double-Blind Method Drug dosages Endocrine pancreas. Apud cells (diseases) Endocrinopathies Fatty Acids, Nonesterified - blood Female Glucose - pharmacokinetics Glucose Clamp Technique Humans Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - pharmacokinetics Injections, Subcutaneous Insulin Insulin - administration & dosage Insulin - analogs & derivatives Insulin - pharmacokinetics Insulin Detemir Insulin, Isophane - administration & dosage Insulin, Isophane - pharmacokinetics Insulin, Long-Acting Male Medical sciences |
title | Double-Blind, Randomized, Dose-Response Study Investigating the Pharmacodynamic and Pharmacokinetic Properties of the Long-Acting Insulin Analog Detemir |
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