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Insulin detemir is a long-acting insulin analogue with slow absorption and a prolonged and consistent metabolic effect. Insulin detemir has a more predictable glucose-lowering effect than insulin suspension isophane (neutral protamine Hagedorn insulin), and less intrapatient variability in glycaemic control than insulin glargine. In comparative trials, insulin detemir was at least as effective as insulin suspension isophane in maintaining glycaemic control and reduced the risk of bodyweight gain in patients with diabetes. Comparative studies with insulin glargine are not yet available. Insulin detemir is as well tolerated as insulin suspension isophane with a similar or lower risk of hypoglycaemia, especially nocturnal hypoglycaemia.