Insulin detemir achieves its prolonged duration of action through which structural modification?

• A Substitution of proline at position B28 with aspartic acid
• B Addition of a myristic acid side chain promoting reversible albumin binding ✓
• C Addition of two arginine residues and glycine to shift the isoelectric point
• D Deletion of the terminal threonine on the beta chain allowing self-association

Explanation

Detemir is acylated with myristic acid at lysine A29, which promotes reversible binding to serum albumin and slow dissociation, producing a smooth 12 to 24 hour profile. Option A defines insulin aspart, option C defines glargine, and option D describes the truncation used in some rapid-acting analog design work. Detemir's albumin binding also means roughly twice the molar dose is required compared with human insulin.

Reference: Katzung Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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