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New Study Finds Once-Weekly Insulin May Be Effective for Managing Type 2 Diabetes

A new study has found that a new once-weekly insulin treatment may be as effective as once-daily insulin in people with type 2 diabetes.

The American Diabetes Association and the European Association for the Study of Diabetes recommend that when people with type 2 diabetes do not reach their goals, treatment should be escalated. However, in practice, this treatment escalation is not happening as much as it should. Data shows that people with type 2 diabetes who need insulin injections prefer fewer injections and more flexibility than a once-daily regimen.1

The new study, published in the New England Journal of Medicine, looked to determine if fewer injections would increase insulin treatment acceptance and adherence and improve glycemic control.1

The researchers studied the new insulin, called insulin icodec. The study looked at the efficacy and safety of the insulin. Researchers compared once-weekly insulin icodec and once-daily insulin glargine in people with type 2 diabetes who:1

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  • Have not taken insulin before, and
  • Whose type 2 diabetes was not well controlled with metformin with or without another oral drug called a dipeptidyl peptidase-4 (DPP-4) inhibitor

How did the once-weekly insulin treatment study work?

The 26-week study included 247 people with type 2 diabetes. People in the study took either:1

  • Insulin icodec injection once a week plus a once-daily placebo, or
  • Insulin glargine injection once a day plus a once-weekly placebo

The study monitored the change in hemoglobin A1C (A1C-measure of glucose control over 3 months) from the beginning of the study to week 26. The study also looked at other factors like fasting sugar level, weight, time spent tightly controlled (blood sugar 70-140 mg/dl), and insulin dose.1

What did the study show in terms of efficacy?

People who took insulin icodec had a 1.33 point decrease in their A1C level. People who took insulin glargine had an average of a 1.15 point decrease in their A1C level.1

At week 26, of people who took insulin icodec:1

  • 72 percent reached an A1C of less than 7
  • 49 percent reached an A1C of 6.5 or less

At week 26, of people who took insulin glargine:1

  • 68 percent reached an A1C of less than 7
  • 39 percent reached an A1C of 6.5 or less

People who took insulin icodec also spent more time in the tight glycemic range of 70-140 mg/dl during the last 2 weeks of the study. Changes in fasting plasma glucose level and body weight were similar between the 2 groups.1

What did the study show in terms of safety and side effects?

About half of the people in each group had an adverse event, including:

  • 2 serious events in 2 people who took insulin icodec
  • 12 serious events (10 occurred in 1 person) in 3 people who took insulin glargine

None of these events were considered to be related to insulin.1

Side effects included mild reactions where the insulin was injected. These reactions were mild and resolved quickly. Another common side effect was hypoglycemia (low blood sugar).1

What did the study conclude?

The study concluded that once-weekly insulin icodec was similar in efficacy and safety to once-daily insulin glargine. For people who have a hard time using insulin daily, insulin icodec may be a good alternative. This would lower the number of injections per year from 365 to 52 and keeping people in a tight glycemic range for longer.1

Can I take insulin icodec now?

Insulin icodec is not yet available and is still being studied. After phase 2 trials, the next step is phase 3, where the researchers study safety and efficacy in hundreds to thousands of people.

However, other weekly insulins are currently available by prescription. Talk to your doctor to see if weekly insulin is right for you. Tell your doctor about all of the medical conditions you have, and do not change medicines without talking to your doctor first. Tell your doctor about any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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