Weekly Insulin Icodec Outperforms Daily Insulin for Type 2 Diabetes Management: Study

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According to a pioneering clinical study published in the New England Journal of Medicine, people with type 2 diabetes who have never received insulin may benefit significantly from a once-weekly dosage of insulin icodec.

Researchers compared the once-weekly basal insulin analogue insulin icodec to the once-daily basal insulin analogue insulin glargine U100 in the ONWARDS 1 trial. When compared to daily insulin icodec administration, once-weekly insulin icodec administration resulted in improved glucose control and higher adherence to medication. 

Incretin-based injectable medications are routinely used as the initial therapy for type 2 diabetes. However, one of the most commonly used methods to improve glycemic control is to introduce once- or twice-daily basal insulin analogues. Many people with type 2 diabetes are unable to achieve adequate glucose control due to a fear of daily injections and a lack of treatment adherence.

Patients frequently prefer once-weekly injections of glucagon-like peptide 1 (GLP-1) receptor agonists, and clinical data shows that they improve therapy adherence and glycemic control. As a result, studies on the advantages of once-weekly insulin injection, as well as weekly GLP-1 receptor agonists, have been done. 

Insulin icodec is a subcutaneous injection of a long-acting basal insulin analogue that gives seven days of basal insulin coverage. The ONWARDS 1 research assessed the efficacy of once-weekly insulin icodec with once-daily insulin glargine U100 in preventing hypoglycemia in persons with type 2 diabetes who had never used insulin previously. In terms of glycemic management and the frequency of hypoglycemia, the study indicated that weekly insulin icodec was equal to daily insulin glargine U100. 

The usage of either medicine dramatically reduced levels of glycated hemoglobin (HbA1c), a critical indicator of long-term glycemic management. When compared to insulin glargine U100 once daily, insulin icodec once weekly dramatically enhanced the amount of time spent within the target glycemic range.

According to the International Consensus on Time in Range, more than 70% of continuous glucose monitor readings should be within the target glycemic range. Those taking insulin icodec once weekly in both treatment groups had an average success rate. Those who took insulin glargine U100 once a day, on the other hand, were less likely to benefit. 

The rate of hypoglycemia in the once-weekly insulin icodec group was somewhat higher than the universally indicated target, however it stayed substantially below this target throughout the study. Despite the fact that both groups had a comparable number of clinically severe hypoglycemic episodes, fewer individuals on once-weekly insulin icodec were able to lower their glycated hemoglobin to 7% without developing hypoglycemia. 

The ONWARDS 1 long-term trial, which included participants from all around the world, found that once-weekly insulin icodec is superior in glucose management. In addition to noninsulin glucose-lowering medications such as GLP-1 receptor agonists and SGLT-2 inhibitors, the findings indicate that once-weekly insulin icodec is superior to once-daily insulin glargine U100 in assisting people with type 2 diabetes to achieve a glycated hemoglobin level of less than 7%.

They also spent more time overall within the target glycemic range and were less likely to reach a glycated hemoglobin level of less than 7% without suffering clinically significant or severe hypoglycemia. These findings support once-weekly insulin icodec as a feasible therapeutic option for people with type 2 diabetes, warranting further research and application. 



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