- A new study finds that a once-a-week insulin shot may help people with type 2 diabetes control their blood sugar.
- In people with type 2 diabetes, basal insulin may be , or alongside rapid-acting insulin or oral diabetes medications.
- About 1 in 10 Americans have type 2 diabetes, according to the U.S. Centers for Disease Control and Prevention.
A once-weekly insulin helped people with type 2 diabetes manage their blood sugar (glucose) levels, with results similar to or better than daily insulin shots, two clinical trials show.
The weekly long-acting treatment, known as icodec, is a basal insulin, which keeps blood glucose levels stable while fasting, such as during sleep.
In people with type 2 diabetes, basal insulin may be , or alongside rapid-acting insulin or oral diabetes medications.
The results of the trials were presented this month at the 83rd Scientific Sessions of the American Diabetes Association, and published separately in two peer-reviewed journals.
Dr. Laura Purdy, a family medicine physician and entrepreneur, said the studies are “extremely reassuring,” especially since daily injections can be burdensome for some people.
“Once-weekly insulin injections could significantly enhance patient compliance to treatment plans, and promote better blood sugar management and weight loss,” said Purdy, who was not involved in the new research.
In one trial, published June 24 in The New England Journal of Medicine, researchers compared once-weekly icodec to once-daily insulin glargine U100.
The trial included 492 people with type 2 diabetes, who were randomly assigned to receive one of the two treatments.
Participants had never previously been treated with insulin, and at the start of the study they had an HbA1c between 7-11%.
The is a blood test that measures average blood sugar levels over the past three months. It is an indicator of how well people manage their blood sugar levels, also known as glycemic control. An HbA1c of 6.5% or above indicates diabetes.
Researchers followed participants for 52 weeks. During this time, people taking icodec had a larger average drop in HbA1c compared to those taking glargine.
People on icodec saw a drop in their HbA1c from 8.50% to 6.93% while those on glargine saw a drop from 8.44% to 7.12% over the course of the year-long study.
By the end of the 52-week period, 57.6% of people taking icodec achieved an HbA1c below 7%, compared to 45.4% of people taking glargine.
This glycemic control was sustained during a 26-week extension of the trial, researchers found.
While both groups had similar changes in fasting plasma glucose, people taking icodec spent more time on average with their blood glucose levels in the target range.
This resulted in “approximately 1 hour and 1 minute additional time spent in range per day” for the icodec group, the researchers wrote according to a report.
The rates of adverse events were also similar between the two groups. However, the rates of low blood sugar were higher in the icodec group.
In the second trial, published June 24 in , researchers compared once-weekly icodec to once-daily insulin degludec.
The study included 588 people with type 2 diabetes (HbA1c of 7-11% at the start of the study) who had never taken insulin.
After 26 weeks, people taking icodec saw a slightly greater drop in HbA1c (8.6% to 7.0%) compared to those taking degludec (8.5% to 7.2%).
Both groups had similar changes in fasting blood glucose levels and body weight.
However, people taking icodec had higher rates of “clinically significant” or “severe” periods of low blood sugar during the 26-week study, compared to the degludec group.
“In clinical practice, the small added glycemic benefit and convenience of the once-weekly administration [of icodec] should be weighed against the small absolute risk of hypoglycemia,” the researchers wrote.
While people taking icodec in both studies lost a similar amount of weight as those taking glargine or degludec, Purdy highlighted that weight loss is an “essential element” in managing type 2 diabetes and improving overall health outcomes.
“This discovery shows the power of using once-weekly injections as an important way to promote weight reduction for better management outcomes overall,” she said, cautioning that further research on icodec is needed.
Developer Novo Nordisk announced that it submitted a biologics license application (BLA) in April to the Food and Drug Administration for once-weekly icodec for the treatment of diabetes. It expects a decision on that application by April 2024.
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