Once-weekly insulin safe, provides effective glucose control

Switching from daily basal insulin to once-weekly insulin icodec results in effective glucose control without increasing the risk of hypoglycaemia, according to the results of a phase II trial.

The trial included type 2 diabetes patients with glycated haemoglobin (HbA1c) of 7.0–10.0 percent (53.0–85.8 mmol/mol) and treated with basal insulin (total daily dose 10–50 units). They were randomized to receive once-weekly icodec with either an initial 100-percent loading dose (in which only the first dose was doubled [icodec LD]) or no loading dose (icodec NLD), or once-daily insulin glargine U100 for 16 weeks.

The primary endpoint of percent time in range (3.9–10.0 mmol/L [70–180 mg/dL]) during weeks 15 and 16 was 72.9 percent with icodec LD (n=54), 66.0 percent with icodec NLD (n=50), and 65.0 percent with glargine U100 (n=50). The difference between icodec LD and glargine was statistically significant (7.9 percentage points, 95 percent confidence interval [CI] 1.8–13.9 percent).

Mean HbA1c dropped from 7.9 percent (62.8 mmol/mol) at baseline to 7.1 percent (54.4 mmol/mol) with icodec LD and to 7.4 percent (57.6 mmol/mol) with both icodec NLD and glargine U100.

The frequency and rates of adverse events and hypoglycaemic episodes were similar across the treatment groups.

The findings demonstrate that loading dose use when switching to once-weekly icodec is beneficial.