A groundbreaking study comparing once-a-week and once-a-day insulin treatments for type 2 diabetes has unveiled that the weekly treatment, icodec, demonstrates superior effectiveness in reducing blood sugar levels when compared to the standard daily injections.
In this Phase 3 trial, researchers assessed the efficacy and safety of icodec, a once-weekly insulin, in contrast to degludec, a long-acting insulin medication, among individuals diagnosed with type 2 diabetes. The trial spanned 26 weeks and involved 588 participants, with an average age of 58 years, from 11 countries, including the United States, Argentina, and China. All participants were already receiving treatment with non-insulin glucose-lowering agents, and more than a third of them were women.
Random assignment placed participants into one of four treatment regimens: once-weekly icodec, once-weekly placebo, once-daily degludec, or once-daily placebo. After the 26-week duration, the researchers observed that icodec demonstrated greater reductions in hemoglobin A1c (HbA1c) levels compared to degludec. HbA1c serves as a measure of average blood sugar levels over the preceding three months. Typically, individuals without diabetes exhibit HbA1c values below 5.7 percent. However, individuals with diabetes are advised to maintain levels at 6.5 pc or below. Throughout the study, HbA1c levels decreased from an average of 8.6 pc to 7 pc in the icodec group, while the degludec group witnessed a decrease from an average of 8.5 pc to 7.2 pc.
Although no significant disparities emerged in fasting blood glucose or body weight between the icodec and degludec groups, the researchers identified that 8.9 pc of participants in the icodec group and 5.8 pc of those in the degludec group experienced hypoglycemia (low blood sugar levels). Moreover, adverse events were reported by 60.4 pc of patients in the icodec group and 56.8 pc of those in the degludec group.
While both groups experienced more common mild events, such as COVID-19, influenza, and diabetic retinopathy, the researchers observed that the differences in adverse events and diabetic retinopathy had not been previously documented in previous icodec trials.
Dr. Absalon Gutierrez, associate professor of endocrinology at McGovern Medical School, UTHealth Houston, commented that icodec demonstrated superior effects in lowering HbA1c levels but had a higher risk of hypoglycemia. He attributed this to the limited ability to adjust the once-weekly treatment compared to the more frequent adjustments possible with degludec.
Despite the increased risk of hypoglycemia, researchers believe that the convenience and potential to enhance treatment adherence offered by icodec could outweigh this concern. By reducing the number of injections from at least 365 to 52 per year, icodec may provide individuals with type 2 diabetes with a more manageable and convenient treatment option.
While these findings show promising results, further studies are needed to fully understand the hypoglycemia risk associated with icodec compared to once-daily insulin injections.
