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Once-Weekly Basal Insulin Shows Promise

Jun 27, 2020
Editor: David L. Joffe, BSPharm, CDE, FACA

Author: Lawand Kamal, PharmD Candidate 2021, Skaggs School of Pharmacy and Pharmaceutical Sciences 

One of the oldest and best tools used in treating people living with diabetes is insulin, including those living with type 2 diabetes (T2D) whose blood glucose and A1c goals are unmet with other therapies. Despite today's advances in the arsenal of various insulins available, many people living with diabetes are reluctant to use insulin due to fear of daily injections, among other justifiable concerns. Insulin icodec is derived from human insulin with three amino acid substitutions, a c20 icosane fatty diacid, and high albumin binding, which results in a geometric mean half-life of roughly 196 hours to allow for once-weekly injections. Previous studies among GLP-1 receptor agonists (another class of injectable diabetes medications) have shown that products that are once-weekly versus once or twice-daily have greater patient adherence and treatment satisfaction. Currently, there is no insulin product on the market that allows for once-weekly dosing. Insulin icodec may potentially help resolve some of the challenges patients living with T2D would face when it comes to starting basal insulin. 

A phase 2 trial by Rosenstock et al. was designed to compare the safety and efficacy of insulin icodec vs. insulin glargine 100 units/mL in combination with metformin with or without a DPP-4i in insulin-naïve patients with T2D. These patients are inadequately treated with their current therapy....

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