The authors of the study have suggested that once-weekly insulin therapy would be easier for patients with type-2 diabetes than taking daily insulin injections especially in patients who are still learning about how to use insulin injections. The study was published in New England Journal of Medicine
‘Icodec is an ultra long acting insulin formulation which can be used once a week in Type 2 diabetic patients who are still learning to use insulin injections. They have no major side effects and are effective in reducing blood sugar. The inability to vary the dose is a disadvantage.’There is an increasing incidence of type-2 diabetes and related complications due to poor blood sugar control. The treatment for diabetes still is less than ideal even with introduction of recombinant insulin, adjunctive therapy, and real time glucose monitoring.
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Currently, for treatment of diabetes the first line therapy is oral anti-diabetics and lifestyle changes. In order to maintain a good control of blood sugar, additional therapies are added. Anti-diabetic agents like glucagon-like peptide 1 (GLP-1) receptor agonists and sodium glucose-like transporter 2 (SGLT2) inhibitors have minimal risk of hypoglycemia and weight gain.
In patients whom the oral agents are ineffective, newer therapies and basal insulin dosing are required. Hence researchers Rosenstock and colleagues have tried to simplify basal insulin therapy in patients with type-2 diabetes with ultra-long acting basal insulin called icodec which can be administered once in a week.
The researchers compared weekly insulin icodec with daily insulin glargine U100 in clinical trial. The results of this study were that icodec was associated with no major adverse effects and was as effective as glargine in lowering blood sugar levels.
There is an increasing number of treatment options for patients with type-2 diabetes hence the particular participants which were included in the trial might not represent the typical patient with diabetes. Therefore further studies are needed to determine how once-weekly insulin can be incorporated in the standard of treatment algorithms.
Patients with type 1 diabetes (destruction of insulin producing cell) can benefit from less frequent administration of insulin. However these patients need the ability to adjust the doses of long and short acting insulin.
Despite the concerns, this trial represents a new drug which can be added for lowering blood sugar. Further studies are required to understand the group of patients which will benefit the most from this study.