A Study on Weekly Insulin for Type 1 Diabetes

Original Article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02179-7/fulltext

Type 1 diabetes and insulin 

People with type 1 diabetes T1D have to take insulin to help their bodies manage their blood sugar effectively. Although an increasing number of people with T1D use an insulin pump which continuously infuses insulin under the skin, worldwide a significant number continue to use daily injections of insulin. Usually this consists of injecting short-acting insulin with meals and a longer-acting (basal) one each day to cover the periods between meals and overnight.

Once-weekly insulin for type 1 diabetes

Recently, a new type of long-acting insulin has become available called icodec. This ultra-long-acting basal insulin needs only to be given once a week. In a major new study, researchers compared icodec once weekly with a traditional once-a-day basal insulin.two different types of insulin treatments for people with type 1 diabetes. The study involved 582 people from 12 countries with T1D and ran for a year. Participants were split into two groups; the first received once-weekly injections of icodec, and the second received daily injections of an established basal insulin degludec, both in combination with short-acting insulin at mealtimes.

After 26 weeks, researchers measured HbA1C to assess overall diabetes control and found that both insulins lowered HbA1c by similar amounts. 

However, icodec caused more low blood sugar events (hypoglycemia). However, despite the higher levels in the icodec group, the researchers pointed out  that the number of hypos were low in both groups and were mild.

What is the take home message for once weekly insulin in T1D?

In this study, once-a-week insulin called icodec worked as well as once-a-day insulin in lowering blood sugar levels for people with type 1 diabetes. But as icodec caused more low blood sugar events, more work needs to be done to understand why this happened and what can be done to prevent low glucose levels in the future.