Once Weekly Insulin Icodec – a Newer Generation of Basal Insulin

Insulin Icodec

Insulin Icodec is once-weekly basal insulin. Unlike all the other basal insulins available until now that are administered once daily, it is administered once a week.

Insulin Icodec is an insulin analog that has a half-life of about once a week and the time to reach the maximum concentration after it is administered is about 16 hours.

See half-lives of various insulin analogs that are used to provide basal insulin cover throughout the day:

half-life of insulin hours compared to insulin icodec
Insulin Icodec has the longest half-life. It is administered as once a week injection.

Insulin Icodec is currently in clinical trials and not yet FDA-approved. It is being manufactured by Novo Nordisk Pharmaceuticals and is undergoing clinical trials in both type 1 and type Diabetes patients.

Insulin Icodec Vs Insulin Glargine:

In a recently published article in NEJM titled ” Once-weekly Insulin for Type 2 Diabetes without previous treatment”, the authors have compared Insulin Icodec with Insulin Glargine U-100.

The study proved the efficacy and safety of insulin Icodec. Insulin Icodec had a comparable efficacy as Insulin Glargine. Greater than two-thirds of the patients achieved the target glycated hemoglobin in the trial. Likewise, the fasting plasma glucose control was similar in both groups.

Insulin Icodec had a superior postmeal blood glucose control compared to Insulin Glargine. There was a greater improvement in the 9-point patient-monitored plasma blood glucose control compared to insulin glargine.

It was also noted that insulin Icodec had a favorable side effect profile compared to insulin glargine as the number of hypoglycemic episodes was few compared to Insulin Icodec.

Insulin Icodec vs glargine efficacy

A comparable reduction in HbA1C with Insulin Icodec compared to Insulin Glargine

Insulin Icodec vs glargine efficacy end points
HbA1C reduction after 26 weeks of treatment was comparable in both the groups (Insulin Glargine and Insulin Icodec).

The effect of Insulin Icodec and Insulin Glargine on body weight:

All insulins are associated with an increase in body weight. Insulin detemir causes the least weight gain compared to other insulins. In this study, Insulin glargine caused a mean weight gain of 1.56 kgs compared to Insulin Icodec that caused a mean weight gain of 1.49 kgs from the baseline.

In previous studies, Insulin glargine was noted to cause a similar amount of weight gain.

In Summary:

Once-weekly administration could provide a stable glycemic control with better treatment adherence and fewer side effects.

What do you think?

Written by Diabetes Doctor

I am an Internist practicing medicine for the last fifteen years. Over the years, I have learned that medicine is not about prescribing pills. True medical practice is helping people.
I do prescribe pills as well but the best results I get are when I motivate people to overcome their problems with little changes in their lifestyles.
Since most of my patients are obese, have diabetes, hypertension, high cholesterol levels, I am writing at when free.
Dibesity, I know the correct word is diabesity. Ignore this! Be with us.

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