Making sense of weekly insulins

Abstract

The current issue of The Lancet Diabetes & Endocrinology sees publication of a phase 2 study of the weekly insulin under development from Eli Lilly. 1 Frias J Chien J Zhang Q et al. Safety and efficacy of once-weekly basal insulin Fc in people with type 2 diabetes previously treated with basal insulin: a multicentre, open-label, randomised, phase 2 study. Lancet Diabetes Endocrinol. 2023; (published online Feb 6.)https://doi.org/10.1016/S2213-8587(22)00388-6 Google Scholar Phase 2 studies have also been published from Novo Nordisk, who have further announced top-line results of a series of phase 3 studies to investors. 2 Rosenstock J Bajaj HS Janež A et al. Once-weekly insulin for type 2 diabetes without previous insulin treatment. N Engl J Med. 2020; 383: 2107-2116 Crossref PubMed Scopus (77) Google Scholar Once-daily basal insulin is the standard starter regimen in people with type 2 diabetes, 3 Davies MJ Aroda VR Collins BS et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022; 65: 1925-1966 Crossref PubMed Scopus (20) Google Scholar and experience with other once-weekly injectables in people with type 2 diabetes, notably of GLP-1 receptor agonists, 4 Holleman C Hopcroft A Close K 3Q22 GLP-1 industry roundup. www.closeconcerns.com/knowledgebase/r/db4d2bb8Date: Nov 15, 2022 Date accessed: December 2, 2022 Google Scholar is of market preference over once-daily preparations; it is probable that clinical practice will adopt licensed weekly insulins very quickly. Weekly basal insulin might be of less relevance to people with type 1 diabetes, for whom multiple meal-time insulin doses will still be needed. Safety and efficacy of once-weekly basal insulin Fc in people with type 2 diabetes previously treated with basal insulin: a multicentre, open-label, randomised, phase 2 studyWeekly BIF achieved a similar efficacy compared with degludec despite higher fasting glucose targets in the BIF groups. Higher fasting glucose targets and lower glucose variability might have contributed to lower hypoglycaemia rates for BIF compared with degludec. These findings support continued development of BIF as a once-weekly insulin treatment for people with diabetes. Full-Text PDF