People with type 1 diabetes (T1D) either use an insulin pump or multiple daily injections to take their insulin. Injection treatment requires using two types of insulin, and generally a total of four daily injections:
- One type of rapid-acting insulin, which is active for about four hours to cover the expected blood sugar spike following a meal.
- One type of long-acting insulin, which is generally taken once a day to cover basal insulin needs between meals.
Experts are mainly aiming to improve the different types of rapid-acting and long-acting insulin, making them increasingly rapid, or increasingly long-lasting and stable, in order to simplify diabetes management.
A few weeks ago, the American Diabetes Association (ADA) Scientific Sessions featured several new studies that showed progress towards new treatments. One of them, named insulin icodec, seems promising. This basal insulin requires only one weekly injection that covers all basal insulin needs for one week. The study involved participants with type 2 diabetes (T2D) who had never taken insulin before.
How does it work?
Due to its two main mechanisms, insulin icodec takes longer to work and to be eliminated from the body:
- Following the injection, its molecules break down very slowly, releasing the insulin in the bloodstream gradually.
- Once in the bloodstream, insulin icodec forms a stronger bond with a protein called albumin than other types of basal insulin available, which allows it to stay in the body for several days.
How does it compare to other types of basal insulin?
The study concluded that insulin icodec was as effective as insulin glargin (e.g., Basaglar, Lantus), and the researchers did not observe any significant improvement in hemoglobin A1c (HbA1c) for the group that used insulin icodec versus the group that used insulin glargin. The risk of hypoglycemia was similar in both groups.
On average, about 229 units of icodec were required for one week, as opposed to 284 units of insulin glargin. People with T2D who were in the group using icodec achieved the same HbA1c results while taking less insulin.
No data is available yet on people with T1D using insulin icodec. However, factors such as the required daily dosage adjustments, situations where the insulin dose must be reduced quickly and unforeseen circumstances (e.g., hospitalization, extended physical activity) are yet to be considered.