Diabetes Health Type 2: Once-Weekly Basal Insulin                                                                                                                                                                                   

Diabetes Health Staff

Making a chore a habit doesn’t take away the fact it’s a chore. If you’re good at doing the dishes after dinner, that says you’ve accepted the inevitable: The dishes won’t get washed until you perform a necessary chore.


If you’re a type 2 person with diabetes, taking basal insulin once or twice daily is a chore. You do it because you have to if you want to maintain your health. You don’t look forward to it, but part of you is always thankful that insulin is available.


So how would you feel about a basal insulin that you take once a week? Not daily, and not every other day, but once every seven days?


That is an insulin now in development by Novo Nordisk, which already sells insulin degludec (Tresiba®) the longest lasting daily basal on the market (along with Sanofi’s insulin glargine 300, Toujeo®).


Called “icodec, the insulin has finished a phase II testing phrase with notable results. The tests involved 247 type 2 patients ages 18 to 75nwho had never previously received basal insulin and had poor glycemic control. All the test participants were taking metformin daily, while some also were taking a DPP-4 inhibitor, such as Januvia®, Tradjenta®, Onglyza®, etc. Their A1c’s ranged from 7.0% to 9.5%.


The 26-week test compared glycemic control between patients taking icodec and patients taking insulin glargine U100, the most often prescribed pre-Tresiba®/pre-Toujeo® basal .


Test results showed that once-weekly icodec versus daily Lantus showed almost identical results. Patients taking icodec saw their A1c’s drop an average of 1.33%, while patients taking Lantus® saw a 1.15% drop.


The mean A1c percentage for the icodec patients was 6.7% compared to 6.9% for Lantus® users. In all, 72 percent of the icodec patients recorded an A1c of less than 7% compared to 68% of Lantus® patients.

These were crucial results since the potential drawback to a once-weekly basal insulin would be a drop off in its performance over the course of 168 hours. Its comparative effectiveness against a daily basal is a good sign that icodec is ready for phase III testing, which will involve a considerably higher number of test patients—a “make or break” segment of drug testing.


Hope for the success of a once-weekly basal insulin rests on the expectation that type 2 insulin users would be more inclined to stick to a weekly rather than a daily schedule. Compliance has always been one of healthcare providers’  main concerns when it comes to insulin-using patients.



Rosenstock J, et al “Once-weekly insulin for type 2 diabetes without previous insulin treatment” N Engl J Med 2020; DOI: 10.1056/NEJMoa2022474.

One thought on “Diabetes Health Type 2: Once-Weekly Basal Insulin                                                                                                                                                                                   

  • October 13, 2020 at 4:38 pm

    Thank you very much for this article. I did not know about basal insulin. What great news for me. I have been living with Type 2 diabetes for 3 years now. Taking insulin injections every day is torture for me. As I have feared injections from my childhood. Every day I stress about taking my insulin injections. I will be seeing my doctor shortly and will definitely ask about basal insulin. I hope this class of insulin works for me. My dream is to have an insulin injection that works for one month.


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