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Once-weekly insulin icodec vs. daily insulin glargine in type 2 diabetes: a meta-analysis with longitudinal insights
Taimoor Ashraf1, Akshy Kumar2, Aniket Tara2
1Department of Medicine, Nishtar Medical University, Multan, Pakistan.
Introduction:
Type 2 diabetes mellitus (T2DM) is a progressive condition often necessitating insulin therapy for sustained glycemic control, yet adherence to daily injections remains a significant challenge. While insulin glargine is effective, reducing injection frequency may improve compliance and outcomes. This study evaluates the efficacy and safety of once-weekly insulin icodec compared to once-daily insulin glargine U100.
Methods:
This systematic review and meta-analysis followed Cochrane and PRISMA guidelines. A comprehensive search across multiple databases identified randomized controlled trials (RCTs) comparing once-weekly insulin icodec with once-daily insulin glargine U100 in adults with T2DM. Eligible studies included adult participants and reported glycemic or safety outcomes. Data synthesis was performed using a random-effects model, with heterogeneity assessed via the I2 statistic.
Results:
Five RCTs comprising 2,019 participants met the inclusion criteria. Insulin icodec significantly reduced glycated hemoglobin (MD: -0.12; 95% CI: -0.20, -0.04; P = 0.003) and increased time in range (TIR; MD: 4.23; 95% CI: 2.20, 6.26; P < 0.0001) compared to insulin glargine. A modest increase in body weight was observed with insulin icodec, while safety profiles, including hypoglycemia rates and adverse events, were comparable between treatments.
Conclusion:
Insulin icodec provides a safe and effective alternative to once-daily insulin glargine for T2DM management, offering similar glycemic control with a once-weekly dosing regimen. The reduced injection burden may enhance adherence and treatment satisfaction, potentially improving long-term disease outcomes.
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