Weekly insulin injections may be the future of type 1 diabetes care and could replace daily insulin injections, according to a global study undertaken by the University of Surrey.
A year-long phase three trial has shown that weekly injections of insulin icodec could be used to manage type 1 diabetes as effectively as daily basal insulin treatments.
The findings, which the researchers say could revolutionise diabetes care and help millions of people better manage their condition, are published in The Lancet.
Icodec is a long-lasting type of insulin which can be used to manage diabetes. Type 1 diabetes occurs when the body does not produce any insulin, leading to high blood sugar levels, which can increase the risk of developing heart, eye and kidney diseases.
The research team tested a weekly basal injection of icodec across 12 countries, including Germany, India, Italy, Japan, Russia, the UK and the US. They recruited 582 adult participants with type 1 diabetes and compared the efficacy and safety of icodec and to a daily basal injection of insulin degludec.
Participants were split into two groups. the first received once-weekly injections of icodec (700U/ml), and the second received daily injections of degludec (100 U/ml) combined with aspart – a short-acting insulin – at mealtimes.
Halfway through the trial, at 26 weeks, the researchers reported the protein HbA1C levels, a universal marker for overall diabetes control, was very similar in both groups. In those taking icodec, HbA1C had decreased from a mean of 7.59% at baseline to an estimated mean of 7.15%. For degludec, the mean had reduced from 7.63% to 7.10%.
With a 0.05% difference between the two groups taking the weekly and the daily medication, the researchers confirmed that icodec was as effective as degludec in managing type 1 diabetes in this study, and offered the potential for a reduced injection frequency.
Professor David Russell-Jones, professor of diabetes and endocrinology at the University of Surrey and a consultant physician at the Royal Surrey NHS Foundation Trust, said: ‘Many people find managing a long-term condition such as diabetes very difficult and report missing vital insulin injections. Missed injections can affect glycaemic control, and a lack of consistency in the treatment has been linked to increased rates of diabetic ketoacidosis, a serious complication of the condition that can be life-threatening.’
He added: ‘Reducing insulin injection frequency could lessen the burden of treatment for some people with the condition and improve their glycaemic control.’
Hypoglycaemic episodes, where patients have abnormally low levels of glucose in the blood, were found to be higher in the icodec group compared to the degludec. However, the researchers recorded low incidences of hypoglycemia in both groups, and most episodes only required oral carbohydrate administration.
Professor Russell-Jones said the findings were ‘promising’ but that further analysis of continuous glucose monitoring data and real-world studies are needed.
This article was originally published by our sister publication Nursing in Practice.
