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 I 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; = 0.003) and increased time in range (TIR; MD: 4.23; 95% CI: 2.20, 6.26; < 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.