Ashraf Taimoor, Kumar Akshy, Tara Aniket, Memon Naila, Muhammad Areej, Turesh Muskan, Dev Shah, Muhammad Noor, Kumar Vikash, Hussain Tooba, Kumar Ravesh, Singh Ajeet, Bajaj Simran, Qammar Asfia, Deepak Fnu, Kumar Aadesh, Yusuf Salih Abdella
Department of Medicine, Nishtar Medical University, Multan, Pakistan.
Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
Ann Med Surg (Lond). 2025 Jun 10;87(7):4452-4466. doi: 10.1097/MS9.0000000000003392. eCollection 2025 Jul.
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.
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.
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.
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.
2型糖尿病（T2DM）是一种渐进性疾病，常常需要胰岛素治疗以持续控制血糖，但坚持每日注射仍然是一项重大挑战。虽然甘精胰岛素有效，但减少注射频率可能会提高依从性并改善治疗效果。本研究评估了每周一次注射icodec胰岛素与每日一次注射U100甘精胰岛素相比的疗效和安全性。
本系统评价和荟萃分析遵循Cochrane和PRISMA指南。通过对多个数据库进行全面检索，确定了比较每周一次注射icodec胰岛素与每日一次注射U100甘精胰岛素治疗成人T2DM的随机对照试验（RCT）。符合条件的研究包括成年参与者，并报告了血糖或安全性结果。使用随机效应模型进行数据合成，通过I统计量评估异质性。
五项RCT共2019名参与者符合纳入标准。与甘精胰岛素相比，icodec胰岛素显著降低糖化血红蛋白（MD：-0.12；95%CI：-0.20，-0.04；P = 0.003），并增加血糖达标时间（TIR；MD：4.23；95%CI：2.20，6.26；P < 0.0001）。观察到icodec胰岛素治疗后体重有适度增加，而包括低血糖发生率和不良事件在内的安全性概况在两种治疗之间具有可比性。
对于T2DM的管理，icodec胰岛素是每日一次注射甘精胰岛素的安全有效替代方案，每周一次给药方案可提供相似的血糖控制。减少的注射负担可能会提高依从性和治疗满意度，潜在地改善长期疾病结局。
