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Journal of Education, Health and Sport

Icodec insulin - revolution in diabetes type 2 insulin therapy
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Icodec insulin - revolution in diabetes type 2 insulin therapy

Authors

  • Michał Dobrzyński 1 Military Clinical Hospital with a Polyclinic in Lublin, Al. Racławickie 23, 20-904 Lublin https://orcid.org/0000-0002-1416-6568
  • Jakub Czarnota Specialist Hospital In Radom of the name Tytus Chałubiński, Adolfa Tochtermana 1, 26-610 Radom https://orcid.org/0000-0003-2783-0349
  • Tomasz Skubel 1 Military Clinical Hospital with a Polyclinic in Lublin, Al. Racławickie 23, 20-904 Lublin https://orcid.org/0000-0001-7572-401X
  • Małgorzata Drozd Independent Public Clinical Hospital No. 4 in Lublin, Jaczewskiego 8, 20-954 Lublin https://orcid.org/0000-0002-0710-2451
  • Iga Dudek 1 Military Clinical Hospital with a Polyclinic in Lublin, Al. Racławickie 23, 20-904 Lublin https://orcid.org/0000-0002-8101-074X
  • Natalia Rybak Independent Public Clinical Hospital No. 4 in Lublin, Jaczewskiego 8, 20-954 Lublin https://orcid.org/0000-0003-1437-7661

DOI:

https://doi.org/10.12775/JEHS.2022.12.08.097

Keywords

Icodec, Insulin, type 2 diabetes

Abstract

Introduction: Basal glucose control in diabetes type 2 is commonly maintained by a single, once-daily administration of insulin through subcutaneous injection. Insulin icodec, a novel ultralong-acting lipidated analog validates the concept of a once-weekly basal injection that is less burdensome, yet equally safe and efficacious as conventional once-daily treatment 1.
Aim: The aim of the study is to introduce once-weekly injected insulin therapy and compare it with conventional basal insulin therapy in diabetes type 2 patients.
Results: The results from phase II trials suggest that switching from an existing basal insulin to icodec, with or without a loading dose, provides effective glycemic control with comparable risk of hypoglycemia.In one of the studies TIR improved from baseline (mean: A 57.0%; B 55.2%; C 51.0%; IGlar U100 55.3%) through weeks 15 and 16 (estimated mean: A 76.6%; B 83.0%; C 80.9%; IGlar U100, 75.9%). No unexpected side effects were observed. It was reassuring that not a single episode of severe hypoglycemia (level 3) was reported for any treatment group throughout the trial duration and that the time spent below range (<3.9 mmol/L [<54 mg/dL]) during weeks 15 and 16 was well below the 4% target recommended by the International Consensus on Time in Range across all treatment groups 2.
Conclusion: In conclusion,insulin icodec, a new acylated basal insulin analog, has been developed with optimized modifications to provide a long half-life suitable for weekly insulin dosing. In a patient population with type 2 diabetes receiving daily basal insulin therapy, switching to once-weekly icodec resulted in effective glycemic control without a transient elevation of fasting glucose levels during the switch and without increasing the risk of clinically relevant hypoglycemia compared with IGlar U100 2.
Key words: Icodec, insulin, diabetes type 2

References

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Rosenstock J, Del Prato S. Basal weekly insulins: the way of the future! Metabolism. 2022;126. doi:10.1016/J.METABOL.2021.154924

Association AD. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2020. Diabetes Care. 2020;43(Supplement_1):S98-S110. doi:10.2337/DC20-S009

Ross SA, Tildesley HD, Ashkenas J. Barriers to effective insulin treatment: the persistence of poor glycemic control in type 2 diabetes. Curr Med Res Opin. 2011;27 Suppl 3(SUPPL. 3):13-20. doi:10.1185/03007995.2011.621416

Bajaj HS, Bergenstal RM, Christoffersen A, et al. Switching to Once-Weekly Insulin Icodec Versus Once-Daily Insulin Glargine U100 in Type 2 Diabetes Inadequately Controlled on Daily Basal Insulin: A Phase 2 Randomized Controlled Trial. Diabetes Care. 2021;44(7):1586-1594. doi:10.2337/DC20-2877

HÖVELMANN U, BRØNDSTED L, KRISTENSEN NR, et al. 237-OR: Insulin Icodec: An Insulin Analog Suited for Once-Weekly Dosing in Type 2 Diabetes. Diabetes. 2020;69(Supplement_1). doi:10.2337/DB20-237-OR

Polonsky WH, Fisher L, Hessler D, Bruhn D, Best JH. Patient perspectives on once-weekly medications for diabetes. Diabetes Obes Metab. 2011;13(2):144-149. doi:10.1111/J.1463-1326.2010.01327.X

Rosenstock J, Bajaj HS, Janež A, et al. Once-Weekly Insulin for Type 2 Diabetes without Previous Insulin Treatment. N Engl J Med. 2020;383(22):2107-2116. doi:10.1056/NEJMOA2022474

Lingvay I, Buse JB, Franek E, et al. A Randomized, Open-Label Comparison of Once-Weekly Insulin Icodec Titration Strategies Versus Once-Daily Insulin Glargine U100. Diabetes Care. 2021;44(7):1595-1603. doi:10.2337/DC20-2878

9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S111-S124. doi:10.2337/DC21-S009

Rubino A, McQuay LJ, Gough SC, Kvasz M, Tennis P. Delayed initiation of subcutaneous insulin therapy after failure of oral glucose-lowering agents in patients with Type 2 diabetes: a population-based analysis in the UK. Diabet Med. 2007;24(12):1412-1418. doi:10.1111/J.1464-5491.2007.02279.X

Kjeldsen TB, Hubálek F, Hjørringgaard CU, et al. Molecular Engineering of Insulin Icodec, the First Acylated Insulin Analog for Once-Weekly Administration in Humans. J Med Chem. 2021;64(13). doi:10.1021/ACS.JMEDCHEM.1C00257

Rosenstock J, Bajaj HS, Janež A, et al. Once-Weekly Insulin for Type 2 Diabetes without Previous Insulin Treatment. N Engl J Med. 2020;383(22):2107-2116. doi:10.1056/NEJMOA2022474/SUPPL_FILE/NEJMOA2022474_DATA-SHARING.PDF

Nishimura E, Pridal L, Glendorf T, et al. Molecular and pharmacological characterization of insulin icodec: a new basal insulin analog designed for once-weekly dosing. BMJ open diabetes Res care. 2021;9(1). doi:10.1136/BMJDRC-2021-002301

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Published

2022-08-25

How to Cite

1.
DOBRZYŃSKI, Michał, CZARNOTA, Jakub, SKUBEL, Tomasz, DROZD, Małgorzata, DUDEK, Iga & RYBAK, Natalia. Icodec insulin - revolution in diabetes type 2 insulin therapy. Journal of Education, Health and Sport [online]. 25 August 2022, T. 12, nr 8, s. 1136–1142. [accessed 23.3.2023]. DOI 10.12775/JEHS.2022.12.08.097.
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Issue

Vol. 12 No. 8 (2022)

Section

Review Articles

License

Copyright (c) 2022 Michał Dobrzyński, Jakub Czarnota, Tomasz Skubel, Małgorzata Drozd, Iga Dudek, Natalia Rybak

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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