Peer Reviewed

Insulin Management

Once-Weekly Insulin Is as Effective as Daily Insulin for Diabetes

A once-a-week injectable insulin treatment is as safe and effective as daily insulin injections for patients with type 2 diabetes, according to the results of 2 recently published studies.

“Insulin treatment is burdensome, requires frequent injections, and continues to carry a certain stigma. The development of an effective and safe insulin that can be administered once a week is a huge advance in the field,” said Ildiko Lingvay, MD, in a press release,1 who worked on both studies examining this new insulin therapy.

The first of the 2 studies was a phase 2, randomized, open-label, treat-to-target clinical trial.2 Included were 205 insulin-naïve adults with type 2 diabetes from the United States, Croatia, Germany, Hungary, Poland, Slovakia, and Spain. Following a 2-week screening period, all participants were randomized to receive either once-weekly or once-daily insulin for the 16-week study period. In a 5-week follow-up, this trial evaluated ways to adjust the dosage of insulin to balance between effectively lowering glucose while minimizing low-glucose events.

The second study was a multicenter, open-label, treat-to-target phase 2 trial in which the researchers examined approaches to switching from a once-daily to once-weekly insulin treatment.3 A total of 154 patients from the United States, Canada, the Czech Republic, Germany, and Italy were included in this trial. Similar to the other study, this trial followed a 23-week time frame. The results of this study indicated that beginning patients on a higher first dose called a loading dose was the most effective method in reaching an optimal glucose target without increasing hypoglycemia risk.

“These two studies served as the steppingstones for a large phase 3 clinical trial program that is currently ongoing at UT Southwestern and other sites, which is designed to evaluate the efficacy of once-weekly insulin administration in patients with either Type 1 or Type 2 diabetes,” Lingvay concluded. “A weekly insulin is a game-changer that will decrease the treatment burden for patients while also improving compliance. This treatment will also decrease the burden on those who care for patients with diabetes requiring insulin. For example, for patients who need help injecting, those living in long-term care facilities, and those with memory problems, a once-weekly insulin will facilitate treatment and decrease the burden on the care providers.”


—Leigh Precopio



  1. Once-a-week insulin treatment could be game-changing for patients with diabetes. News release. UT Southwestern Medical Center; April 19, 2021. Access April 20, 2021.
  2. 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(4):dc202878. doi: /10.2337/dc20-2878
  3. Bajaj HS, Bergenstal RM, Christoffersen A, et al. Switching to once-weekly insulin icodec versus once-daily insulin gargine U100 in type 2 diabetes inadequately controlled on daily basal insulin: a phase 2 randomized controlled trial. Diabetes Care. 2021;44(4):dc202877. doi: /10.2337/dc20-2877