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Insulin icodec — a basal insulin that can be injected once weekly —currently is under consideration by the U.S. FDA but has not yet been approved. In a recent study, insulin icodec was compared with insulin glargine in patients with type 2 diabetes who already were on a basal-bolus regimen (NEJM JW Gen Med Jun 15 2023 and Lancet 2023; 401:1929).
Now, in another manufacturer-sponsored study, nearly 1000 adults who had not received insulin treatment previously were randomized to begin icodec (70 U weekly) or glargine (10 U daily); doses were titrated to achieve fasting glucose levels of 80 to 130 mg/dL. At baseline, mean duration of diabetes was 12 years, mean glycosylated hemoglobin (HbA1c) was 8.5%, and mean fasting glucose level was 185 mg/…