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The following is a summary of “Efficacy and Hypoglycemia Profile of Once-Weekly Insulin Icodec vs. Once-Daily Comparators across Demographic Subgroups,” published in the March 2025 issue of Journal of Clinical Endocrinology & Metabolism by Lingvay et al. 

Researchers conducted a retrospective study to analyze the impact of age, ethnicity, and race on efficacy and hypoglycemia outcomes with once-weekly insulin icodec (icodec) compared to once-daily (OD) basal insulin, using data from the ONWARDS 1–5 phase 3a clinical trials.  

They analyzed efficacy and hypoglycemia outcomes in insulin-naive (ONWARDS 1, 3, and 5) and insulin-experienced (ONWARDS 2 and 4) adults (≥18 years) with type 2 diabetes. Subgroup analyses were conducted based on age (<55, 55–64, and ≥65 years), ethnicity (Hispanic/Latino and non-Hispanic/Latino), and race (Asian, Black/African American, White, Other). The primary outcome measured was the change in glycated hemoglobin (HbA_1ac) from baseline to the planned end of treatment. Additional outcomes included the proportion achieving HbA_1ac <7% (<53 mmol/mol) without clinically significant or severe hypoglycemia and the incidence of clinically significant or severe hypoglycemic episodes.  

The results showed that across all trials, the estimated treatment differences in HbA_1ac reduction and the odds ratios for achieving HbA_1ac <7% (<53 mmol/mol) without clinically significant or severe hypoglycemia were comparable across age, ethnicity, and race subgroups with icodec vs OD insulin. No statistically significant treatment-by-subgroup interactions were observed (P > 0.05 in all instances). Hypoglycemia rates remained numerically low in both treatment groups and showed consistency across all age, ethnicity, and race subgroups.  

Investigators concluded that icodec’s effectiveness and low hypoglycemia risk remained consistent across diverse patient groups, regardless of age, ethnicity, or race. 

Source: academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgaf168/8086419