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Diabetes: Once weekly insulin could be as effective as daily injections, studies indicate

BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q2005 (Published 12 September 2024) Cite this as: BMJ 2024;386:q2005
  1. Jacqui Wise
  1. Kent

Daily insulin injections can be burdensome to patients but are the cornerstone of type 1 diabetes management and often become necessary over time for type 2 diabetes. Could they soon become a thing of the past, asks Jacqui Wise

The effectiveness of a new class of once weekly basal insulin, called efsitora alfa, has been tested in two separate phase 3 trials: one in patients with type 1 diabetes and one in those with type 2. The results, presented at the European Association for the Study of Diabetes in Madrid on 10 September and simultaneously published in the New England Journal of Medicine and the Lancet, show that the weekly injection is as effective as a daily injection of a long acting basal insulin, although with type 1 diabetes there was a higher incidence of hypoglycaemia, including severe hypoglycaemia.

What is the evidence for type 2 diabetes?

Previous studies have been limited to small phase 1 or phase 2 trials. The new phase 3 study, published in the New England Journal of Medicine,1 included 928 patients with type 2 diabetes who had not previously received insulin and were taking oral antidiabetes medications but were still not at their glycaemic goals. They were randomly assigned to efsitora or degludec (a standard long acting basal insulin that gives patients with …

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