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Once-weekly Insulin Hurdles Treatment Barriers

OVERCOMING barriers to adherence to insulin therapy can significantly improve the risks associated with diabetes: once-weekly insulin treatment could transform therapy for previously poorly compliant patients. Two international trials have shared their successful results in patients with Type 2 diabetes. 

The first study recruited 205 patients from seven countries, examining first a 2-week screening period followed by 16 weeks of treatment and 5 weeks of follow-up, across three patterns of treatment optimisation and adjustment. The second study of 154 patients followed a similar 23-week design but further examined practical factors of insulin use and how to transition from daily to weekly insulin therapy.  

The two studies found that once-weekly insulin therapy was both safe and effective for the management of Type 2 diabetes in these patients. Particularly, the study determined that transitioning from daily to weekly insulin was best supported by a high first dose to act as a loading dose, enabling patients to reach their optimal glucose target more rapidly. 

Barriers to insulin therapy can include phobias of needles, and the inconvenience and burden of daily injectable therapy. Titrating insulin dosing can also prove complex when considering glucose readings, meal and dose timings, and different day-to-day factors. A once-weekly regimen could simplify the overall titration of dosing, which would support adherence with the long-term therapy for overwhelmed patients. Simplified regimens would also benefit those caring for patients with diabetes, such as those in long-term facilities or with memory difficulties, highlighted Ildiko Lingvay, lead study author and Professor of Internal Medicine and Population and Data Sciences at UT Southwestern, Dallas, Texas, USA. 

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,” outlined Lingvay. The next step is a large, Phase III trial to evaluate the efficacy of once-weekly insulin treatment in both Type 1 and 2 diabetes.