Diabetes patients who are sick of daily insulin shots may soon only have to inject themselves once a week. A year-long phase three clinical trial has shown that a weekly form of the hormone is just as effective in managing the disease as the daily form.

For patients with type 1 diabetes, regulating blood glucose levels involves subcutaneous shots of insulin every day, as well as at mealtimes. That routine can require major lifestyle adjustments and many patients report missing shots, which can be hazardous to their health.

In recent years scientists have developed an alternative form of insulin that only needs to be administered once a week, which should be less intrusive to a patient’s life. Known as icodec, this longer-lasting type of insulin has a half-life of about seven days, and maintains a slow and steady release over that time. Phase two trials of the drug have proven promising, suggesting weekly shots are just as effective as daily ones.

Now scientists have conducted a larger phase three trial and confirmed the benefits. The team recruited 582 patients with type 1 diabetes, and gave half of them weekly injections of icodec, while the other half received daily shots of a common form of insulin called degludec. Both groups also received a short-acting insulin called aspart at mealtimes.

After 26 weeks the scientists checked the patients’ progress by examining levels of a protein called HbA1C, which is used as a universal marker for diabetes control. The levels in patients who received the weekly shots were only 0.05% worse off than those taking insulin daily, which the team says is a negligible difference given the reduced injection frequency.

On the negative side, there was a higher rate of hypoglycemic episodes (low glucose levels) in the icodec group compared to degludec. However, the team says that these incidences were low in both groups and were usually solved with quick carbs. There was one death in the icodec group, but the investigators deemed it unrelated.

“What we have found is that once-weekly icodec injections showed non inferiority to once-daily injections of degludec in reducing HbA1C after 26 weeks,” said Professor David Russell-Jones, first author of the study. “Although there is a slightly higher rate of hypoglycaemia under this regime, we found this could be easily managed. We’ve concluded this new insulin may have a role in reducing the burden of daily basal injections for patients managing type 1 diabetes.”

With the conclusion of the phase three clinical trial, this weekly form of insulin is another step closer to being available for patients. But further real world studies are needed before that can happen, the team says.

The research was published in the journal The Lancet.

Source: University of Surrey