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SYSTEMATIC REVIEW article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1459127
This article is part of the Research Topic Advances in Diabetes and Hypertension Research View all articles

Efficacy and safety of once-weekly insulin versus once-daily insulin in patients with type 1 and type 2 diabetes mellitus: An updated meta-analysis of randomized controlled trials

Provisionally accepted
Mei Xue Mei Xue 1Pan Shen Pan Shen 2Jun Tang Jun Tang 1Xuan Deng Xuan Deng 3*Zhe Dai Zhe Dai 1*
  • 1 Department of Endocrinology, Zhongnan Hospital, Wuhan University, Wuhan, China
  • 2 Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 3 Department of Nephrology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China

The final, formatted version of the article will be published soon.

    Background: This meta-analysis was performed to obtain a comprehensive overview of differences between once-weekly basal insulin (including icodec and basal insulin Fc) with once-daily basal insulin (including glargine and degludec) in patients with type 1 and type 2 diabetes mellitus. Methods: PubMed, EMBASE, and Cochrane Library were systematically searched for eligible studies up to January 2, 2024. Results: A total of 12 studies were included comprising 5895 patients, 3104 (52.7%) using once-weekly insulin and 2791 (47.3%) using once-daily insulin. In the pooled data, glycated hemoglobin (HbA1c) change from baseline (MD -0.11%; 95% CI -0.20 to -0.01%) and the odds of achieving an end-of-trial HbA1c <7% (OR 1.41, 95% CI 1.13, 1.77) demonstrated a significantly well glycemic control in the once-weekly insulin group, especially in insulin-naïve type 2 diabetes or people using icodec. Body weight increase for once-weekly insulin was 0.43kg compared to controls (95% CI 0.09 to 0.76kg). In addition, once-weekly insulin was correlated with a higher risk of level 1 hypoglycemia (OR 1.42, 95% CI 1.26 to 1.6). There was no significant difference in fasting plasma glucose (MD 2.46 mg/dL; 95% CI -2.60 to 7.52 mg/dL), time in range (MD 2.03%; 95% CI -0.50 to 4.56%), and level 2 or 3 hypoglycemic events (OR 1.19; 95% CI 0.93 to 1.53). Conclusions: Once-weekly basal insulin is safe and effective in modestly reducing HbA1c with similar level 2 or 3 hypoglycemic events compared to once-daily insulin, although the risk of level 1 hypoglycemia and weight gain was slightly increased.

    Keywords: Once-weekly insulin, once-daily insulin, Diabetes Mellitus, Glycosylated hemoglobin (HbA1c), Hypoglycemia

    Received: 03 Jul 2024; Accepted: 24 Oct 2024.

    Copyright: © 2024 Xue, Shen, Tang, Deng and Dai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xuan Deng, Department of Nephrology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
    Zhe Dai, Department of Endocrinology, Zhongnan Hospital, Wuhan University, Wuhan, China

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