Continuous Glucose Monitoring–Based Metrics and Hypoglycemia Duration in Insulin-Experienced Individuals With Long-standing Type 2 Diabetes Switched From a Daily Basal Insulin to Once-Weekly Insulin Icodec: Post Hoc Analysis of ONWARDS 2 and ONWARDS 4
Authors' conclusion
In insulin-experienced participants with long-standing type 2 diabetes, CGM-based TIR, TAR, and CGM-derived hypoglycemia duration (<3.9 mmol/L) were comparable for icodec and once-daily basal insulin analogs during all time periods. TBR remained within recommended targets.
Study context
- Population
- Insulin-experienced individuals with long-standing T2D switched from daily basal insulin
- Comparison
- Once-weekly insulin icodec vs once-daily basal insulin analogs
- Primary endpoint
- CGM-based metrics (TIR 3.9-10.0 mmol/L, TAR >10.0 mmol/L, TBR <3.9 and <3.0 mmol/L) and CGM-derived hypoglycemic episode duration (<3.9 mmol/L)
- Follow-up
- Switch [weeks 0-4], end of treatment [weeks 22-26], and [weeks 27-31]
Methodological details26-week phase 3a trials, double-blind continuous glucose monitoring (CGM) data
- 26-week phase 3a trials
- Double-blind CGM data
Primary result
As reported in the abstract
TIR, TAR, TBR (<3.0 mmol/L) · all time periods
- In both trials, no statistically significant differences in time in range (TIR), time above range (TAR), or time below range (TBR) (<3.0 mmol/L) for icodec vs comparators across all time periods
Further findings
Mean
| Outcome | Icodec | Degludec | Glargine U100 |
|---|---|---|---|
| Mean TIR, ONWARDS 2 · end of treatment [weeks 22-26] | 63.1% | 59.5% | — not stated in the abstract |
| Mean TIR, ONWARDS 4 · end of treatment [weeks 22-26] | 66.9% | — not stated in the abstract | 66.4% |
— not stated in the abstract
Safety
TBR <3.9 mmol/L and <3.0 mmol/L · across time periods
- Mean TBR remained within recommended targets (<4% and <1%, respectively) across time periods and treatment arms
Hypoglycemic episode duration (<3.9 mmol/L) · across time periods
- Comparable across time periods and treatment arms; median duration
- ≤40 min
Original publication
Continuous Glucose Monitoring–Based Metrics and Hypoglycemia Duration in Insulin-Experienced Individuals With Long-standing Type 2 Diabetes Switched From a Daily Basal Insulin to Once-Weekly Insulin Icodec: Post Hoc Analysis of ONWARDS 2 and ONWARDS 4. Diabetes Care. Published 21 February 2024. doi:10.
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