Efficacy and safety of once‐weekly basal insulin therapy in people with type 1 diabetes: A systematic review and meta‐analysis
Authors' conclusion
This meta-analysis is the first to evaluate the efficacy and safety of once-weekly basal insulin therapy exclusively in adults with type 1 diabetes and including all published RCTs. The analysis demonstrated a similar glucose-lowering effect compared to once-daily basal insulin but revealed an increased occurrence of severe hypoglycaemia.
Study context
- Population
- Adults with T1D in Randomized Controlled Trials (RCTs) (MEDLINE, Web of Science, CENTRAL to 1 April 2025)
- Participants
- 1,629 adults5 RCTs
- Comparison
- Once-weekly basal insulin vs once-daily basal insulins
- Outcome
- Change in HbA1c
Methodological detailsfixed- or random-effects models
- Fixed- or random-effects models
Pooled result
As reported in the abstract
- Similar effects on HbA1c with once-weekly and once-daily basal insulins (high certainty)
Further pooled results
| Outcome | Estimated treatment ratio (95% CI) | |
|---|---|---|
| Weekly bolus insulin doseI2 = 0%; high certainty | 0.837 (0.794–0.882) | |
| 0.512Estimated treatment ratio (log scale) |
Body weight, TIR and TAR
- Similar effects on body weight (moderate certainty), TIR (moderate certainty) and TAR
Safety
| Outcome | IRR (95% CI) | |
|---|---|---|
| Level 3 hypoglycaemiaModerate certainty | 2.532 (1.758–3.645) | |
| 0.20.5125Incidence rate ratio (log scale) |
Original publication
Efficacy and safety of once‐weekly basal insulin therapy in people with type 1 diabetes: A systematic review and meta‐analysis. Diabetes Obes Metab. Published 6 October 2025. doi:10.
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