Efficacy and safety of once‐weekly insulins in type 2 diabetes: A systematic review and meta‐analysis
Pooled result · HbA1c reductionResult — go to the resultPooled mean difference −0.12 % 95% CI −0.19 to −0.04Authors' conclusion
OW insulins modestly improve glycaemic control without increasing hypoglycaemia risk, though slight weight gain may occur.
Study context
- Population
- Randomized Controlled Trials (RCTs) of Once-weekly (OW) insulins in T2D; PubMed, WoS, ClinicalTrials.gov and EU Clinical Trials searched up to June 202516 RCTs
- Comparison
- Once-weekly insulins vs once-daily insulin or semaglutide
- Outcome
- Efficacy (HbA1c, fasting plasma glucose (FPG), time-in-range (TIR), time-above-range) and safety outcomes (body weight, hypoglycaemia, time-below-range)
Methodological detailsfrequentist and Bayesian approaches, meta-regression
- Frequentist and Bayesian approaches
- Meta-regression
Pooled result
HbA1c reduction
Pooled mean difference
−0.12 %
95% CI −0.19 to −0.04
P = 0.007
OW insulinsvs Once-daily insulin or semaglutide
pooled mean difference −0.12 % (95% CI −0.19 to −0.04); P = 0.007
As reported in the abstract
Further pooled results
| Outcome | Difference (mg/dL) (95% CI) | P value | |
|---|---|---|---|
| FPG changeComparable | −3.37 (−7.95 to 1.21) | P = 0.14 | |
| −10−505Difference, mg/dL (linear scale) |
| Outcome | Difference (% of total time) (95% CI) | P value |
|---|---|---|
| TIR | +2.41 (1.13–3.69) | P = 0.002 |
Effect consistency (meta-regression)
- Consistent effect sizes across OW insulin types, treatment durations and prior insulin regimens
Safety
Body weight change
- Modest weight gain excluding trials using IcoSema
- +0.33 kg (95% CI 0.04 to 0.62, p = 0.030)
- Body weight changes generally similar
Clinically significant or severe hypoglycaemia
- Incidence did not differ between groups; pooled IRR
- 1.04 (95% CI 0.79 to 1.28, p = 0.75)
Original publication
Efficacy and safety of once‐weekly insulins in type 2 diabetes: A systematic review and meta‐analysis. Diabetes Obes Metab. Published 23 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →