Dallas, TX—While daily insulin objections are theoretically effective in lowering blood glucose levels, many factors—ranging from the burden of treatment to fear of injections to accuracy of doses—affect adherence.

That’s why ongoing trials of once-weekly insulin are considered so important in overcoming reluctance to initiate insulin therapy while also improving long-term adherence by patients with diabetes, according to studies published online by Diabetes Care.

Those studies found that once-a-week injectable insulin therapy was as safe and as effective as daily insulin injections. “Insulin, which has been the foundation of diabetes treatment for 100 years, is an effective glucose-lowering agent and is safe when used at the correct dose,” advises the lead author of one of the studies, Ildiko Lingvay, MD, MPH, a professor of internal medicine and population and data sciences at UT Southwestern. “Insulin treatment is burdensome, requires frequent injections, and continues to carry a certain stigma. The development of an effective and safe insulin that can be administered once a week is a huge advance in the field.”

The study led by Dr. Lingvay, who is a consultant for Novo Nordisk, involved 205 patients from seven countries—the United States, Croatia, Germany, Hungary, Poland, Slovakia, and Spain. It included a 2-week screening period, 16 weeks of treatment, and a 5-week follow-up to evaluate three different ways to adjust and optimize the insulin dose.

Dr. Lingvay also is a coauthor of the second study that included 154 patients from five countries—the U.S., Canada, the Czech Republic, Germany, and Italy. Following the same 23-week time frame, that study evaluated practical aspects of insulin use as well as the best ways to transition from a daily regimen to the new weekly insulin injections. The conclusion was that beginning with a higher first dose—called a loading dose—helped patients to reach their optimal glucose target faster.

“These two studies served as the steppingstones for a large phase 3 clinical trial program that is currently ongoing at UT Southwestern and other sites, which is designed to evaluate the efficacy of once-weekly insulin administration in patients with either Type 1 or Type 2 diabetes,” Dr. Lingvay explained in a UT Southwestern press release. “A weekly insulin is a game-changer that will decrease the treatment burden for patients while also improving compliance. This treatment will also decrease the burden on those who care for patients with diabetes requiring insulin. For example, for patients who need help injecting, those living in long-term care facilities, and those with memory problems, a once-weekly insulin will facilitate treatment and decrease the burden on the care providers.”

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