Insulin “Icodec” Could Be a Diabetes Breakthrough with a Half Life of Over 8 Days

Most people with insulin-dependent diabetes either have to inject themselves with insulin one or more times a day or have their insulin pumps give them insulin. Insulin pumps make taking insulin easier, but the user still has to manually tell the pump when to give them insulin, and the infusion sets still need to be changed every one to three days. That’s what makes the latest breakthrough in diabetes management so “transformational.”

That’s the word used by the lead investigator studying a new basal insulin which would only need to be delivered once a week, which may reduce the number of injections many people with diabetes need. This new insulin “icodec,” as it’s being called, is not yet available to the public, but it has crossed a major hurdle in its journey to approval; it has officially posted positive results in a phase 2 clinical trial, lowering glucose levels in participants just as well (and just as safely) as traditional 24-hour basal insulins.

Novo Nordisk‘s insulin icodec is a long-acting basal insulin analogue with a half-life of 196 hours, which is just over eight days. The product works by binding to albumin in the bloodstream, which allows it to lower glucose more slowly and steadily.

Pharmaceutical companies around the globe have been working on creating a once-weekly basal insulin for more than 10 years in the hopes of giving people with diabetes some relief from constant injections. Now that Novo Nordisk has released the results of its most recent study on the subject, this dream feels a lot closer. If this new drug is successful, it would help thousands of people feel less tied down to their diabetes supplies and less “burnt out” due to the constant work of controlling their diabetes. It might even help many keep up with a care regime that they would otherwise struggle to stick with.

The trial involved 247 adults with type 2 diabetes and a history of difficulty controlling their blood glucose levels with the use of non-insulin medications. Half of them were given a traditional 24-hour basal insulin to use once a day, while the other half were given the once-weekly insulin icodec. Using various glycemic benchmarks, researchers determined that those who took weekly insulin achieved results at least as good as those who took insulin every day. Nor was the overall number of serious hypoglycemic events increased among those on insulin icodec.

And one of the best parts? Those participants who took weekly basal insulin actually used significantly less insulin overall than the control group. Insulin can increase weight and worsen heart disease risk factors, so being able to take less of it could actually help improve other areas of health as well for people with diabetes.

“My feeling – totally biased – is that this insulin, if proven efficacious … is going to be transformational in the management of Type 2 diabetes,” says Dr. Julio Rosenstock, who led the study.

Of course, insulin icodec isn’t going to be the perfect solution for everyone. Dr. Rosenstock admits that it’s less likely to help people with type 1 diabetes, who may struggle more with erratic insulin absorption when they are ill, exercise vigorously, or drink alcohol. Anyone who has to fine-tune their insulin intake on a day-by-day or hour-by-hour basis may have trouble getting insulin icodec to work effectively for them. However, Novo Nordisk still plans to pursue a type 1 clinical trial to see how the drug does.

A larger and longer phase 3 trial of insulin icodec in type 2 diabetes patients will begin later this year. Researchers hope it can answer more questions about the safety and efficacy of the drug as well as reveal any negative side effects and show how the insulin affects patients’ insulin sensitivity over time.

Phase 3 trials have a higher failure rate than phase 1 and 2 trials, so there are still many hurdles left before the finish line. But we have high hopes for insulin icodec and can’t wait to hear more about it!