Comparing the Effectiveness of Weekly Insulin Injection to Daily Injection in Managing Type 2 Diabetes
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on August 11th, 2025
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For patients with type 2 diabetes, insulin injection is recommended if standard glucose-reducing agents cannot achieve effective glycemic control. Daily insulin injections pose significant challenges to patients and can reduce treatment adherence. Eli Lilly had sponsored a study to assess the feasibility of a once-weekly insulin injection to manage blood glucose level.
The phase 3 clinical trial enrolled 795 participants with an average age of 56 years old who had been diagnosed with type 2 diabetes but have not used insulin previously. At baseline, these patients have an average glycated hemoglobin level of 8.24% and a fasting serum glucose level of 161 mg/dL. 93.5% of the participants were treated with metformin, 31.1% of them was treated with a DPP-1 inhibitor. The rate of SGLT-2 inhibitor, GLP-1 receptor agonist, and Thiazolidinedione usage was lower.
The patients were randomly assigned to be treated with either daily injection with insulin glargine or once-weekly insulin efsitora. Both medications were injected subcutaneously. Glargine was given at an initial dose of 10U, and the once-weekly insulin efsitora given at a starting dose of 100U. If the blood glucose persistently stays above 130 mg/dL, the dosage of both medications can be increased.
After 52 weeks of treatment, the researchers found the once-weekly injection of insulin efsitora was equally effective with the daily insulin glargine injection at managing glycated hemoglobin level and fasting blood glucose concentration. There was no significant difference in the risk of hypoglycemia or other adverse events between the two treatment groups. The convenience of weekly injection and the promising effectiveness might make glycemic management more feasible for patients.
The phase 3 clinical trial enrolled 795 participants with an average age of 56 years old who had been diagnosed with type 2 diabetes but have not used insulin previously. At baseline, these patients have an average glycated hemoglobin level of 8.24% and a fasting serum glucose level of 161 mg/dL. 93.5% of the participants were treated with metformin, 31.1% of them was treated with a DPP-1 inhibitor. The rate of SGLT-2 inhibitor, GLP-1 receptor agonist, and Thiazolidinedione usage was lower.
The patients were randomly assigned to be treated with either daily injection with insulin glargine or once-weekly insulin efsitora. Both medications were injected subcutaneously. Glargine was given at an initial dose of 10U, and the once-weekly insulin efsitora given at a starting dose of 100U. If the blood glucose persistently stays above 130 mg/dL, the dosage of both medications can be increased.
After 52 weeks of treatment, the researchers found the once-weekly injection of insulin efsitora was equally effective with the daily insulin glargine injection at managing glycated hemoglobin level and fasting blood glucose concentration. There was no significant difference in the risk of hypoglycemia or other adverse events between the two treatment groups. The convenience of weekly injection and the promising effectiveness might make glycemic management more feasible for patients.