People diagnosed with diabetes generally do not enjoy injecting insulin. Hence, they would prefer injecting themselves less frequently while still maintaining their blood glucose levels in a desirable range. Novo Nordisk recently finished their phase 2 of clinical trials for their new long-acting, “basal” insulin preparation: Icodec.

Icodec represents a new concept with insulin. Instead of injecting it daily, Icodec is only injected once a week. In the Icodec phase 2 trial, researchers concluded that icodec was just as safe and effective as once-daily insulin glargine U100, marketed as Lantus or Basaglar (Rosenstock, et al. New Engl J Med 2020; DOI: 10.1056/NEJMoa2022474).

How does it work?

The icodec insulin is modified to strongly bind to albumin, a common protein that circulates in the blood. This causes a slow and steady release of insulin to decrease blood sugar levels over the course of 196 hours, or one week. Since icodec insulin stays in the body longer than typical long-acting insulins, this means fewer injections are required for a patient to maintain glucose control.

There is now a plan to initiate phase 3 clinical trials for icodec which involves distributing it to roughly 1,000 people for further testing. The goal of this phase is to establish icodec for its safety and efficacy before moving on to FDA approval.

If approved, icodec insulin would make it more convenient for people to maintain their blood sugar levels. They would only need to inject it once a week and get the same blood sugar control they do now with once-daily insulin injections. This would hopefully lead to better adherence to their medications schedule.