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Introducing Insulin Icodec (Awiqli): The First Once-Weekly Insulin
Introducing Insulin Icodec (Awiqli): The First Once-Weekly Insulin
- Jason K
If you’re managing diabetes, there’s exciting news on the horizon! Insulin Icodec (Awiqli) is set to be the first once-weekly insulin option, offering a convenient alternative to daily injections. Think of it as an ultra-long-acting insulin that works over a full week to help regulate your blood sugar levels.
How Does Icodec Work?
Icodec works a bit differently than the daily insulin injections you may be familiar with. It has a long half-life—about a week—thanks to its strong binding with a protein in your blood called albumin. This binding process creates a “depot,” or reservoir, that slowly releases insulin into your system, giving it a long-lasting effect.
While there’s a lot of buzz about Icodec, it’s important to understand how it compares to other types of insulin and whether it’s the right choice for you.
Benefits of Icodec
For people with type 2 diabetes, studies show that Icodec can slightly lower A1c (a measure of your average blood sugar over the past few months) compared to daily basal insulins like glargine or degludec. It also has similar rates of low blood sugar episodes (hypoglycemia) when compared to these daily insulins.
However, if you’re on a basal-bolus regimen (using both long-acting and short-acting insulins), Icodec doesn’t necessarily offer better A1c lowering than insulin glargine. Plus, for those with type 1 diabetes, the risk of hypoglycemia with Icodec may be higher compared to other insulins like degludec.
Key Differences Between Insulin Icodec and Other Basal Insulins
| Feature | Insulin Icodec | Other Basal Insulins |
|---|---|---|
| Dosing Frequency | Once weekly | Once daily |
| Duration of Action | 7 days | 24-42 hours |
| A1c Reduction in Type 2 | Slightly lower than daily glargine or | Effective in lowering A1c |
| Hypoglycemia Risk in Type 2 | Similar to daily basal insulin | Low |
| Switching from Daily Basal Insulin | Requires 7 times previous daily dose | Simple daily adjustment, if needed |
| Adjustment Frequency | Adjusted weekly | Adjusted daily or every few |
| Onset of Action | Slow onset due to weekly dosing | Relatively faster onset |
| Side Effects | Potential for hypoglycemia, weight gain, injection site reactions | Potential for hypoglycemia, weight gain, injection site reactions |
Who Could Benefit from Once-Weekly Insulin?
One of the main advantages of Icodec is that you only need to take it once a week. This could be helpful for people who have trouble sticking to a daily insulin routine. However, if you’re already managing well with your current insulin schedule, or if you also need to take multiple daily bolus (mealtime) insulin injections, the weekly option may not make much of a difference for you.
It’s also important to consider your risk of hypoglycemia (low blood sugar). Icodec might not be the best choice for people who experience frequent hypoglycemia or have lifestyle factors that increase this risk, such as intense exercise or irregular eating patterns.
Safe Use and Starting Doses
If you and your healthcare provider decide that Icodec is a good fit for you, here are some general guidelines for getting started:
For type 2 diabetes patients new to insulin: Start with 70 units of Icodec once a week. Adjust the dose in week 2 based on your blood sugar readings.
For patients switching from daily basal insulin: Take 7 times your current daily basal insulin dose as a once-weekly dose of Icodec. For example, if you currently take 10 units of basal insulin per day, your new Icodec dose would be 70 units once a week. Start this the day after your last dose of daily basal insulin and adjust the dose in week 2.
For certain low-risk patients: In some cases, your healthcare provider may recommend a higher starting dose of 10.5 times your daily dose in week 1, followed by 7 times your daily dose in week 2, with further adjustments in week 3.
Be sure to properly dispose of any remaining daily basal insulin to avoid accidentally doubling up on doses.
Managing Hypoglycemia
It’s important to know how to manage low blood sugar episodes while on Icodec, especially during the adjustment period. You may need to increase your carbohydrate intake until your weekly insulin dose can be adjusted. If you’re taking other diabetes medications like sulfonylureas or repaglinide, your healthcare provider might also suggest reducing the dose to lower your risk of hypoglycemia.
References:
American Diabetes Association. “Insulin Therapy in Type 2 Diabetes.” Diabetes Care, 2021.
https://diabetesjournals.org/careNovo Nordisk. “Icodec: A Once-Weekly Insulin for Type 2 Diabetes.” Press Release, 2023.
https://novonordisk.com/media/news-and-releasesClinical Diabetes Journal. “Comparing Long-Acting Insulins for Type 2 Diabetes.” Clinical Diabetes, 2022.
https://clinical.diabetesjournals.org/