{"doi":"10.2337/dc20-2878","title":"A Randomized, Open-Label Comparison of Once-Weekly Insulin Icodec Titration Strategies Versus Once-Daily Insulin Glargine U100","abstract":"OBJECTIVE Insulin icodec is a novel once-weekly basal insulin analog. This trial investigated the efficacy and safety of icodec using different once-weekly titration algorithms. RESEARCH DESIGN AND METHODS This was a phase 2, randomized, open-label, 16-week, treat-to-target study. Insulin-naive adults (n = 205) with type 2 diabetes and HbA1c 7–10% while treated with oral glucose-lowering medications initiated once-weekly icodec titrations A (prebreakfast self-measured blood glucose target 80–130 mg/dL; adjustment ±21 units/week; n = 51), B (80–130 mg/dL; ±28 units/week; n = 51), or C (70–108 mg/dL; ±28 units/week; n = 52), or once-daily insulin glargine 100 units/mL (IGlar U100) (80–130 mg/dL; ±4 units/day; n = 51), all titrated weekly. Percentage of time in range (TIR) (70–180 mg/dL) during weeks 15 and 16 was measured using continuous glucose monitoring. RESULTS TIR improved from baseline (means: A, 57.0%; B, 55.2%; C, 51.0%; IGlar U100, 55.3%) to weeks 15 and 16 (estimated mean: A, 76.6%; B, 83.0%; C, 80.9%; IGlar U100, 75.9%). TIR was greater for titration B than for IGlar U100 (estimated treatment difference 7.08%-points; 95% CI 2.12 to 12.04; P = 0.005). No unexpected safety signals were observed. Level 2 hypoglycemia (<54 mg/dL) was low in all groups (0.05, 0.15, 0.38, 0.00 events per patient-year of exposure for icodec titrations A, B, and C and IGlar U100, respectively), with no episodes of severe hypoglycemia. CONCLUSIONS Once-weekly icodec was efficacious and well tolerated across all three titration algorithms investigated. The results for icodec titration A (80–130 mg/dL; ±21 units/week) displayed the best balance between glycemic control and risk of hypoglycemia.","journal":"Diabetes Care","year":2021,"id":150168,"datarank":4.709242660802699,"base_score":4.574710978503383,"endowment":4.574710978503383,"self_citation_contribution":0.6862066467755076,"citation_network_contribution":4.023036014027192,"self_endowment_contribution":0.6862066467755076,"citer_contribution":4.023036014027192,"corpus_percentile":null,"corpus_rank":null,"citation_count":96,"citer_count":79,"citers_with_citation_signal":57,"citers_with_endowment":57,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9424,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03951805"],"figshare":["10.2337/figshare.14054921"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":34495,"name":"John B. Buse","orcid":"0000-0002-9723-3876","position":1,"is_corresponding":false},{"id":638466,"name":"Edward Franek","orcid":"0000-0002-5953-7908","position":2,"is_corresponding":false},{"id":590491,"name":"M. Hansen","orcid":"0000-0001-7116-2216","position":3,"is_corresponding":false},{"id":440553,"name":"Mette Koefoed","orcid":null,"position":4,"is_corresponding":false},{"id":418338,"name":"Chantal Mathieu","orcid":"0000-0002-6099-2406","position":5,"is_corresponding":false},{"id":237704,"name":"Jeremy Pettus","orcid":"0000-0002-5999-0091","position":6,"is_corresponding":false},{"id":639510,"name":"Karolina Stachlewska","orcid":null,"position":7,"is_corresponding":false},{"id":320000,"name":"Julio Rosenstock","orcid":"0000-0001-8324-3275","position":8,"is_corresponding":false},{"id":231195,"name":"Ildiko Lingvay","orcid":"0000-0001-7006-7401","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T23:43:01.325389Z","pmid":"33875484","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}