Abstract Body

Once weekly basal insulin is being developed for both type 1 and type 2 diabetes. Although most of the studies with weekly basal insulin are looking at type 2 diabetes , there are a few studies looking at the effects of weekly basal insulin in type 1 diabetes treated with a multiple daily injection regimens. Both Lilly’s BIF and NovoNordisk’s Icodec appear to be safe and effective comparted to insulin glargine and/or insulin degludec in clinic trials (details will be shown and discussed at the presentation). The promise of once weekly basal insulin comparted to once daily basal insulin includes greater convenience, better adherence, improved quality of life, reduced burden of self-management and easier for individuals in need of self-care assistance.

Is there an unmet need in type 1 diabetes? For individuals on “dumb” pumps and hybrid closed loop systems there Is no obvious need unless an individual feels the technology is burdensome and stressful. For many on multiple daily injections regiments currently doing well on the second generation basal insulins supported by a CGM may or may not enjoy the need for one less injection per day. There will be a subset of T1Ds were adherence with their current daily basal insulin is poor leading to an elevated A1c and TIR in which weekly basal insulin may help.

The successful use of weekly basal insulin in T1D, as well as T2D will require an intensive education program to the people living with diabetes and their HCPs for the proper switching, initiation, titration and long term monitoring. Education and protocols will also be needed for acute situations where the dose of basal insulin must be significantly reduced or increased.