Abstract 141: CGM-based measurements for once-weekly insulin icodec versus once-daily insulin glargine U100 in insulin-treated patients with type 2 diabetes: A post hoc analysis

Insulin icodec (icodec) is a once-weekly basal insulin in clinical development. In a phase 2 treat-to-target trial in patients with type 2 diabetes (T2D) switching from daily insulin (N = 154), icodec with an initial 100% loading dose (LD; doubling the first dose) showed greater time in range (TIR, 3.9-10 mmol/L) vs once-daily insulin glargine U100 (IGlar U100) at weeks 15 & 16 (primary endpoint), as measured by double-blinded Dexcom G6® continuous glucose monitoring (CGM). This post hoc analysis compared TIR, time above range (TAR, >10 mmol/L) and below range (TBR, <3.9 and <3.0 mmol/L) for icodec LD and icodec with no loading dose (NLD) vs IGlar U100, calculated using CGM data from the 2-week screening and the 16-week treatment periods. Over the 16 weeks, overall observed mean TIRs were 71.4% for icodec LD, 60.7% for icodec NLD and 64.3% for IGlar U100. TBR<3.9 mmol/L and TBR<3.0 mmol/L remained below the internationally recommended targets (<4% and <1%, respectively) in all groups over the 16 weeks. At weeks 15&16, the proportion of patients achieving a combination of >70% TIR and <4% TBR<3.9 mmol/L was 64.2% for icodec LD, 40.0% for icodec NLD and 45.8% for IGlar U100. Icodec LD prevented a mild transient increase in TAR observed during the switch with icodec NLD and appeared to lead to a lower TAR than IGlar U100 over the 16-week treatment period. Overall, switching to icodec LD appeared to result in higher TIR and lower TAR than IGlar U100 through 16 weeks. TBR remained within the recommended targets. [Image: see text] [Image: see text]