Diabetes affects millions of people in Canada, and insulin therapy is often a central component of its management. However, the need for daily or multiple daily insulin injections can be burdensome, often leading to poor adherence. In response, a promising new treatment has been introduced: a once-weekly insulin injection, offering a more convenient alternative for individuals living with type 1 or type 2 diabetes.
What type of insulin is once-weekly?
The once-weekly insulin formulation, known as insulin icodec and sold under the brand name Awiqli®, was approved in Canada in March 2024 for adults with diabetes. This ultra-long-acting basal insulin is designed to regulate blood sugar over 7 days. Unlike daily injections, insulin icodec provides consistent blood sugar control throughout the week due to its slow absorption, eliminating the need for daily dosing.
4 benefits of once-weekly insulin
1. Convenience: One of the most significant advantages of insulin icodec is its convenience. Insulin can now be injected just once a week, which simplifies the diabetes management routine. This may help with consistency of treatment plans, ultimately improving health outcomes.
2. Reduced injection site issues: Fewer injections reduce the risk of common side effects associated with insulin therapy, such as irritation, bruising or scar tissue at the injection site (this is known as lipohypertrophy). This can result in decreased blood sugar variability, better skin health and a more comfortable injection experience over time.
3. Improved quality of life: For many people, frequent injections cause psychological stress or needle anxiety. The once-weekly regimen alleviates some of these emotional burdens, enhancing quality of life and making it easier to adhere to treatment plans.
4. Comparable or superior blood sugar control: Insulin icodec provides a more stable and prolonged insulin effect, helping to maintain smoother blood sugar levels over time. This can reduce fluctuations in blood sugar and contribute to better long-term diabetes management.
Challenges and considerations
While once-weekly insulin offers many benefits, there are still challenges to consider. Individuals using insulin icodec, as well as healthcare providers, will need time to adapt to the new dosing schedule. As with all insulins, proper education regarding administration is essential.
Additionally, insulin icodec may cause side effects, including a rare risk of hypoglycemia, particularly in the early days of the dosing cycle (days 2 to 4). Therefore, insulin icodec is not recommended for people with hypoglycemia unawareness. Close monitoring of blood sugar remains crucial to ensure its effectiveness.
While clinical trials have yielded promising results, the long-term, real-world effects of this treatment are still being studied. Cost may vary depending on insurance coverage, but public and private insurance plans are expected to include insulin icodec as it becomes more widely available.
Dosing
The recommended starting dose of insulin icodec for type 2 diabetes is 70 units once a week, administered on the same day each week. When switching from other long-acting insulins, it’s important to consult with a healthcare provider for proper dose conversion. The titration guide allows for adjustments based on pre-breakfast blood sugar values on the 2 days before and on the day of their next injection, with dose changes in 10-unit increments.
The once-weekly insulin option represents a significant advancement in diabetes care. By offering increased convenience, improved adherence and potentially better blood sugar control, insulin icodec stands to enhance the lives of people with diabetes. With proper education and monitoring, this treatment promises to simplify diabetes management and provide a more effective solution for adults with the condition.
