The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Efficacy and Safety of Insulin Icodec Versus 
Glargine U100- A meta-analysis of 
randomized controlled trials 

Kirubel Zerihun, MD1*, Mohammed Mhanna, MD, MPH2, Hazem Ayesh, MD1, 
MPH, Sami Ghazaleh, MD3, Yasmin Khader, MD1, Azizullah Beran, MD1, 
Abdulaziz Aldhafeeri, MD1, Sadikshya Sharma, MD1, Amna Iqbal, MD1, Juan 
Jaume, MD1

1Division of Internal Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Department of Surgery, The University of Toledo, Toledo, OH 43614 
3Division of Gastroenterology and Hepatology, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: Kirubel.Zerihun@utoledo.edu

Published: 05 May 2023 

Background: Insulin Icodec is a once-weekly basal ultra-long-acting insulin that is currently in 
development.  

Methods: We conducted a meta-analysis of randomized controlled trials that investigated the efficacy 
and safety of insulin icodec compared to glargine U100. From each clinical trial, we collected the 
number of patients who received icodec insulin and glargine U100. The primary outcome was change in 
hemoglobin A1C (HBA1C) from baseline. Secondary outcomes included percent of time in range (TIR) 
of blood glucose (3.9-10.0 mmol/L or 70-180 mg/dL) measured via continuous glucose monitoring 
during weeks 15 and 16 as well as occurrence of hypoglycemic episodes during treatment. The random-
effects model was used to calculate the risk ratios (RR), mean differences (MD), and confidence 
intervals (CI). A p-value <0.05 was considered statistically significant.  

Results: Three randomized controlled trials involving 552 patients with type 2 diabetes were included in 
the meta-analysis. The difference in change in HBA1C between the icodec and glargine U100 groups 
was not statistically significant (Standard difference in means: -0.068, 95% CI: -0.388, 0.253, P-
value=0.679, I2=67%). Furthermore, TIR percentage was comparable between the two groups (RR: 
1.04, 95% CI: 0.898, 1.206: P-value=0.593, I2=0%). However, treatment with icodec was associated 
with lower risk of combined level 2 (< 3 mmol/L or < 54 mg/dL) and 3 (severe) hypoglycemia (RR: 
0.69, 95% CI: 0.674, 0.713: P-value <0.05, I2=99.9%)  

Conclusion: Our meta-analysis demonstrated that in comparison to once daily insulin glargine U100, 
once weekly treatment with insulin icodec had similar glucose lowering efficacy but a better safety 
profile. 

https://dx.doi.org/10.46570/utjms.vol11-2023-730 

https://dx.doi.org/10.46570/utjms.vol11-2023-730
mailto:Kirubel.Zerihun@utoledo.edu