Once-Weekly Insulin Icodec vs Once-Daily Insulin Glargine U100 for type 2 diabetes in insulin naive patients: a systemic review and meta-analysis

: Insulin Therapy is essential for managing diabetes, but difficulties such as daily injections and hypoglycemia risk hinder patient compliance. Recent advancements have brought basal insulin analogs such as insulin icodec and insulin glargine U100 so in this study we aimed to assess the efficacy and safety of Once-Weekly Insulin icodec and Once-Daily insulin glargine-U100 in Insulin-Naive type 2 diabetic patients (T2DM). : The PRISMA guidelines were followed in conducting this meta-analysis. An electronic search was conducted utilizing databases such as PubMed, Google Scholar, OvidSP, and the Cochrane Database of Controlled Studies (CENTRAL). The analysis findings were combined using a random-effects model. Continuous outcomes were expressed as mean difference (MD), whereas dichotomous outcomes were represented as odds ratios (ORs) with 95% confidence intervals (95% CIs). : 3 randomized control trials (RCTs) comprising 1436 patients were included in our analysis. Pooled analysis showed a significant difference in improved time with glucose range (%TIR) between icodec group and glargine U100 (MD=4.89; 95% CI= 2.95 to 6.82; P=<0.00001; I2=0%), reduction in HbA1c (MD=-0.19; 95% CI= -0.30 to -0.08; P=0.0009; I2=0%), risk of hypoglycemia alert (OR=1.47; 95% CI=1.18-1.84; P=0.0006; I2=0%). There was no significant difference in pooled analysis for fasting plasma glucose levels, severe hypoglycemia, and any adverse effects or hyperactivity events. : Our systematic review and meta-analysis provided evidence that favored Once-Weekly Insulin Icodec over Once-Daily Insulin Glargine U100 for patients with T2DM.