Once-weekly administration of insulin in the real-world management of type 2 diabetes. A Delphi-like consensus

Background: Despite major advancements in diabetes management, insulin therapy continues to have a prominent role in glycemic control, aiding numerous patients. However, treatment-associated unmet needs pose a hindrance to therapy acceptance and adherence, negatively affecting patient outcomes due to less effective glycemic management. Method: A consensus study was conducted using a Delphi-like methodology, with the aim of highlighting and discussing the potential benefits and challenges with the introduction of once-weekly basal insulin icodec in the management of diabetes. Results: The consensus firmly highlights the transformative approach and the timely adoption of once-weekly basal insulin for patients affected by type 2 diabetes. Once-weekly insulin icodec was broadly supported as a viable alternative to daily basal insulin, particularly for insulin-naïve individuals and those on basal-only regimens. Key advantages included reduced injection burden, improved adherence, and potential cost savings. The therapy was also seen as a way to counteract therapeutic inertia and improve quality of life. Although some implementation challenges were noted, namely patient selection and titration, most experts endorsed educational efforts and digital tools to support adoption. The panel supported the progressive replacement of daily with weekly basal insulin. Conclusion: The advent of once-weekly insulin icodec therapy is an unprecedent breakthrough in diabetes care. Compared with once-daily insulin analogues, it offers a simplified, secure, enhanced, and sustained glycemic control, counteracting therapeutic inertia, expectedly improving adherence to insulin therapy. Insulin icodec can not only enable personalized treatment and positively impact the clinical outcome, but also improve patient satisfaction and overall quality of life.