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Clinical Trial Shows Once-Weekly Insulin Improves A1C

Updated: 8/16/22 3:33 pmPublished: 8/16/22
By Arvind Sommi

Clinical trial results have shown that once-weekly basal insulins are just as effective at reducing A1C as once-daily insulin. 

In July 2022, Novo Nordisk announced the results of the ONWARDS 3 and ONWARDS 4 clinical trials, showing that icodec, a once-weekly basal insulin, was just as effective as once-daily insulin. 

Here is a summary of the results: 


Insulin icodec (once-weekly)

Insulin degludec (Tresiba, once-daily)

A1C Reduction After 26 weeks





Insulin icodec (once-weekly)

Insulin glargine (Lantus, once-daily)

A1C Reduction After 26 weeks



*People in both trials had an average A1C of around 8.4%

In both trials, insulin icodec performed as well as once-daily insulins (Tresiba and Lantus). However, icodec could prove to be a more convenient alternative for many people on daily insulin therapy.

Safety was a major focus of the ONWARDS 3 and ONWARDS 4 trials; would participants in the insulin icodec group experience hypoglycemia more frequently than in the "control" group after being given seven days of insulin in one injection? However, no significant differences in the frequency of severe or clinically significant hypoglycemia were found between the icodec group and the control group.

Insulin icodec is still in clinical trials, but these results bring it one step closer to being available for people with diabetes. Additionally, Lilly is working on their own once-weekly insulin, and it is also in clinical trials.

To learn more about the different types of insulin and other types of diabetes medications, read our articles:

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About the authors

Arvind Sommi joined the diaTribe Foundation in 2021 after graduating from the University of Florida with a degree in Biology. Sommi is an Editor for diaTribe Learn. Arvind Sommi joined... Read the full bio »