{"id":159070,"date":"2024-10-22T15:17:18","date_gmt":"2024-10-22T15:17:18","guid":{"rendered":"https:\/\/news.talkwithrattan.com\/index.php\/2024\/10\/22\/once-weekly-insulin-might-mean-fewer-shots-for-some-with-diabetes\/"},"modified":"2024-10-22T15:17:18","modified_gmt":"2024-10-22T15:17:18","slug":"once-weekly-insulin-might-mean-fewer-shots-for-some-with-diabetes","status":"publish","type":"post","link":"https:\/\/news.talkwithrattan.com\/index.php\/2024\/10\/22\/once-weekly-insulin-might-mean-fewer-shots-for-some-with-diabetes\/","title":{"rendered":"Once-weekly insulin might mean fewer shots for some with diabetes"},"content":{"rendered":"<div style=\"text-align:center\"><img decoding=\"async\" src=\"https:\/\/i0.wp.com\/www.sciencenews.org\/wp-content\/uploads\/2024\/10\/101524_ac_weekly-insulin_feat.jpg?fit=800%2C450&amp;ssl=1\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"Once-weekly insulin might mean fewer shots for some with diabetes\" title=\"Once-weekly insulin might mean fewer shots for some with diabetes\" \/><\/div> \r\n<br><br><div data-component=\"video-embed\">\n\t\t\t\t\n\n\n\n\n<p>Life with diabetes usually includes many injections of the blood sugar\u2013controlling hormone insulin. Recent research investigating a once-weekly shot finds it might help lessen the burden a bit for some with the disease.<\/p>\n\n\n\n<p>Two pharmaceutical companies have developed weekly insulin formulations and have tested the drugs in late-stage clinical trials. This September, in the <em>New England Journal of Medicine<\/em>, researchers reported <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2403953\" target=\"_blank\" rel=\"noopener\">promising results for efsitora<\/a>, from Eli Lilly. For adults with type 2 diabetes, the drug worked as well as a once-daily formulation of insulin. But a trial of adults with type 1 diabetes, reported the same month in the <em>Lancet<\/em>, found there were more episodes of dangerously <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(24)01804-X\/abstract\" target=\"_blank\" rel=\"noopener\">low blood sugar in the group on efsitora<\/a> than in the group taking a once-daily insulin shot.<\/p>\n\n\n<aside class=\"sn-conversion rich-text rich-text--with-sidebar\">\n<style><![CDATA[\n.email-conversion {\n  border: 1px solid #ffcccb;\n  color: white;\n  margin-top: 50px;\n  background-image: url(\"\/wp-content\/themes\/sciencenews\/client\/src\/images\/cta-module@2x.jpg\");\n  padding: 20px;\n  clear: both;\n}\n\n]]><\/style>\n\n\n\n                        <style class=\"is-layout-flow 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unset);line-height:unset;margin:unset;padding:unset;border:unset;background:unset;&:hover, &:focus-visible {\n            border: unset;\n            background: unset;\n        }}.zephr-form-disabled-div{pointer-events:none;opacity:0.8}.zephr-form-relative-container{position:relative}.zephr-form-flex-container{display:flex}.zephr-form-input-inner-button{cursor:pointer;position:absolute;top:50%;transform:translateY(-50%);right:5px;padding:10px 5px}.zephr-form-input-inner-text{color:var(--zephr-color-text-main);font-size:var(--zf-subtext-fontSize);font-weight:bold;font-family:var(--zf-root-fontFamily)}\n]]><\/style>\n                        \n                        <style><![CDATA[.zephr-form-max-width.zephr-payment-form-max-width {\n    background-image: url(https:\/\/www.sciencenews.org\/wp-content\/themes\/sciencenews\/client\/src\/images\/cta-module@2x.jpg);\n    padding:20px;\n    max-width: 100%;\n}\n\n.zephr-form-custom-text > p {\n    display: none;\n}\n\nform.zephr-form-content {\n    opacity: .9;\n}\n\nlabel.zephr-form-checkbox-label {\n    font-size: 1.2rem;\n    font-weight: bolder;\n}\n\n.zephr-form-custom-text > h4 {\n    color: black !important;\n}\n\nbutton.zephr-form-button {\n    background: #d4441f !important;\n    font-weight: bold !important;\n    text-transform: uppercase !important;\n}\n\nlabel.zephr-payment-form-checkbox-label {\n    color: white;\n    font-size: 1.6rem;\n}\n\n.zephr-form-content {\n    background:#2f537f;\n    \n}\n\n.zephr-payment-form-custom-text {\n    margin-top: .2rem;\n}\n\n.zephr-payment-form-checkbox-label {\n    display: flex;\n    align-items: center;\n    font-family: var(--zephr-typography-body-font), var(--zephr-typography-body-fallbackFont);\n    color: white;\n    font-weight: bold;\n}]]><\/style>\n                        \n                        \n<\/aside>\n\n\n<p>Meanwhile icodec, from Novo Nordisk, has received approval for use in adults with diabetes by <a href=\"https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/awiqli\" target=\"_blank\" rel=\"noopener\">the European Union<\/a> and by <a href=\"https:\/\/dhpp.hpfb-dgpsa.ca\/review-documents\/resource\/RDS1711383693011\" target=\"_blank\" rel=\"noopener\">Canada<\/a> and a few other countries. But the U.S. Food and Drug Administration announced in July that it is not ready to approve the company\u2019s application for icodec. In May, an FDA advisory committee had voted against moving the drug forward in part due to safety concerns from the <a href=\"https:\/\/www.fda.gov\/media\/182560\/download\" target=\"_blank\" rel=\"noopener\">increased risk of hypoglycemia<\/a> \u2014 the clinical term for blood sugar that\u2019s too low \u2014 for those with type 1 diabetes.<\/p>\n\n\n\n<p>It will likely take time before things shake out on whether, when and for whom weekly insulin will become available in the United States. For now, the clinical trials provide some insight into the usefulness and limitations of a weekly formulation. <em>Science News<\/em> talked with two experts about weekly insulin, what\u2019s challenging when trying to mimic the body\u2019s system for regulating blood sugar and what else would be helpful for people managing diabetes.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What is diabetes, and how is it treated?<\/h3>\n\n\n\n<p>Diabetes develops when blood levels of glucose become too high, because the body has lost the ability to properly regulate this sugar \u2014 the body\u2019s main fuel \u2014 with the hormone insulin. Type 1 diabetes is an autoimmune disease that destroys the cells in the pancreas that make insulin. With type 2 diabetes, these cells don\u2019t make enough insulin or the body doesn\u2019t respond to insulin effectively, or both. Over time, high levels of blood sugar can harm the kidneys, heart, eyes and nerves.<\/p>\n\n\n\n<p>An estimated <a href=\"https:\/\/www.cdc.gov\/diabetes\/php\/data-research\/\" target=\"_blank\" rel=\"noopener\">38 million people have diabetes in the United States<\/a>, nearly 12 percent of the population, according to the U.S. Centers for Disease Control and Prevention. Close to 2 million of those have type 1.<\/p>\n\n\n\n<p>Managing diabetes means monitoring blood sugar levels throughout the day and, for those with type 1 and some with type 2, figuring out how much insulin to take. If an insulin dose is too high, blood sugar drops too much. The effects can be quickly felt, and can include shakiness, nausea, fatigue, hunger, dizziness and irritability, among other symptoms. If blood sugar levels become severely low, a person can become confused, feel weak, have difficulty walking and even lose consciousness. Severe hypoglycemia is a medical emergency.<\/p>\n\n\n\n<p>With diabetes, there\u2019s \u201ca lot of thinking about food and thinking about numbers,\u201d says Laura Young, an endocrinologist specializing in diabetes care at the University of North Carolina School of Medicine in Chapel Hill. \u201cIt doesn\u2019t ever stop.\u201d<\/p>\n\n\n\n<p>People with type 1 and some with type 2 can face multiple daily injections of insulin. Short-acting insulin covers the spike in glucose that comes with meals. Long-acting insulin lasting around 24 hours manages the time between meals and at night. Covering three meals and the rest of the day and night adds up to \u201cat least four shots, and that\u2019s probably the minimum,\u201d Young says.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How does the body usually regulate blood sugar, and why is this hard to copy?<\/h3>\n\n\n\n<p>Special cells in the pancreas, called <a href=\"https:\/\/www.sciencenews.org\/article\/long-road-beta-cells\">beta cells<\/a>, make insulin (<em>SN: 12\/11\/07<\/em>). The beta cells detect the amount of glucose in the blood and secrete the needed amount of insulin, responding to changes in glucose due to meals, exercise, illness and stress. In the body, there\u2019s \u201ccontinuous regulation to keep sugar in a good range, even if we don\u2019t eat,\u201d says endocrinologist Giulio Romeo of Harvard Medical School and the Joslin Diabetes Center in Boston. \u201cIt\u2019s hard to replicate our body\u2019s ability to fine tune\u201d this process, Romeo says.<\/p>\n\n\n<aside class=\"sn-conversion rich-text rich-text--with-sidebar\">\n<p class=\"has-text-align-center wp-elements-27c40654034fbeecef6418d6adfe0794\" style=\"color:gray; margin-bottom:0px; font-size:.9rem;\">Sponsor Message<\/p>\n<!-- Tag ID: sciencenews-org_leaderboard_incontent -->\n\n<\/aside>\n\n\n<p>Insulin injections can\u2019t mimic the responsiveness of beta cells. How quickly a shot of insulin is absorbed into the blood depends upon where the injection is given. And while researchers have made innovative chemical modifications to insulin formulations, creating versions that last for 24 hours or more, long-acting insulins aren\u2019t able to provide the same steady management of glucose between meals that beta cells can.<\/p>\n\n\n\n<p>Instead, there are small highs and lows as long-acting insulin is released, Romeo says. That means there can be a bit too much or a bit too little insulin available over time. Plus, once a dose is taken, \u201cyou can\u2019t change it,\u201d Romeo says. If a long-acting dose turned out to be more than needed for the next 24 hours, a person may end up with low blood glucose levels.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How would once-weekly insulin be used?<\/h3>\n\n\n\n<p>Once-weekly insulin is meant to take the place of a once-daily long-acting shot. It could make a difference for people\u2019s quality of life \u201cto have to take one less shot a day,\u201d Young says. But the key thing is going to be \u201cmaking sure that it\u2019s the right dose,\u201d she says. With a once-daily shot, if the dose is too high, \u201cit\u2019s a lot easier to deal with hypoglycemia for that period of time versus the whole entire week.\u201d<\/p>\n\n\n\n<p>In the clinical trials of the two weekly formulations, there were more episodes of <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(23)02179-7\/fulltext\" target=\"_blank\" rel=\"noopener\">severe hypoglycemia in participants with type 1 diabetes<\/a> taking once-weekly insulin compared with those taking once-daily. This wasn\u2019t an issue with trials of participants with type 2 diabetes.<\/p>\n\n\n\n<p>People with type 2 diabetes \u201cstill make a little bit of their own insulin,\u201d Young says, and \u201cfor the most part, have lower variability in their blood sugar\u201d than people with type 1 diabetes. That may reduce the risk of ending up with hypoglycemia. Weekly insulin \u201cis certainly promising\u201d for type 2 diabetes, she says. For type 1, \u201cI think they\u2019re going to have to show some more data and be a little more precise\u201d about which people with type 1 might benefit, she says, in terms of their blood sugar variability and other factors.<\/p>\n\n\n\n<p>It\u2019s harder to make needed adjustments \u201cwhen you\u2019re committing to a medication that is injected once a week,\u201d Romeo says. \u201cI think people with type 1 need a system level of fine-tuning on a day-to-day basis that makes the weekly insulin possibly not the best option in general.\u201d<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What other health care improvement would help people manage diabetes?<\/h3>\n\n\n\n<p>\u201cAffordability of continuous glucose monitoring systems is really key,\u201d Romeo says, to help broaden access to these devices. Continuous glucose monitors read blood sugar levels 24 hours a day via a sensor placed under the skin. Without this technology, people test for glucose by pricking the finger for drops of blood multiple times a day. The use of continuous glucose monitors to manage diabetes can <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7901259\/\" target=\"_blank\" rel=\"noopener\">reduce hospitalizations<\/a> and <a href=\"https:\/\/academic.oup.com\/jcem\/article\/103\/3\/1224\/4801237?login=false\" target=\"_blank\" rel=\"noopener\">improve the quality of life<\/a> for those on intensive insulin schedules. But it can be difficult to meet the <a href=\"https:\/\/www.frontiersin.org\/journals\/endocrinology\/articles\/10.3389\/fendo.2023.1083145\/full\" target=\"_blank\" rel=\"noopener\">eligibility requirements insurance companies impose<\/a> to get coverage for the devices, which could cost several thousand dollars out-of-pocket.<\/p>\n\n\n\n<p>Young wishes more people had access to and took advantage of <a href=\"https:\/\/www.cdc.gov\/diabetes\/education-support-programs\/index.html\" target=\"_blank\" rel=\"noopener\">diabetes education<\/a>, which includes how to monitor blood sugar, how to inject insulin, understanding the impact of activity and different foods on blood glucose and more. A study published in 2022 found that <a href=\"https:\/\/journals.sagepub.com\/doi\/10.1177\/26350106211065378\" target=\"_blank\" rel=\"noopener\">only half of adults with diabetes reported receiving diabetes education<\/a>. Those who did were <a href=\"https:\/\/www.cdc.gov\/diabetes\/data-research\/research\/diabetes-education.html\" target=\"_blank\" rel=\"noopener\">more likely to take steps to manage their diabetes and get clinical care<\/a> than those who didn\u2019t. Diabetes education \u201cseems a little old-fashioned,\u201d Young says, \u201cbut it\u2019s really important.\u201d<\/p>\n\n\n\n\t\t\t<\/div>\r\n<br>\r\n<br><a href=\"https:\/\/www.sciencenews.org\/article\/diabetes-blood-sugar-insulin-weekly\">Source link <\/a>","protected":false},"excerpt":{"rendered":"<p>Life with diabetes usually includes many injections of the blood sugar\u2013controlling hormone insulin. Recent research investigating a once-weekly shot finds it might help lessen the burden a bit for some with the disease. Two pharmaceutical companies have developed weekly insulin formulations and have tested the drugs in late-stage clinical trials. This September, in the New [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":159071,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","fifu_image_url":"https:\/\/i0.wp.com\/www.sciencenews.org\/wp-content\/uploads\/2024\/10\/101524_ac_weekly-insulin_feat.jpg?fit=800%2C450&ssl=1","fifu_image_alt":"","footnotes":""},"categories":[606],"tags":[4537,4262,124248,23098],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/159070"}],"collection":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/comments?post=159070"}],"version-history":[{"count":1,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/159070\/revisions"}],"predecessor-version":[{"id":159072,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/159070\/revisions\/159072"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/media\/159071"}],"wp:attachment":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/media?parent=159070"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/categories?post=159070"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/tags?post=159070"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}