Simplified Switching to Once-Weekly Insulin Icodec Without an Initial One-Time Additional Dose Versus Once-Daily Insulin Glargine U100 in Basal Insulin-Treated Type 2 Diabetes (ONWARDS 10): A Randomised Controlled Trial.
Diabetes Obes MetabMay 21, 2026 (epub)
Julio Rosenstock, Chantal Mathieu, Joshua Buron Feinberg et al.
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In 30 seconds
The ONWARDS 10 trial evaluated the switch from daily insulin glargine U100 to once-weekly insulin icodec without an initial additional dose in adults with type 2 diabetes. This randomized controlled trial demonstrated non-inferiority in HbA1c reduction, with icodec achieving a mean HbA1c of 7.2% compared to 7.5% for glargine U100 at 26 weeks (ETD: -0.2%-points).
Key findings
- At week 26, HbA1c was 7.2% with icodec and 7.5% with glargine U100, confirming non-inferiority.
- Change in time in range was significantly higher with icodec (18.0%-points) compared to glargine U100 (12.1%-points).
- The rate of combined clinically significant or severe hypoglycaemia was lower with icodec (0.45 vs 0.59 episodes per patient-year).
Why it matters
This study highlights a simplified approach to switching insulin regimens in type 2 diabetes, potentially improving patient adherence and glycaemic control without increasing hypoglycaemia risk.