FUDiabetes

Once weekly long-acting insulin?

Novo Nordisk just completed a Phase II of this new insulin. Seems like a cool option if it passes Phase III trials. I can imagine this giving a little peace of mind to parents of forgetful teenagers, for instance…

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One issue I see with that is the easy potential to forget something if you only do it once a week (would probably need to both set phone reminders and also tie it into some other ritual to be safest), but for something that long-acting, I’m guessing there would be lots of flexibility re dosing timing, which is nice. Also I would imagine there would be little to no flexibility to adjust for activity levels (I already see that as a Tresiba user), so most teenagers might be the exact wrong audience, vs adults with very stable schedules, unless you use this for an untethered pump approach or something with MDI, where you have a background dose of minimum basal with the weekly shot to prevent DKA and then supplement with Levemir or such for adjustability.

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Yeah I was imagining this as mainly a thing that keeps you out of DKA. You don’t get the full amount of basal you need – just enough to prevent a hospital trip. And then you can use a pump for the rest of the time.

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The funny part is the company creating the insulin probably doesn’t understand how actual diabetics would use this. Their financial projections are probably based on people using it for 100%.

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I think for a lot of T2s, that’s how they would use it (100% of their insulin, possibly without short-acting), and there are way way more T2s than T1s, and they generally take much bigger doses, so that’s probably where the most profits are anyway.

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The ridiculous thing about this is that we started with basal’s that lasted 8 hours. Then 12. Then 18. Then 40 hours. Now a basal that lasts a week. Great.

But how about making a bolus insulin that does NOT last 4 hours?!?

How about that, Novo? Lilly?

:man_shrugging:

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Fiasp only lasts three hours for me. And only an hour and a half to two hours if I do an IM injection, but those are hard for me to get right, so I often don’t get that benefit when I try them. I’m excited to try the new ultra rapid-acting Lilly insulin whenever it comes to Canada, as I’ve read it may be slightly faster even than Fiasp. Also, I think Afrezza only has a very short tail of perhaps an hour or so, based on what I’ve read.

I think it must be harder to make an insulin with a short tail than to make an insulin with a super long tail.

I, personally, think a week-long basal would be near-useless for anything other than untethered pumping, at least for me. Tresiba was far too long-acting and not adjustable for me. I like Levemir, and if I were to ever stop pumping, that’s what I’d use. For untethered pumping, though, Tresiba is great, and this insulin would be even better. I could also see this being very useful for people with Type 2 who just take some background level of insulin to supplement what their pancreas makes.

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@Jen,
I agree with all your points.

Yep. :+1:

Yep. :+1:

Yes, me too!

Yes, it is a little shorter. But it is not that significant. I mean, 3 versus 4 hours, or whatever.

The idea of having IOB from a bolus and stacking. I’d love to be able to remove that whole thing with a pump insulin.

And yes, it can be shortened with IM or IV. And Afrezza is short, but it also does not give you very precise and granular dosing. It has that 4, 8, 12 dose thing.

But doing insulin that has only 1 hour of duration and that can be used with a pump! That would really be the thing.

I just wish they would focus on something like that!

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Yes, this would be ideal for a pump. Even for people using injections, if they wanted to correct highs.

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It only lasts about 3 hours for me as well. Sometimes I think it lasts less than that but I’m still learning.

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They’re working on it! (New study for very rapid acting insulin which takes full action within 10 minutes and is completely finished within 2 hours…although I know that since you [in particular] are accustomed to doing both IM and IV shots are already onto this “method” of insulin action.)

(PS: I can’t remember which thread refers to this study, but trust me, its been recently posted)

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It seems to me, and please correct me if I am off base here, that there is a greater amount of money put into the research and treatments for T2 Ds bc there are so many more than T1Ds out there, and the pharmaceutical companies are going where the money leads them.There is a greater profit margin in producing meds for T2 Ds.

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You are correct, 90% of diabetics are Type 2. There are approximately 34 million diabetics in the US. So 30.6 million Type 2’s and only 3.4 million Type 1’s.

In addition to the size issue, Type 2 has many more opportunities to try and develop a successful treatment, you could delay the onset of the use of insulin, you could address insulin resistance, etc.

So I think it is a combination of where the money is, but also that is where the pharmaceutical opportunity lies to improve the disease progress and quality of life. Honestly, for Type 1’s without insulin resistance, there just aren’t as many pathways to improve your treatment and outcomes. Unless of course we are speaking of the holy grail which is the cure that elusively remains 5 years away at all times.

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This is remarkable. I always knew that there were many many more T2s but I had absolutely no idea that the discrepancy was this overwhelming. WOW.

And just as an aside, I know that when searching for a really good endo to treat me for my T1 D, it was much more difficult to find one; most endos (I think) are apt to treat T2Ds than having/wanting to “deal with” the treatment of T1s. Please correct me if I am off base here.

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Also, I did note that you said “approximately,” but I was also thinking about all the potential T2s that are unaware of their condition and are therefore undiagnosed and reported.

(as it seems that the physical conditions for diagnosing T1Ds can be much more severe and obvious, at least enough to get them to see a medical professional compared to the T2Ds out there that seem rather asymptomatic.)

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There are also many diseases that endo’s treat that have nothing to do with diabetes.
i.e.

  • Osteoporosis.
  • Thyroid Cancer.
  • Addison’s Disease.
  • Cushing’s Syndrome.
  • Graves’ Disease.
  • Hashimoto’s Thyroiditis.

So finding one that really gets Type 1’s isn’t as easy as you would imagine, and of course have found out.

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Approximately 20% of the 34 million Type 2’s don’t know they have it. i.e. 7 million or so.

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I was on the same page as you here; I responded a few seconds too late, and if you look upwards to my other post, you’ll see.

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Totally!

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I also have Graves Disease, for which I underwent many years of treatment, terrible medications (Prednisone, Innositol, Percodan,and more) as well as having to have radiation treatment for a year. It was miserable. I had bulging eye syndrome (think Barbara Bush) and was not able to see without Prism Lenses in my eye glasses. It was terribly painful and I was unable to hold down food and was emaciated (kind of like before my D dx)

Finally after 2 years, I went into remission, and I was able to have corrective eye surgeries and now I merely take a pill each morning for it. (I was, however in and out of remission about 4 times over the years)

But as you pointed out, this was my introduction into living tethered to an Endo.

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