A weekly insulin injection will soon become available in Canada, which doctors say will “make life easier” for people living with diabetes and is an “exciting” treatment to have in the toolbox.
Starting June 30, Canada will become the first country to make the medication, called insulin icodec, available, drug manufacturer Novo Nordisk announced on Monday.
The medication, which will be sold under the brand name Awiqli, was approved by Health Canada in March for the treatment of adults with Type 1 and Type 2 diabetes.
“I think it’s a real convenience,” said Daniel Drucker, a professor of medicine at the University of Toronto and senior scientist at Sinai Health’s Lunenfeld-Tanenbaum Research Institute.
“We know that many people with Type 2 diabetes often have to treat cholesterol, they often have to treat high blood pressure in addition to their blood sugar, so having less burden in terms of number of days that you need to take your medicine is clearly an improvement in quality of life, and it’s more convenient,” he told Global News in an interview.
More than 11 million Canadians are living with diabetes or prediabetes, according to Diabetes Canada.
Diabetes is a chronic disease that occurs when the body is unable to produce or properly use insulin – a hormone that controls blood sugar levels.
Type 2 diabetes is more common, accounting for more than 90 per cent of total diabetes cases in Canada.
What is Awiqli?
Awiqli is a long-acting basal insulin that is injected once a week.
The drug helps control high blood sugar levels in adults with diabetes over a seven-day period as opposed to the daily basal insulin option.
The pre-filled pen can provide a dose of 10-700 units in one injection in increments of 10 units, according to Novo Nordisk.
For Type 2 diabetes patients, Awiqli may be used along with other tablets or injections, including short- or rapid-acting insulins.
For Type 1 diabetes patients, who are more insulin-dependent, Awiqli must be used in regimens containing rapid-acting or short-acting insulin to cover mealtime insulin requirements, the drug manufacturer says in a product monograph.
This medicine does not replace the mealtime insulin, but is another option instead of the daily background insulin that patients take, said Jeremy Gilbert, an endocrinologist at Sunnybrook Health Sciences Centre in Toronto.
How will this drug help diabetes patients?
The main advantage of weekly insulin is the convenience, experts say.
Taking one basal insulin injection per week rather than seven in a week makes adhering to this new regime “more convenient” and “user-friendly,” Gilbert said, especially for people who need help taking their insulin daily.
While the drug extends the length of time that the basal insulin acts, it does not necessarily mean that it will improve disease outcomes compared with other treatments, Drucker said.
The series of randomized clinical trials for Awiqli — which included many countries, such as Canada and the U.S. — were mostly done with Type 2 patients.
Only one of the trials involved patients with Type 1 diabetes and it found a higher risk of low blood sugar when those patients took the weekly insulin option.
The U.S. Food and Drug Administration has not approved Awiqli. Its endocrinology and metabolic drugs advisory committee concluded in May that more information is needed about the use of the weekly insulin in Type 1 diabetes patients.
Can children use it?
Health Canada has not approved Awiqli for children and adolescents under 18 years since the drug has not been studied in that age group.
Gilbert said expanding the medicine’s use for the pediatric population, older adults and pregnant people could be “very useful” down the road.
Awiqli should also not be used during pregnancy and breastfeeding, Novo Nordisk says.
What are the side effects?
The side effects of this drug are not any different from other types of insulin, experts say.
Clinical data showed that low blood sugar, known as hypoglycemia, was the most common adverse reaction in patients.
Other possible side effects include allergic reactions, skin problems where the injection is given, weight gain, swelling of the ankles and feet and the forming of anti-insulin antibodies.
— with files from The Canadian Press.
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