Current guidelines support incorporating GLP-1 receptor agonists into basal insulin-based treatment to achieve better glycemic control while limiting weight gain and hypoglycemia risk. Based on this approach, a phase 3b trial compared the efficacy and safety of IcoSema, a once-weekly combination of basal insulin icodec and semaglutide, with insulin glargine U100 in individuals with type 2 diabetes (T2D) receiving oral glucose-lowering medications. In the 40-week study conducted across 97 sites in nine countries, 243 patients were randomized to IcoSema and 242 to glargine U100, with a median age of 58 years.

IcoSema produced a greater reduction in HbA1c than glargine U100, with mean changes of −3.32 versus −2.44 percentage points from baseline values of 9.57% and 9.50%, respectively. Mean bodyweight decreased by 0.79 kg with IcoSema and increased by 3.81 kg with glargine U100. The rate…