2852-LB: Efficacy and Safety of Insulin Glargine 300 U/mL (Gla-300) vs. Insulin Icodec in People with Type 2 Diabetes (PWT2D): A Systematic Literature Review and Network Meta-analysis

Introduction and Objective: No head-to-head studies compare daily Gla-300 vs weekly insulin Icodec. This analysis compared these two basal insulins in insulin-naïve PWT2D on OADs. Methods: MEDLINE®, Embase, and CENTRAL databases were searched on July 3, 2025 for RCTs evaluating once-daily Gla-300 or once-weekly Icodec in insulin-naïve PWT2D. Treatment effects at ~6 months were estimated using Bayesian and frequentist models. Results: Five RCTs (n=3,246; Gla-300 n=2,411; Icodec n=835) with comparable baseline characteristics were included (Table). Gla-300 was consistently associated with lower risk and event rates of 24-hour hypoglycemia vs Icodec, including level 1, level 2, and combined level 2/3 hypoglycemia. No significant differences were observed for level 3 hypoglycemia. Glycemic outcomes were generally similar, with no significant differences in HbA1c or body weight change. Gla-300 patients were less likely to attain HbA1c <7%, and FPG reduction was smaller vs Icodec; final daily insulin dose (U/day) was higher, with no difference per U/kg. Non-hypoglycemia safety outcomes were comparable. Frequentist analyses were broadly concordant (data not shown). Conclusion: In insulin-naïve PWT2D on OADs, Gla-300 was associated with lower level 1 and 2 hypoglycemia risk vs Icodec, with broadly comparable glycemic measures and overall safety at ~6 months. Disclosure R. Ritzel: Other - Advisory board/speaker bureau/honoraria; Current; Novo Nordisk, Sanofi, Merck & Co., Inc., AstraZeneca, Lilly, Novartis Pharmaceuticals Corporation, Pfizer Inc. F. Gomez-Peralta: Research Support; Ended; Abbott Diabetes, Novo Nordisk. Research Support; Current; Eli Lilly and Company. Speaker's Bureau; Ended; AstraZeneca. Advisory Panel; Current; Insulcloud SL, Sanofi. Speaker's Bureau; Ended; Sanofi. R. Napoli: None. A. Ratzki-Leewing: Advisory Panel; Current; Sanofi. Consultant; Current; Vertex Pharmaceuticals Incorporated, Dexcom, Inc. Research Support; Current; Sanofi. Other - Paid presentation; Ended; Abbott. Consultant; Current; Sanofi. M. N. Mabunay: Employee; Current; Sanofi. M. Szigeti: Employee; Current; Sanofi. S. Sanyal: Employee; Current; Sanofi. A. Alvarez: Employee; Current; Sanofi. V. Wan: Consultant; Current; Sanofi. F. Giorgino: Advisory Panel; Current; Abbott. Consultant; Current; Lilly, Novo Nordisk. Advisory Panel; Current; AstraZeneca, Medtronic. Research Support; Current; Roche Diabetes Care. Advisory Panel; Current; LifeScan, Sanofi. Advisory Panel; Ended; Merck Sharp & Dohme Corp. Advisory Panel; Current; Boehringer Ingelheim International GmbH. Funding This study was funded by Sanofi