Daily basal insulin injections pose a significant treatment burden in type 2 diabetes. This study was presented at the European Association for the Study of Diabetes Congress 2025. In a 78-week, open-label, parallel-design Phase 3 trial, 986 adults with type 2 diabetes (HbA1c 6.5–10%) on basal insulin were randomized 2:1 to receive once-weekly efsitora alfa or daily degludec. Doses were titrated to fasting blood glucose targets of 80–120 mg/dL.

At week 26, efsitora demonstrated noninferior HbA1c reduction compared to degludec (−0.81% vs −0.72%; estimated treatment difference −0.09%; 95% CI −0.19 to 0.01). Percent time in range (70–180 mg/dL) increased by approximately 2 hours in both groups, reaching 62.8% for efsitora and 61.3% for degludec. Rates of combined clinically significant or severe hypoglycaemia were low and comparable between arms (0.84 vs 0.74 events per patient-year). Serious adverse events occurred slightly more often with efsitora (15.7% vs 11.2%), with angina unstable most frequent in the efsitora group.

These findings indicate that once-weekly efsitora provides comparable glycaemic efficacy, improved time in range, and low hypoglycaemia risk, offering a convenient alternative to daily basal insulin therapy.