Reducing injection frequency can significantly improve treatment adherence and patient satisfaction in type 2 diabetes. This phase 2 trial of the novel once-weekly insulin analogue GZR4 was presented at the European Association for the Study of Diabetes 2025 (EASD 2025).

Eighty-three insulin-naïve participants with HbA1c between 7.5% and 10% were randomized 1:1 to GZR4 or once-daily insulin degludec for 16 weeks in an open-label, treat-to-target design. The primary endpoint was the change in HbA1c from baseline.

Results showed that GZR4 achieved comparable glycemic control to degludec, with HbA1c reductions of −1.50% versus −1.48% (p = 0.902). Fasting plasma glucose reductions and target achievement rates were similar. Notably, GZR4 required half the weekly insulin dose at steady state (80.6 vs 165.8 units, p<0.001). Adverse events were mild and comparable across groups, with low rates of level 2 hypoglycaemia and no serious adverse events related to GZR4.

These findings support GZR4 as a promising once-weekly basal insulin, offering effective glycemic control with a lower treatment burden.