Reducing injection frequency remains a key strategy to improve adherence and treatment acceptance in type 2 diabetes. A recent phase 2 trial investigated the efficacy and safety of a novel once-weekly insulin analogue, GZR4, compared with once-daily insulin degludec in basal insulin-treated participants inadequately controlled on oral antidiabetic drugs.

In this open-label, treat-to-target study, 96 participants with HbA1c between 7.5 and 10% were randomized 1:1 to GZR4 or degludec for 16 weeks. The primary endpoint was change in HbA1c from baseline.
Results showed that GZR4 achieved a significantly greater HbA1c reduction than degludec (−1.26% vs −0.87%, p<0.01), with a higher proportion of participants reaching HbA1c <7%. GZR4 was administered at a substantially lower weekly insulin dose (88.7 vs 218.2 units, p<0.001). Treatment-emergent adverse events were similar between groups, although a slightly higher rate of level 2 hypoglycemia was observed with GZR4.

These findings highlight GZR4 as a promising once-weekly basal insulin, offering superior glycemic control and lower injection burden while maintaining an acceptable safety profile.