Efficacy and Safety of Once-Weekly Insulin Icodec vs. Once-Daily Basal Insulin in Individuals with Type 2 Diabetes by Kidney Function—ONWARDS 1–5
Bibliographic record
Abstract
Introduction & objective : This post hoc analysis assessed the efficacy and safety of once-weekly insulin icodec (icodec) vs once-daily (OD) basal insulin in insulin-naive (ONWARDS 1, 3, 5) and insulin-experienced (ONWARDS 2, 4) adults with T2D by kidney function subgroup. Methods : Treatment outcomes were analyzed by kidney function subgroup (eGFR≥90; eGFR≥60 -<90; eGFR≥30-<60; eGFR<30; all mL/min/1.73m2). Results : In ONWARDS 1, 3, and 5, there were no statistically significant treatment by kidney function subgroup interactions for change in A1C from baseline to planned end of treatment (EOT); however, in ONWARDS 2 and 4, there were significant subgroup interactions with higher A1c in the icodec group in patients with mild renal impairment, but not for normal kidney function or moderate renal impairment. No trend for heterogeneity was observed by kidney function sub-group for overall rates of clinically significant or severe hypoglycemia. Across kidney function subgroups, the proportion of participants achieving A1C<7% without clinically significant or severe hypoglycemic episodes at EOT was similar or higher for icodec vs comparators. Additionally, there were no statistically significant differences in average weekly insulin doses for icodec vs OD comparators by kidney function subgroup during the last 2 weeks of treatment in ONWARDS 1-5. Conclusion : Overall, the efficacy and safety for once-weekly icodec vs OD comparators was consistent, with no trend across kidney function subgroups. Publication History Article published online: 28 May 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".