No Evidence of Increased Physical Activity–Related Hypoglycemia with Once-Weekly Insulin Icodec vs. Once-Daily Basal Insulin in Type 2 Diabetes—ONWARDS 1–5
Bibliographic record
Abstract
Introduction & Objective : The ONWARDS (ON) phase 3a trials showed the efficacy and safety of once-weekly (OW) basal insulin icodec (icodec) vs once-daily (OD) basal insulin comparators. This post hoc analysis examined physical activity (PA)-related hypoglycemia (measured by BG), based on self-reported data, in adults with T2D in ON 1-5. Methods : Hypoglycemia occurrence was evaluated in insulin-naive (ON 1, 3, 5) and insulin-treated (ON 2, 4) adults with T2D receiving icodec vs OD comparators. In each trial, participants who experienced hypoglycemic episodes were instructed to note any relation to PA in a digital diary. Results : The number of PA-related level 2 or level 3 hypoglycemic episodes was low in all trials, except ON 4 (basal-bolus trial). The proportion of hypoglycemic episodes that were related to PA trended higher or was comparable with icodec vs OD comparators in insulin-naive T2D and trended lower or was comparable in insulin-experienced T2D. There were no statistically significant differences in the odds of experiencing a PA-related level 2 or level 3 hypoglycemia for icodec vs OD comparators. Conclusion : The incidence of PA-related level 2 or level 3 hypoglycemia in T2D was low in these trials of basal insulins and was not worsened by treatment with icodec vs OD basal insulin comparators. Despite some uncertainty due to low incidences, these data are reassuring. 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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 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".