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A Study Using Flash Glucose Measurements for a New Once-weekly Insulin (Insulin Icodec) in People With Type 2 Diabetes Who Have Not Used Insulin Before (ONWARDS 9)

A Study to Evaluate Flash Glucose Monitoring Based Titration of Once-weekly Insulin Icodec in Insulin-naïve Participants With Type 2 Diabetes

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05823948
Acronym
ONWARDS 9
Enrollment
51
Registered
2023-04-21
Start date
2023-04-11
Completion date
2024-04-11
Last updated
2026-04-30

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes Mellitus, Type 2

Brief summary

This study looks at how a person with type 2 diabetes can be treated with insulin icodec and a flash glucose monitor (a small sensor inserted under the skin to measure blood sugar all the time). The study will look at how well insulin icodec controls blood sugar when used in combination with a flash glucose monitor. Participants will get insulin icodec that they have to inject once a week on the same day of the week. The insulin will be injected with a needle in a skin fold in the thigh, upper arm, or stomach. The study will last for about 8 months. Participants will have to wear a flash glucose monitor throughout the study. This is a sensor that fits on arm. Participants will be asked to use a commercially available app called LibreView to allow team to view flash glucose monitor data. Participants will get a study phone to scan the flash glucose monitor 4 times daily and they will be able to see all of the flash glucose monitor data during the study. Women cannot take part if pregnant, breast-feeding or planning to get pregnant during the study period.

Interventions

DRUGInsulin Icodec

Participants will receive insulin icodec once-weekly subcutaneously into the thigh, upper arm or abdomen.

Sponsors

Novo Nordisk A/S
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Informed consent obtained before any study-related activities. Study-related activities are any procedures that are carried out as part of the study, including activities to determine suitability for the study * Age above or equal to 18 years at the time of signing informed consent * Diagnosed with type 2 diabetes (T2D) greater than or equal to (\>=) 180 days before screening * HbA1c from 7.0%-11.0% (53.0-96.7 millimoles per mole \[mmol/mol\]) both inclusive at screening confirmed by central laboratory analysis * Insulin-naïve. However, short term insulin treatment for a maximum of 14 consecutive days before screening is allowed, as is prior insulin treatment for gestational diabetes * Stable daily dose(s) \>=90 days before screening of any of the following antidiabetic drug(s) or combination regimen(s) at effective or maximum tolerated dose as judged by the investigator: 1. Any metformin formulations \>= 1500 milligrams (mg) or maximum tolerated or effective dose or 2. Any metformin combination formulations \>=1500 mg or maximum tolerated or effective dose or 3. Other antidiabetic Drugs including combination products (\>=half of the maximum approved dose according to local label or maximum tolerated or effective dose) of the classes specified below: Sulfonylureas, Meglitinides (glinides), Dipeptidyl peptidase-4 (DPP-4) inhibitors, Sodium-dependent glucose cotransporter 2 (SGLT2) inhibitors, Thiazolidinedione, Alpha-glucosidase inhibitors, Oral combination products (for the allowed individual oral antidiabetic drugs, Oral or injectable glucagon-like peptide-1 (GLP-1) receptor agonists * Intensification with basal insulin is indicated to achieve fasting glycaemic target (4.4-7.2 millimoles per liter \[mmol/L\]; 80-130 milligrams per deciliter \[mg/dL\]) at the discretion of the treating investigator * Body mass index (BMI) less than or equal to (\<=) 40.0 kilograms per meter square (kg/m\^2)

Exclusion criteria

* Unwilling or unable to avoid concomitant medication e.g., ascorbic acid (vitamin C) that can influence the flash glucose monitoring (FGM) sensor throughout the study and contraindications e.g., implanted medical devices such as pacemakers * Any episodes of diabetic ketoacidosis within 90 days before screening as declared by the participant or in the medical records * Myocardial infarction, stroke, transient ischaemic attack or hospitalisation for unstable angina pectoris within 180 days before the day of screening and between screening and initiation visits * Chronic heart failure classified as being in New York Heart Association (NYHA) Class IV at screening * Anticipated initiation or change in concomitant medications (for more than 14 consecutive days) known to affect weight or glucose metabolism (e.g., treatment with orlistat, thyroid hormones, or corticosteroids) * Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within 90 days before the day of screening or in the period between screening and initiation visits. Pharmacological pupil dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination

Design outcomes

Primary

MeasureTime frameDescription
Change in Glycosylated Haemoglobin (HbA1c)Baseline (week 0), week 26Change in HbA1c from week 0 to week 26 is presented in percentage-point.

Countries

United States

Contacts

STUDY_DIRECTORClinical Transparency (dept. 2834)

Novo Nordisk A/S

Participant flow

Recruitment details

The trial was conducted at 9 sites in United States of America.

Pre-assignment details

The trial explores the initiation and titration of once-weekly insulin icodec using intermittently scanned continuous glucose monitoring (isCGM) device system in combination with non-insulin antidiabetic drugs in insulin-naïve participants with type 2 diabetes (T2D). The trial included up to 2 weeks of screening period, a 2-week run-in period, a 26-week intervention period and a 5-week follow-up period.

Baseline characteristics

Characteristic
Age, Continuous61.27 Years
STANDARD_DEVIATION 9.9
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
46 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
2 Participants
Race (NIH/OMB)
Black or African American
4 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
44 Participants
Sex: Female, Male
Female
21 Participants
Sex: Female, Male
Male
30 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 51
other
Total, other adverse events
17 / 51
serious
Total, serious adverse events
2 / 51

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: May 1, 2026