Hospitalization outcomes in adults with type 2 diabetes mellitus treated with once-weekly insulin efsitora versus once-daily basal insulins: A post hoc analysis of the QWINT-1 to -4 randomized trials
In brief
About 27% stopped weekly efsitora, versus 16% on daily insulin
In a post hoc analysis pooling four trials, hospitalization rates were 9.2% with weekly efsitora and 7.1% with daily basal insulin, while median hospital stays were 5 days in both groups. Blood sugar and hypoglycemia measures were similar around hospitalization, but permanent treatment discontinuation, primarily due to adverse events, was higher with efsitora; the exploratory findings need cautious interpretation.
- Journal
- Diabetes research and clinical practice (Q1)
- Published
- 3 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Athena Philis-Tsimikas, Rodolfo J Galindo, Bruno Guerci, Rebecca J Threlkeld, Bellina Mushala, C P Shyam, et al.
- PMID
- 42829184
- DOI
- 10.1016/j.diabres.2026.113586
Why clinicians should know about it
- Picked for Internal Medicine (top studies of the week, 1 November 2026): Hospitalization outcomes with weekly insulin efsitora
Abstract
AIMS: To describe hospitalization and associated outcomes using pooled data from QWINT-1-4 trial participants. METHODS: The multicenter, open-label, treat-to-target phase 3 QWINT-1 through QWINT-4 clinical trial program randomized adults with type 2 diabetes mellitus (T2D) toonce-weekly insulin efsitora alfa (efsitora)versus once-daily basal insulin comparators (insulin glargine: QWINT-1, QWINT-4; insulin degludec: QWINT-2, QWINT-3). This exploratory, post hoc analysis pooled data from QWINT-1-4 trials of participants receiving once-weekly efsitora(N = 1883) or once-daily basal insulin comparators (comparators, N = 1556). Unadjusted summary statistics by treatment group are reported for hospitalization incidence, duration of hospital stay, treatment discontinuation, glycated hemoglobin (HbA1c), insulin doses, and hypoglycemia rates. RESULTS: Overall, 173 (9.2 %) participants receiving once-weekly efsitora and 110 (7.1 %) receiving once-daily comparators (p = 0.17) were hospitalized. The duration of hospital stay was numerically similar for participants receiving efsitora (median 5.0 days) or comparators (median 5.0 days). Permanent treatment discontinuation, primarily driven by adverse events, was more frequent among efsitora-treated (26.6 %) than comparator-treated (16.4 %) participants (p = 0.03). Mean HbA1c, insulin doses, and hypoglycemia rates before and after hospitalization were numerically similar in both groups. CONCLUSIONS: Once-weekly efsitora or once-daily insulin treatment does not appear to impact duration of hospitalization or glycemic parameters before or after hospitalization. CLINICALTRIALS: govidentifiers: NCT05662332 (QWINT-1), NCT05362058 (QWINT-2), NCT05275400 (QWINT-3), NCT05462756 (QWINT-4).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.