{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:12:36Z","timestamp":1788469956465,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Once\u2010weekly insulin efsitora is a novel basal insulin designed to maintain glycaemic control with fewer injections, potentially improving adherence. Data on its efficacy and safety remain scarce. This systematic review and meta\u2010analysis analysed randomized controlled trials (RCTs) comparing the efficacy and safety of once\u2010weekly efsitora versus once\u2010daily basal insulin in adults with type 2 diabetes mellitus (T2D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      PubMed, Embase, and Scopus databases were searched up to July 6, 2025 to identify RCTs comparing once\u2010weekly efsitora with once\u2010daily basal insulin for T2D. Primary outcomes included changes in glycated haemoglobin (HbA1c), changes in fasting plasma glucose, change in total weekly insulin dose, and HbA1c target achievement. Statistical analyses were performed using Review Manager (RevMan) version 5.4, employing a random\u2010effects model to pool mean differences (MDs) and 95% confidence intervals (CIs), with heterogeneity assessed using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven RCTs involving 4170 participants were analysed (2347 on efsitora and 1877 on once\u2010daily insulin). At 26\u2009weeks, HbA1c reduction was similar between groups (mean difference (MD) \u20130.02%; (\u22120.11 to 0.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.74)). At 52\u2009weeks, efsitora achieved statistically significant greater reduction in HbA1c (MD \u20130.12%; \u22120.20 to \u22120.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and was associated with a lower change in total weekly insulin dose (MD \u221230.55, (\u221246.48 to \u221214.52;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0002)). Time in the target glucose range showed a non\u2010significant numerical increase (MD: 1.72 (95% CI: \u22120.10 to 3.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06)), while time above range decreased (MD: \u20132.13 (95% CI: \u22124.01 to \u22120.25;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03)). Hypoglycaemia, serious adverse events, injection\u2010site reactions, and hypersensitivity events were comparable across groups, although a numerically, non\u2010significant increase in major adverse events with efsitora was noted, with an odds ratio of 1.22 (95% CI: 0.97\u20131.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.09).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Once\u2010weekly insulin efsitora demonstrated comparable glycaemic efficacy and superiority in reduction of HbA1c and change in total weekly insulin dose at 52\u2009weeks, while maintaining an acceptable safety profile. Longer\u2010term studies and real\u2010world data are warranted to further confirm sustained efficacy, safety, and cost\u2010effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70399","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:11:19Z","timestamp":1768810279000},"page":"2138-2148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of once\u2010weekly insulin efsitora versus once\u2010daily basal insulin in type 2 diabetes: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9950-0346","authenticated-orcid":false,"given":"Mariam","family":"Akmal","sequence":"first","affiliation":[{"name":"Lahore Medical and Dental College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1641-3899","authenticated-orcid":false,"given":"Sheharyar","family":"Tariq","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsan","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulraiz","family":"Gulzar","sequence":"additional","affiliation":[{"name":"Khawaja Muhammad Safdar Medical College  Sialkot Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumaisa","family":"Riaz","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleena","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furqan","family":"Sethi","sequence":"additional","affiliation":[{"name":"Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areeba","family":"Akmal","sequence":"additional","affiliation":[{"name":"Nawaz Sharif Medical College University of Gujrat  Gujrat Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannat","family":"Fatima","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9320-1228","authenticated-orcid":false,"given":"Minahil","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Allama Iqbal Medical College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9236-0822","authenticated-orcid":false,"given":"Sufyan","family":"Shahid","sequence":"additional","affiliation":[{"name":"Khawaja Muhammad Safdar Medical College  Sialkot 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