{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:30:26Z","timestamp":1786685426624,"version":"build-2736575974"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We conducted this network meta-analysis to compare the efficacy and safety of insulin icodec vs insulin efsitora for patients with type 2 diabetes (T2D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a comprehensive systematic search across PubMed, the Cochrane Library, and Embase up to November 11, 2025. Eligible trials compared insulin icodec and insulin efsitora against each other, placebo or other glucose-lowering drugs. Primary outcome was change in HbA1c. Secondary outcomes were change in body weight, percentage of patients achieving HbA1c &amp;lt; 7%, change in fasting plasma glucose (FPG), and safety outcomes including level 1 hypoglycemia, level 2 or level 3 hypoglycemia, adverse events (AEs), and serious adverse events (SAEs). We used version 2 of the Cochrane risk-of-bias tool to assess the risk of bias. A frequentist network meta-analysis was used to calculate the risk ratios or mean difference with corresponding 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen RCTs involving 7,402 participants were included. Insulin icodec resulted in a lower HbA1c level compared to insulin efsitora, but was associated with a higher incidence of level 1 hypoglycemia. The two treatments showed no significant differences in other outcomes, including change in body weight, percentage of patients achieving HbA1c &amp;lt;7%, change in FPG, incidence of level 2 or 3 hypoglycemia, AEs, and SAEs. Compared to daily insulins, insulin icodec led to lower HbA1c levels. Weight gain was lower with insulin glargine than with insulin icodec. A higher percentage of patients in the icodec group achieved HbA1c &amp;lt;7% compared to those receiving daily insulins. Regarding safety outcomes, insulin degludec had a lower incidence of both level 1 and level 2 or 3 hypoglycemia than the other three insulins. Insulin icodec showed a higher incidence of level 1 hypoglycemia than insulin glargine. Additionally, the incidence of AEs was higher with insulin icodec than with insulin degludec.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with T2D, once-weekly insulin icodec may provide slightly better glycaemic control than daily insulin. Insulin icodec was more effective than insulin efsitora in reducing HbA1c levels; however, this benefit was offset by a significantly higher risk of level 1 hypoglycemia. The two insulins were comparable in terms of body weight change, glycemic target achievement, FPG reduction, and safety profiles, including level 2 or 3 hypoglycemia, AEs, and SAEs. Direct head to head RCTs are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD420251177019.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1902260","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:24:22Z","timestamp":1786685062000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of insulin icodec compared with insulin efsitora in patients with type 2 diabetes: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Jingxin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junxia","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuilu","family":"Quan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajie","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"B1","unstructured":"Magliano\n              DJ\n            \n            \n              Boyko\n              E\n            \n            \n             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