824-P: No Evidence of Increased Physical Activity–Related Hypoglycemia with Once-Weekly Insulin Icodec vs. Once-Daily Basal Insulin in Type 1 Diabetes—ONWARDS 6

Introduction & Objective: ONWARDS 6 compared the efficacy and safety of once-weekly insulin icodec (icodec) and once-daily insulin degludec (degludec) in adults with T1D. This post hoc analysis examined physical activity-related hypoglycemia in ONWARDS 6.

Methods: During the trial, participants experiencing hypoglycemic episodes were asked to indicate any relationship to physical activity in a digital diary. Overall hypoglycemia rate was also assessed based on baseline physical activity level recorded using the International Physical Activity Questionnaire.

Results: The proportion of physical activity-related hypoglycemic episodes relative to overall hypoglycemic episodes was similar or lower for icodec vs degludec (Figure A); odds of having physical activity-related level 2 or level 3 hypoglycemia were similar between groups (OR: 1.04; 95% CI: 0.75-1.46; p = 0.8060). Most physical activity-related level 2 or level 3 hypoglycemic episodes did not lead to further hypoglycemic episodes within 24 hrs in either group (Figure B). Overall hypoglycemia rates (including those unrelated to physical activity) were comparable within each group regardless of baseline physical activity level (data not shown).

Conclusion: There was no evidence of increased risk of physical activity-related hypoglycemic episodes with icodec versus degludec in adults with T1D.

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