Denmark’s Novo Nordisk, the world’s largest insulin seller, is betting on a new way to stay ahead in the $40 billion-plus diabetes market by trying to develop the world’s first once-weekly insulin injection.

Almost 592 million people are expected to live with diabetes by 2035, up 55 percent from last year’s level, according to the International Diabetes Federation. Most will have type 2 diabetes, which is linked to obesity and lack of exercise.

This new product is based on super-long acting insulin known as LAI287. It is currently starting its Phase I clinical trials and could be on the market by 2020. This ambitious project remains risky because the research is still early stage. But Chief Science Officer Mads Krogsgaard Thomsen thinks it could be an opportunity for people who wish to use less needles.

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It could work well for patients at the beginning of their illness, when the pancreas is still able to produce some insulin by itself, and who are not as dose-dependent as they will be later when the pancreas completely stops production. A key issue for the ongoing clinical tests is whether LAI287 might push sugar levels dangerously low.

“We must examine whether diabetics will have the same low risk of hypoglycemia as with other insulins or whether the risk is increased because the drug works over a longer period,” Thomsen said.

Novo Nordisk currently has a leading 47 percent share of the insulin drug market but it faces challenges. Only one other company in the world, California-based AntriaBio, is working on a once-a-week version of insulin due to the complexity involved in its development. But Novo Nordisk has the advantage to be specialized in the diabete since 90 years. Eli Lilly, main competitor of Novo Nordisk, might also work secretly on a similar product.

Novo Nordisk is also working on an oral version of insulin and have to decide whether to start Phase II clinical trials in 2015, while another project to make the first pill version of a different kind of diabetes medicine, known as a GLP-1 drug, is expected to report Phase II results early in 2015.

“The goal is to offer patients more options and build as broad a portfolio within diabetes as possible,” said Thomsen.

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