A once-weekly insulin injection is an exciting development in diabetes care, but is it automatically better for everyone? That’s the question we asked experts as Danish drugmaker Novo Nordisk (NOVOb.CO) recently launched its weekly basal insulin injection, Awiqli, in India.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
“The arrival of once-weekly basal insulin is one of the most meaningful advances in insulin therapy for people with type 2 diabetes. It is not just about reducing injections from 365 a year to only 52. It is about making treatment simpler, less intimidating, and easier to follow over the long-term,” said Dr Rajiv Kovil, diabetes and obesity specialist, Zandra Healthcare.
The biggest advantage is convenience. “Instead of remembering a daily injection, a person only needs one injection a week. This may make treatment easier to follow, especially for those who struggle with missed doses,” Dr Vijay Negalur, HoD diabetology, KIMS Hospitals, Thane.
Notably, the ONWARDS clinical programme (a series of six global Phase 3a trials by Novo Nordisk) tests insulin icodec, a long-acting basal insulin taken once a week instead of daily. It involves over 4,000 adults with type 1 or type 2 diabetes) has shown that once-weekly insulin icodec (Awiqli) delivers an HbA1c reduction comparable to, and in some studies slightly better than, once-daily basal insulin, while maintaining an overall similar safety profile. “This means patients do not have to compromise on glucose control to gain convenience,” described Dr Kovil.
However, convenience is just one part of the picture. The main goal of insulin therapy is to achieve good blood sugar control. Dr Negalur said that some people need the flexibility of daily insulin, where doses can be adjusted more frequently based on blood sugar readings, meals, activity levels, or illness. “For them, daily injections may still be the better option,” said Dr Negalur.
Dr Kovil noted that many people with type 2 diabetes delay insulin because they fear daily injections or struggle to remain consistent. “Simplifying treatment improves acceptance, adherence, and persistence, three factors that are just as important as the medicine itself. Better compliance often translates into better long-term outcomes,” said Dr Kovil.
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What should you consider? (Photo: Getty Images/Thinkstock)
Once-weekly insulin is designed to release slowly and work over several days. “Early studies have shown that it can provide blood sugar control similar to daily long-acting insulin for many adults with type 2 diabetes. That said, doctors still need to consider factors like age, kidney function, risk of low blood sugar, other medications being taken, and how stable a person’s diabetes is before deciding which option is best,” said Dr Negalur.
Dr Kovil suggested that for patients who are already using a once-daily basal insulin such as glargine or degludec and are otherwise appropriate candidates, switching to once-weekly insulin can be considered under medical supervision, and the best part is that convenience comes with no extra cost.
Experts urge that for someone who has trouble remembering daily injections, travels often, or finds the routine burdensome, a weekly injection could significantly improve quality of life. “On the other hand, a person whose insulin needs change frequently may benefit more from the precision that daily dosing provides,” said Dr Negalur.
However, patients should also understand that a weekly insulin shot does not replace healthy habits. “Regular exercise, a balanced diet, weight management, and monitoring blood sugar remain important,” said Dr Negalur.
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So, the question is not which option is best for everyone, but which option is best for a specific patient. “The right choice should come after a detailed discussion with the treating doctor, considering blood sugar patterns, lifestyle, and long-term diabetes goals,” said Dr Negalur.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
