Once-a-week insulin launched in India, but doctors say it won't replace daily shots for all

India becomes one of the first countries to get Novo Nordisk's weekly basal insulin Awiqli; experts say it offers a new treatment option rather than a replacement for conventional insulin therapy.

Nearly 104 years after daily insulin injections became the standard treatment for diabetes, patients in India now have access to a once-a-week insulin shot.

Danish drugmaker Novo Nordisk on Thursday launched Awiqli (insulin icodec), India's first once-weekly basal insulin for adults with Type 1 and Type 2 diabetes. India is among around a dozen countries where the drug has been introduced.


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Doctors, however, said the new therapy is unlikely to replace daily insulin for all patients and should be viewed as an additional treatment option for those who are suitable candidates.

Fewer injections

India is home to an estimated 101 million people living with diabetes and another 136 million with prediabetes, making it one of the world's largest diabetes markets.

In people with diabetes, the body either does not produce enough insulin or cannot use it effectively. While people with Type 1 diabetes require insulin throughout their lives, those with Type 2 diabetes need insulin only when oral medicines are no longer able to control blood sugar levels.

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Awiqli reduces the number of injections from 365 a year to 52. Novo Nordisk said the weekly formulation could address one of the biggest barriers to insulin therapy in India i.e., the fear of daily injections, which often delays insulin initiation by seven to nine years.

The company said clinical trials involving more than 4,000 adults, including Indian participants, showed greater reduction in HbA1c levels compared with daily basal insulin.

Doctors see benefits, but not for every patient

Delhi-based endocrinologist Dr Anoop Misra said the biggest advantage of the new therapy is the reduction in the number of injections.

"There has been little innovation in basal insulin for nearly two decades. Fewer needle pricks may encourage patients to start insulin when they need it," he told TOI.

Doctors stressed that patients using weekly insulin would still need to monitor their blood sugar regularly.

Endocrinologist Dr Shashank Joshi of Lilavati Hospital said, "It is a useful addition to our treatment options but would be best suited for patients willing to use technology to manage their diabetes."

Who is it most suitable for?

KEM Hospital endocrinologist Dr Tushar Bandgar, who led one of the Indian trial centres, said the treatment is most suitable for patients who continue to produce some insulin naturally and require only basal insulin replacement.

"Those needing multiple insulin injections every day may not benefit as much," he told TOI.

Dr Bandgar added that the growing use of newer weight-loss medicines and GLP-1 receptor agonists is already reducing insulin requirements in many patients.

"While once-weekly insulin is an important advance, the number of patients needing basal insulin may gradually shrink," he said.

(With inputs from TOI)