Awiqli insulin launched in India: Doctor explains what people with diabetes need to know

For the millions of people living with diabetes, insulin has long been synonymous with one thing: a daily injection. That practice may now be changing.

India has launched Awiqli (insulin icodec), the world’s first once-weekly basal insulin for adults with diabetes.

Eligible patients may now need only one injection a week instead of a daily dose. While this marks a significant milestone in diabetes treatment, experts emphasise that it is not a replacement for insulin therapy in all patients.

Why once-weekly insulin could change diabetes care

“The most common reason people are hesitant to start insulin is not the medicine itself, but the thought of injecting themselves every day,” says Dr Nishant Raizada, Professor and Head, Endocrinology and Diabetes, Amrita Hospital, Faridabad.

“An insulin taken only once a week could help reduce treatment fatigue and improve adherence, especially for people who struggle with daily injections.”

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For many people with diabetes, the burden of daily injections can affect consistency and confidence in managing the condition. A once-weekly option could make insulin therapy easier to follow for appropriately selected patients.

What is Awiqli and how does it work?

Awiqli contains insulin icodec, a long-acting basal insulin designed to work over an entire week.

It is a basal insulin (also known as background insulin), which helps maintain blood glucose levels between meals and overnight. However, it is not designed to manage the sharp rise in blood sugar that occurs after meals.

“Basal insulin helps control blood sugar levels in the background, but it does not cover the postprandial spike,” explains Dr Raizada.

“Depending on the patient’s condition, some people may still require rapid-acting insulin with meals.”

How effective is once-weekly insulin?

Clinical trials have shown that, in appropriately selected patients, once-weekly insulin icodec was as effective as commonly used daily basal insulins in controlling blood glucose levels.

For some patients, fewer injections may translate into better adherence, reduced treatment fatigue and improved diabetes management.

However, doctors stress that the medication must be introduced carefully, with appropriate monitoring and dose adjustments.

Why it is not a replacement for insulin in everyone

While once-weekly insulin represents an important advancement, it is not suitable for every person living with diabetes.

“This should never be seen as a convenience product that anyone can just switch to,” says Dr Raizada.

“The dose needs to be carefully calculated, with regular glucose monitoring for patients during the transition, and any changes must be overseen by an endocrinologist.”

Patient selection is crucial, and factors such as the type of diabetes, current treatment plan, blood glucose levels and overall health need to be considered before making any changes.

Lifestyle changes remain essential

Even with advances in diabetes medication, experts stress that insulin alone cannot replace healthy lifestyle habits.

“An unhealthy lifestyle cannot be compensated for by insulin alone,” says Dr Raizada.

A balanced diet, regular physical activity, maintaining a healthy weight, adequate sleep, stress management and routine HbA1c testing remain essential components of diabetes care.

What this means for diabetes care in India

India has more than 100 million people living with diabetes, making innovations that simplify treatment particularly significant.

A once-weekly insulin option could help address one of the major barriers associated with insulin therapy - the challenge of managing frequent injections over the long term.

However, the success of this treatment will depend on careful patient selection, medical supervision and continued commitment to overall diabetes management.

Reducing the number of injections may make treatment easier, but effective diabetes care will continue to rely on a combination of the right medication, regular monitoring and a healthy lifestyle.