India’s First Weekly Basal Insulin
Weekly Basal Insulin are now available in India for the first time, giving some adults with diabetes an alternative to daily basal insulin injections. The new treatment is being welcomed as an important advance, but doctors are quick to point out that it will not replace daily insulin for everyone. Instead, they see it as another option that could help the right patients start and stay on insulin therapy.
Danish pharmaceutical company Novo Nordisk has launched Awiqli (insulin icodec) in India. The country is among a small group of about a dozen markets where the medicine has been introduced. The launch comes at a time when India is dealing with one of the world’s biggest diabetes challenges. Around 101 million people in the country are living with diabetes, while another 136 million have prediabetes.
Insulin has been saving lives for more than a century. Yet, for many people, the thought of taking an injection every day remains a major hurdle. Doctors say that fear often leads patients to delay insulin treatment, even after tablets are no longer enough to control blood sugar levels.
That is where the new weekly insulin could make a difference.
Instead of taking a basal insulin injection every day, eligible patients can take one injection each week. Over a year, that brings the number of injections down from 365 to 52. Novo Nordisk says this simpler schedule could encourage more people to begin insulin treatment when they need it rather than putting it off for years.
The company also says clinical studies involving more than 4,000 adults, including participants from India, showed that insulin icodec delivered better reductions in HbA1c than daily basal insulin. HbA1c is the standard blood test used to measure average blood sugar levels over the previous two to three months.
Even so, specialists say the launch should not be seen as the end of daily insulin.
Dr. Anoop Misra, an endocrinologist based in Delhi, believes the biggest benefit is convenience. He notes that there has been little innovation in basal insulin over the past two decades. Fewer injections, he says, may help patients overcome their hesitation and start insulin when doctors recommend it.
Patients should not expect fewer clinic visits or less monitoring, however.
Dr. Shashank Joshi, an endocrinologist at Lilavati Hospital, says people using weekly insulin will still need to check their blood sugar regularly. He adds that the treatment may be especially useful for patients who are comfortable using glucose monitoring technology as part of their daily diabetes care.
Doctors also stress that the medicine is designed for a specific group of patients.
According to Dr. Tushar Bandgar, an endocrinologist at KEM Hospital who led one of the Indian trial centres, the treatment is best suited for people who still produce some insulin on their own and only need basal insulin replacement. Those who require multiple insulin injections every day are unlikely to see the same benefit from switching to a weekly basal insulin.
The diabetes treatment landscape is also changing in other ways. Newer medicines, including GLP-1 receptor agonists and weight-loss therapies, are helping many people with Type 2 diabetes reduce their need for insulin. Dr. Bandgar says this trend could gradually reduce the number of patients who require basal insulin alone.
For now, doctors believe the arrival of once-a-week insulin shots is good news because it gives physicians and patients another treatment choice. It does not replace existing insulin therapies, nor is it suitable for every person with diabetes. But for patients who need basal insulin and struggle with daily injections, a weekly dose could make treatment easier to follow. In a country carrying one of the heaviest diabetes burdens in the world, even small improvements in treatment adherence can have a meaningful impact.
