From daily jabs to one shot a week: how a new insulin could change diabetes care in India

For decades, insulin has meant one thing without exception: a daily jab, every single day, for life. That routine is about to change for millions of people in India, after Novo Nordisk launched Awiqli, the world’s first once-weekly basal insulin approved for clinical use, in the country on July 9.

Instead of 365 injections a year, patients on Awiqli, known generically as insulin icodec, would need just 52. Traditional basal insulin — the background insulin that keeps blood sugar steady between meals and overnight — is typically injected once every 24 hours, but Awiqli is built to work across a full week instead.

The change matters most in a country like India, where more than 101 million people are living with diabetes and another 136 million have prediabetes, according to the ICMR-INDIAB study cited by the company. Many people who need insulin simply don’t start it, or don’t stick with it, because the idea of a daily injection feels overwhelming — something Vikrant Shrotriya, Managing Director of Novo Nordisk India, addressed directly, saying the company believes Awiqli will reduce the psychological and physical barriers to insulin initiation.

Backed by the global ONWARDS Phase 3 clinical programme involving more than 4,000 adults worldwide, including participants from India, Awiqli showed a greater reduction in HbA1c and improved time in range compared with once-daily insulin glargine U100, with a comparable safety profile. Priced at Rs 261 per week, the drug makes India the seventh market globally to receive the therapy, following earlier approvals in the US and the European Union.