By Amber Jackson RN, DCES – IDS Intern
Imagine! Only having to take one shot per week – well, your dreams have come true.
The FDA has approved icodec-abae (Awiqli), the first once-weekly basal insulin for adults with type 2 diabetes.
Developed by Novo Nordisk, this new option offers a major shift from traditional daily insulin injections, potentially improving convenience and adherence for many patients.
What the research shows
Approval was based on multiple phase 3 trials comparing weekly icodec to daily basal insulin. Results showed:
- Similar or better glucose control compared to daily basal insulin
- Effective use alongside mealtime insulin, GLP-1 medications, or oral therapies
Why this matters
A once-weekly insulin may:
- Simplify diabetes management
- Improve adherence, especially for patients already using weekly GLP-1 therapies
- Reduce the daily burden of injections
Safety considerations
- Slightly higher (but not statistically significant) rates of hypoglycemia were observed in some studies
- Patients with variable activity levels may require closer monitoring, as insulin needs can change day to day. For example, for those who are sedentary, this drug is very helpful in adherence. BUT for those who are active or whose activity schedule varies, the drug may cause more harm than good because it is so long-lasting that you cannot adapt quickly to a change in schedule or insulin demand.
Who is it for?
- Approved for type 2 diabetes only
- Not approved for type 1 diabetes due to concerns about hypoglycemia risk
Bottom line:
Once-weekly insulin represents an exciting advancement in diabetes care, offering greater convenience with comparable effectiveness—but patient selection and education will be key to safe use.
References:
Tucker, Miriam E. “FDA Approves First Once-Weekly Insulin for Type 2 Diabetes.” Medscape, 31 March 2026.
