World’s First Once-Weekly Insulin Arrives in India, Reducing Diabetes Injection Burden

India’s diabetes treatment landscape has entered a new phase with Novo Nordisk launching Awiqli, a once-weekly basal insulin, in the Indian market. The medicine, also known as insulin icodec, is being positioned as the world’s first once-weekly basal insulin approved for clinical use. Its arrival gives adult diabetes patients a new option that can reduce the injection burden from daily dosing to one basal insulin injection per week.

For people living with diabetes, this is a significant development because insulin therapy is often associated with routine disruption, injection fatigue and hesitation around long-term use. A daily basal insulin schedule means nearly 365 injections a year. Awiqli brings that down to around 52 injections annually, which could make insulin therapy easier to accept for patients who need it but delay initiation because of fear, discomfort or lifestyle concerns.

Basal insulin plays the role of maintaining background insulin coverage through the day and night. It helps control blood glucose between meals and during sleep. Awiqli is designed to provide this long-acting basal coverage for an entire week. It is given as an injection under the skin, usually in the abdomen, thigh or upper arm, and the dose is adjusted by doctors based on blood glucose monitoring.

The importance of this launch is especially high for India. The International Diabetes Federation estimates that India had about 89.8 million adults aged 20–79 years living with diabetes in 2024, and this number is projected to rise to about 156.7 million by 2050. India also has the second-highest number of adults with diabetes in the world.

Novo Nordisk has priced the weekly dose of 70 insulin units at around ₹261. The medicine will be available in two FlexTouch pen variants: a 1 ml pen containing 700 units priced at ₹2,611 and a 3 ml pen containing 2,100 units priced at ₹7,833. According to Reuters, the company said Awiqli will be rolled out in India next week after the launch announcement.

The clinical value of Awiqli comes from convenience without compromising the basic goal of basal insulin therapy: stable blood sugar control. The European Medicines Agency notes that Awiqli was studied in adults with both type 1 and type 2 diabetes. In type 2 diabetes studies involving more than 3,500 adults, Awiqli achieved HbA1c reductions similar to daily basal insulins such as insulin degludec or insulin glargine.

For type 1 diabetes, Awiqli may replace the long-acting basal component, but it does not remove the need for short-acting insulin around meals. This distinction is important because type 1 diabetes management depends on both basal and mealtime insulin coverage. Patients using Awiqli still require medical supervision, regular glucose monitoring and proper dose adjustment.

Like all insulin treatments, Awiqli carries a risk of hypoglycaemia, or low blood sugar. The European Medicines Agency lists hypoglycaemia as the most common side effect, and it also notes that in type 1 diabetes, hypoglycaemic events are more common compared with daily basal insulin. This means the convenience of weekly dosing must be balanced with careful prescription, patient education and close monitoring.

The launch also addresses a major treatment gap in India: delayed insulin initiation. Many patients with diabetes continue oral medicines for long periods even when insulin becomes clinically necessary. Fear of injections, expected pain, cost concerns and social discomfort often delay the move to insulin. Novo Nordisk said insulin initiation in India is delayed by an average of 7–9 years due to such barriers.

A once-weekly insulin can help reduce this psychological barrier. For working adults, elderly patients, caregivers and people managing multiple medicines, fewer injections may improve treatment consistency. It could also help doctors discuss insulin therapy earlier, especially for patients whose blood sugar remains uncontrolled despite lifestyle changes and oral medicines.

The launch places India among the early markets for this new insulin format. Reuters reported that India is the seventh country where Novo Nordisk has launched Awiqli. The medicine has already received approval in the United States and the European Union, along with other countries.

For India’s healthcare system, Awiqli represents more than a new diabetes product. It signals a broader move toward therapies that are easier to follow, less intrusive and better aligned with real patient behaviour. Diabetes management depends not only on medical effectiveness, but also on whether patients can sustain treatment over years. A therapy that reduces injection frequency may help improve adherence, especially in a country where diabetes care is a lifelong challenge for millions.

However, Awiqli is not a self-switch option. Patients already using insulin should not change their dose or schedule without medical advice. Weekly insulin has a different action profile, and dose conversion must be handled carefully by qualified doctors. The real benefit will come when the medicine is used in the right patient, at the right dose and with proper monitoring.

Novo Nordisk’s once-weekly insulin launch marks an important moment in India’s diabetes journey. It brings convenience, modern delivery and a new approach to basal insulin therapy. For many patients, the promise is simple: fewer injections, easier long-term management and a possible reduction in the fear that keeps insulin therapy delayed.

In a country facing one of the world’s largest diabetes burdens, such innovations can make treatment more practical. Awiqli will not replace discipline, diet, monitoring or medical supervision, but it can make one part of diabetes care less difficult. That makes its arrival in India a meaningful step in patient-centred diabetes management.